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Treatment of Inappropriate Sexual Behavior in Persons With Dementia: A Systematic Review
Natasha E Lane1,2, Manan Ahuja3, Stacey Hatch4
1Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada.
Journal of the American Geriatrics Society
|April 28, 2025
Summary
Non-pharmacologic interventions show promise for managing inappropriate sexual behavior (ISB) in dementia patients, but pharmacologic treatments are often necessary. More research is needed to confirm effectiveness and safety.
Area of Science:
- Gerontology
- Neuroscience
- Psychiatry
Background:
- Inappropriate sexual behavior (ISB) affects up to 25% of individuals with dementia.
- This review synthesizes evidence on interventions for ISB in dementia.
Approach:
- Systematic review of 74 studies (case studies, case series, one RCT) without meta-analysis.
- Searched multiple databases from inception to September 2023 for pharmacologic and non-pharmacologic interventions.
- Synthesized findings using vote counting based on the direction of effect.
Key Points:
- Non-pharmacologic interventions (distraction, environmental modification) improved ISB in 72% of cases, but often required co-prescribed pharmacotherapy.
- Hormonal treatments (progestins, anti-androgens) were more effective than antipsychotics, antidepressants, or anticonvulsants in men with ISB.
- Most studies focused on pharmacologic interventions (64%).
Conclusions:
- Non-pharmacologic interventions can effectively reduce ISB in dementia.
- Pharmacologic interventions are frequently necessary adjuncts or primary treatments.
- Further randomized trials are crucial to establish the effectiveness and safety of both intervention types.
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