Inappropriate Sexual Behaviours in Dementia: Epidemiology and Pathophysiology EPIDEMIOLOGY

Significant variation exists in the reported prevalence of dementia-related ISB, with estimates ranging anywhere from 4-5% up to 25%. This variation is likely due to multiple factors. First, individual studies frequently differ in the participants they recruit (e.g., dementia type and severity) and study setting (e.g., community versus long-term care). Second, epidemiologic studies vary in how they capture behaviours (e.g., direct observation of behaviours versus patient/proxy report) and the duration of the observation period. Third, a variety of approaches are used in these studies to define the specific behaviours that qualified as inappropriate. Examples of ISB include lewd or suggestive language, implied sexual acts (e.g., requesting unnecessary genital care, viewing pornography in public), and overt sexual acts (e.g., touching, grabbing, or disrobing of self or others, public masturbation). The St. Andrew’s Sexual Behaviour Assessment Scale (SASBA) includes four categories of ISB. Use of standardized tools to define ISB, such as the SASBA, may improve the comparability of future epidemiologic studies.