The cognitive aspects of sexual intimacy in dementia patients: a neurophysiological review

Abstract

Changes in higher-order cognitive behaviors such as reward recognition, salience processing, novelty perception, decision-making, emotional contagion, motivation, and empathy may contribute to intimacy dysfunction. Network circuitry underlying these cognitive functions is often activated in sexually intimate behavior. We propose that sexual dysfunction in AD and bvFTD is more nuanced than is commonly believed, and propose how AD and bvFTD atrophy may correlate neuroanatomically to brain regions and networks that contribute to the higher-order cognitive aspects of intimacy. The characterization of sexual intimacy in dementias must be expanded to meet the needs of our dementia patients and their romantic partners.

Keywords: Alzheimer’s; Sexual dysfunction; bvFTD; cognitive; dementia; disinhibition; hypersexuality; intimacy; neurodegenerative; salience.