Sexual Conversation as a Warning Sign of Dementia

Reader’s Question

My father is talking like he would never talk. He has been saying things he would never say. He told me about a dream he had of me (his daughter) and him participating in sexual acts with one another. He’s in his mid-60’s. Is this considered to be a beginning stage of Alzheimer’s? My mother just got diagnosed with Alzheimer’s.

Our Clinical Psychologist’s Reply

This type of conversation is a significant personality change in your father and such changes are often an early sign of Alzheimer’s or Dementia. We often think of the early warning signs of dementia as:

• Loss of recent memory,
• Difficulty performing familiar tasks,
• Problems with language,
• Disorientation to time and place,
• Poor judgement,
• Problems with abstract thinking,
• Misplacing things,
• Changes in mood and/or behavior,
• Changes in personality, and
• Loss of initiative and motivation

(Source: Better Health)

However, clinical experience tells us that many individuals exhibit a pattern of unusual or inappropriate behavior before the classic early warning signs surface. Some of those early-early warning signs include:

• Labile or unstable mood including crying easily or increased temper outbursts.
• Suspicion and social sensitivity. Problems with memory, in the early stages, make the individual feel people are “playing tricks” on them — moving their possessions, hiding things, or even stealing their money. They may identify certain family members as being untrustworthy.
• Time problems in which they report talking with someone yesterday when in reality it was last week.
• Financial poor judgement. This is a major issue in some cases as we have normally competent adults spending their money recklessly, giving away large amounts of money to television promotions, etc. They often fall victim to the variety of money scams found on the television and internet. Highly educated individuals fall for the Nigerian email scam for example.
• Inappropriate social behavior and poor social judgement are often found. They seem unable to understand the socially inappropriate nature of their comments and often discuss personal or sexual topics with strangers, family and even children.
• Inappropriate sexual preoccupation and comments are common and when combined with poor social judgement can create significant conflicts in the home and family. Some become sexually preoccupied and begin ordering sexual products and/or literature/media — soon flooding their home with such products. In another case of poor judgement, they often leave such products very visible in their home where grandchildren may find them.
• Bizarre projects. They may become preoccupied with unusual if not bizarre projects, often purchasing equipment with no obvious value to them.
• Confusion with technical operations. I was asked to help an elderly neighbor with his computer, finding that he has saved all his individual documents to the “desktop” — producing about 300 overlapping icons on the screen.
• Sexual misconduct is also found, especially when the misconduct exhibits no attempt to shelter loved ones from the consequences. In severe cases, the individual may subject the family to public humiliation due to the obvious, bizarre nature of their behavior.

From your viewpoint, you’ll need to monitor your father’s behavior and comments for additional warning signs. Ask to accompany him to his physician to discuss the changes in his behavior and thinking. Remember that it’s very possible he has experienced no dreams involving you, as in dementia, the individual often produces inappropriate conversation about events that never happened such as having dinner with a deceased relative or recently eating at a restaurant when they haven’t left the house in two weeks. Try to look at his comments as a symptom of his mental state, not as a sexual issue. A family meeting would be helpful as other family members may be seeing different early signs.