Ageing and sexuality

Sexuality is a dimension that concerns human health with profound implications not only in the biological and psychological aspects, but also in the social and cultural dimensions, affecting all ages of life. Sexuality in old age is still conditioned by biases, prejudices and from a stereotyped vision, which considered older people as ‘‘asexual’’, in spite of several studies and surveys showing that older persons have sexual potential to express. In population surveys, a fair number of men and women aged over 60 years reported having sex at least once a month. The most influential predictor of sexual activity seems to be the physical health in older men, and the quality of the relationship in older women. The most common sexual disorders are erectile dysfunction and delayed ejaculation in older men, and reduced sexual interest, arousal disorder, female orgasmic disorder, genitopelvic pain and ailments of penetration in older women. A careful evaluation can identify the presence and severity of disorders in different phases of the sexual response cycle. The management of sexual dysfunction in older people may include reassurance, education, sex therapy and/or the use of drugs in specific cases. Sexuality in patients with dementia may arise as inappropriate sexual behaviour (ISB) due to behavioural disinhibition. Manifestations of ISB can be very distressing for family members and other caregivers and can present substantial challenges for staff and health care providers in long term care. Although there is no established treatment algorithm for dementia-related ISB, there are various non-pharmacological and pharmacological treatments, which can help in the management of these patients.