Hypersexual disorder: Prevalence in patients with Frontotemporal Dementia and Alzheimer’s Disease

According to scientific studies, numerous neurological disorders like dementia, multiple sclerosis, cerebral anoxia, and Parkinsonian disorders can lead to the alterations of sexual behavior. Aside from experiencing neurological problems, patients may either experience inhibited sexual interest (known as hyposexuality) or greatly increased sexual desire (hypersexuality).  

Over the past decades, increasing cases of hypersexual behavior have been documented in both medical and research settings. Dementia, a common cause of altered sexual behavior, is a general term to denote diseases associated with memory, cognition, and communication. In particular, behavioral variant Frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD) are the two most common types of dementia that lead to increased sexual arousal.


Hypersexuality in patients with Frontotemporal dementia and Alzheimer’s disease

Most of the time, dementia is diagnosed in elderly patients. The deterioration of cognitive function, changes in personality, and worsening perception all contribute to the alterations of sexual behavior.

Hypersexual disorder can result in considerable anxiety and even put people at very high risks. Disturbingly, patients diagnosed with bvFTD or AD and hypersexual disorder had more than just sexual arousal but also greatly heightened sexual desire. These patients tend to actively look for sexual stimulation and even gain arousal from various stimuli (i.e.elderly partners).

  • While there was no significant difference in terms of their neuropsychological attributes, bvFTD and AD significantly differ in terms of the memory retention in patients. As expected, patients diagnosed with the former showed relatively better recall than the latter.
  • Ultimately, it was found out that hypersexual behavior is more prevalent in patients with bvFTD than those with AD. Furthermore, it was also found out that the severity of sexual interests significantly increases the emotional burden not only with the patients but their families as well. In worst cases, patients with severe symptoms may require institutionalization.


The neurobiology of hypersexual disorder

Although there is already numerous research about hypersexuality and its attributes, there are still a lot of mysteries regarding its exact definition and classification, diagnosis, and treatment. Nevertheless, the understanding of the sexual behaviors associated with both bvFTD and AD may give a new ray of hope on the neurobiology of HD.

  • To date, it is already known that sexual arousal in patients may be of different origins. The origin of hypersexual disorder in the frontal lobes of the brain was suggested by its prevalence in patients with bvFTD. Because of this, it was found out that during sexual arousal, the prefrontal, orbitofrontal, as well as the anterior cingulate cortices are activated.
  • In the case of patients with HD, it was found out that sexual arousal may also originate from the anterior temporal lobe. Studies show that differences in the ability of the lobe to prevent subcortical and limbic areas are a probable reason.

The increasing prevalence of hypersexual disorder, as well as other functional impairment that can result from it, would require greater awareness and attention from physicians. Future studies on HD as a behavioral manifestation of neurological disorders like bvFTD and AD may aid in clarifying the mechanisms for the disorder.

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