Gender differences in sexual behaviors of AD patients and their relationship to spousal caregiver well-being

Abstract

Objectives: Little is known about gender differences in sexuality among community-dwelling heterosexual couples in which one partner has Alzheimer's disease (AD). Few studies have examined gender differences in specific sexual behaviors or their associations with caregiver well-being. This study evaluated the impact of gender differences on intimacy and sexual satisfaction in marital relationships in which one partner has AD.

Method: Baseline measures were collected from 162 AD patients and their partners enrolled in a multi-site study between 2001 and 2009 to evaluate gender differences in measures of intimacy, caregiver well-being, and patient sexual behaviors.

Results: While over 70% of all patients initiated physically intimate activities (i.e., kissing, hugging, and intercourse), most did not initiate intercourse specifically. Female caregivers reported higher levels of stress and depressive symptoms than male caregivers (p < 0.01). Satisfaction with intimacy was significantly associated with fewer stress and depressive symptoms in female caregivers (r = −0.29, p < 0.01). Caregiver gender, satisfaction with intimacy, and caring for a patient with mild AD were significant predictors of caregiver depressive symptoms (p's < 0.05).

Conclusion: The majority of couples dealing with AD reported engaging in intimacy, suggesting its importance in the relationship. Female caregivers who reported less sexual satisfaction reported more frequent stress and depressive symptoms. Caregiver gender, satisfaction with intimacy, and the AD patient's level of cognitive functioning significantly contributed to caregiver well-being. Gender-specific therapies to address patient sexual difficulties and caregiver well-being could potentially maintain or improve the marital relationship.

Keywords:

• dementia
• Alzheimer's disease (AD)
• sexuality
• intimacy
• gender differences

Acknowledgments

The authors thank Dr. Booil Jo for her statistical consultation, Meena Nuthi for editing assistance, and Carole Bibeau, Jean Coleman, and Mary Beth Stamps for data collection. This study was supported by VA Sierra Pacific Mental Illness Research, Education and Clinical Center (MIRECC) at the Veterans Affairs Palo Alto Health Care System; the National Institute on Aging (AG17824); and the State of California Department of Health Services (Grant Agreement No. 09-11412).