Sexuelle Verhaltensstörungen bei Demenz

 

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Zusammenfassung

Bei demenzkranken Betagten treten in vielen Fällen zusätzliche nicht kognitive Störungen und Verhaltensauffälligkeiten auf (Behavioral and Psychological Symptoms of dementia [BPSD]), darunter sexuelle Verhaltensstörungen. Der Artikel fasst den Wissensstand zu den mit Sexualität verbundenen Verhaltensstörungen zusammen. Generell erschweren das Fehlen klarer Definitionen, ätiologischer Einteilungen und diagnostischer Instrumente die Untersuchung dieser Störungen. Bedingt durch die Heterogenität der Studienpopulationen, Definitionen und Erhebungsmethoden variieren die Prävalenzraten stark (1,8 – 18 %). Ätiologisch werden Dysfunktionen in verschiedenen Hirnbereichen diskutiert. Die Störungen sind bei Männern häufiger als bei Frauen und scheinen bei vaskulären, frontotemporalen und parkinsonassoziierten Demenzen häufiger vorzukommen als bei Alzheimer Demenzen. Die publizierten medikamentösen und nicht medikamentösen Therapiestrategien sind bezüglich der Wirksamkeit unbefriedigend untersucht.

Abstract

In addition to diagnostically decisive cognitive problems, behavioural and psychological symptoms (BPSD) are frequent among people with dementia, including sexually related behavioural problems. This paper provides an overview on the state of knowledge about these problems. Research on this topic is hampered by the absence of unanimous definitions, aetiological classifications, and diagnostic instruments. The wide range of prevalence rates reported (1.8 – 18 %) originate from the heterogenity of study samples as well as in the variety of definitions and instruments employed. Regarding aetiology, dysfunctions in various cortical regions are being discussed. Sexually related behavioural problems are more prevalent in men and among patients with vascular, frontotemporal and Parkinson-associated forms of dementia, as compared with dementias of the Alzheimer type. The pharmacological and non-pharmacological treatment strategies published to date have not been sufficiently studied.

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