Background: Many factors affect sexuality in the elderly such as dementia which is a common cause of inappropriate sexual behaviors. These behavioral disturbances are distressing, disruptive and impair the care of the patient. Summery: The onset of dementia does not erase sexuality. Sexual expression can be an important aspect of wellbeing for older adults with dementia. This study gives a general overview about the relationship between sexuality and cognitive impairment. It starts with a general discussion of sexual aspects in the elderly. This is followed by research studies in this field including effects of dementia on sexual life, sexuality issues related to cognitive decline, inappropriate sexual behaviors in dementia patients and sexuality in healthcare institutions. We discuss also ethical aspects in relation with sexuality and dementia. Finally, we show different approaches to treat inappropriate sexual behaviors. Key messages: The discussion of sexuality in dementia raises many medical and ethical concerns. Inappropriate sexual behaviors are estimated to occur in about 7% to 25% of demented patients. The question is how to address such a delicate subject and discuss it in an easy way without making the patient feel humiliated or mistreated. This narrative review reveals sexual problems and difficult questions encountered in daily practice with patients suffering from cognitive impairment.


中文翻译：

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性与神经退行性疾病：患者、护理人员和治疗面临的未解决挑战。

背景：许多因素会影响老年人的性行为，例如痴呆症，这是导致不当性行为的常见原因。这些行为障碍令人痛苦，具有破坏性并损害患者的护理。总结：痴呆症的发作并没有消除性欲。性表达可能是老年痴呆症患者幸福的一个重要方面。本研究概述了性行为与认知障碍之间的关系。首先是对老年人性方面的一般性讨论。随后是该领域的研究，包括痴呆对性生活的影响、与认知能力下降相关的性问题、痴呆患者的不当性行为和医疗机构的性行为。我们还讨论了与性和痴呆有关的伦理方面。最后，我们展示了治疗不当性行为的不同方法。关键信息：关于痴呆症性行为的讨论引发了许多医学和伦理问题。据估计，大约 7% 到 25% 的痴呆患者会出现不适当的性行为。问题是如何解决这样一个微妙的话题并以一种简单的方式讨论它，而不会让患者感到羞辱或虐待。这篇叙述性回顾揭示了认知障碍患者在日常实践中遇到的性问题和难题。问题是如何解决这样一个微妙的话题并以一种简单的方式讨论它，而不会让患者感到羞辱或虐待。这篇叙述性回顾揭示了认知障碍患者在日常实践中遇到的性问题和难题。问题是如何解决这样一个微妙的话题并以一种简单的方式讨论它，而不会让患者感到羞辱或虐待。这篇叙述性回顾揭示了认知障碍患者在日常实践中遇到的性问题和难题。