How Alzheimer’s Affects Sex, for Both the Patient and the Partner

Alzheimer’s disease affects much more than memory. It impacts all aspects of life: work, relationships, daily activities and, yes, sex.

What follows is an overview of Alzheimer’s, and what it means for the lives of both the patient and loved ones.

What is Alzheimer’s?

Alzheimer’s is a progressive neurological disease and the most common cause of dementia, accounting for 60 to 80 percent of cases in the United States. Currently, 5 million Americans suffer from it.

Alzheimer’s causes the death of brain cells and gradual shrinking of the brain, resulting in deterioration of memory, thinking and learned behavior. Signs and symptoms include memory loss (beginning with an inability to recall newly learned information), disorientation, mood/behavior changes, confusion and subsequent suspicion, and, in its final stages, difficulty speaking, swallowing and walking.

Age is the greatest risk factor. A majority of affected individuals are more than 65 years old. Nevertheless, early onset Alzheimer’s affects 200,000 Americans younger than 65. Other predictors include family history, lifestyle, and history of head trauma or heart/cardiovascular diseases.

In later stages, patients often struggle with daily activities, holding coherent conversations, and recognizing loved ones and surroundings. There is currently no cure, but treatments can slow progression and modestly improve patients’ memory.

Effects on physical & mental health 

In addition to memory issues, Alzheimer’s can cause stiff muscles, difficulty with balance and coordination, weakness, incontinence, twitches and seizures. Daily activities such as personal hygiene, eating and dressing also may become difficult and require assistance.

Diagnosis alone can cause grief, shock, denial, fear and anger. Mental health may also be affected, with long-term issues including anxiety and depression, as well as frequent and difficult-to-control mood changes. Sufferers may lose confidence and self-esteem as their memory declines. The physical and emotional toll on caregivers is enormous.

Alzheimer’s & sexual health

Sex while suffering from Alzheimer’s is possible. In fact, a 2018 study from the Journal of the American Geriatrics Society reported that among singles, 46 percent of men and 18 percent of women with dementia were sexually active; and among people with partners, 59 percent of men and 51 percent of women were sexually active. And, reportedly, 40 percent of partnered dementia patients ages 80 to 91 were still having sex.

Physical symptoms such as decreased coordination, tense muscles and incontinence can make sex difficult. An individual may be less interested due to the disease’s mental health effects, like anxiety, depression and anger, or simply as a result of lost self-confidence.

Medications for Alzheimer’s may lower libido, however, some sufferers, especially those with frontotemporal dementia, experience hypersexuality—they are overly interested in sex—as a symptom. In cases that are further along, sex may no longer be possible if memory issues are too great. Sadly, the affected person may forget entirely their past relationship or feelings toward a partner.

Caregivers, too, may experience negative issues with their love life. If it’s their partner who is affected, they may feel uncomfortable having sex with them. Consent is required to engage in any sexual activity, whether with a new partner or a long-term one. In some cases, people with Alzheimer’s might be too confused or mentally distant to truly understand what is being asked of them, so even spouses should be mindful.

Coping with changes

A doctor or a social worker can help address changes in intimacy due to Alzheimer’s, and decreased libido and hypersexuality can be treated with medications.

However, if you are a partner to someone with Alzheimer’s, you may struggle if your lover loses interest in sex or seems to forget how to have it. You may feel like strangers at times. If both of you do want to have sex, talk to a doctor about how to keep it safe and overcome any barriers posed by your partner’s condition.

Sex may no longer be a priority or a big part of the relationship, and that’s OK. Whether or not it leads to sex, masturbation is healthy in any relationship and can be a great outlet for caregivers.

In addition, you can explore new ways to spend time together. There are many ways to be close and show affection: bathing a partner, hugging, massaging and holding hands. Sounds, odors and tastes may help trigger positive memories. Cook a nice meal together, listen to a favorite song or even dance. Also, consider joining a support group for Alzheimer’s patients and caregivers.

Alzheimer’s disease is a challenge for affected individuals and their loved ones. While it will inevitably change many aspects of life, it doesn’t have to be the end of anyone’s sex life, and it certainly doesn’t have to prevent displays of affection and closeness with a partner.