Abstract
Inappropriate sexual behaviors (ISBs) in dementia are sexual behaviors that are inappropriate, disruptive, and distressing, and that impair the care of the individual with dementia in a particular environment. ISBs can cause significant distress to the individuals exhibiting these behaviors, their families, and to their caregivers. In addition, they worsen morbidity among these individuals. ISBs are thought to occur due to a complex interplay between the different biological, psychological, social, and environmental factors. The evaluation of ISBs includes a thorough history, detailed mental status, and focused physical examinations, and appropriate laboratory data. Nonpharmacological and pharmacological treatments appear to show benefit in the management of ISBs. However, the evidence for the use of pharmacological agents in the management of ISBs is limited to case reports, and case series. The use of hormonal agents for ISBs may result in significant emotional distress among the individuals exhibiting ISBs, their families and caregivers. Furthermore, the use of these agents may result in significant adverse effects among these individuals. Hormonal agents should be reserved for use only among refractory cases of ISBs. Future research should evaluate the neurobiology of ISBs, develop objective assessment tools to quantify and qualify these behaviors, and assess the efficacy, and tolerability of novel therapies for managing these distressing behaviors.