Eloniemi-Sulkava Ulla, Notkola Irma-Leena, Hämäläinen Kaija, Rahkonen Terhi, Viramo Petteri, Hentinen Maija, Kivelä Sirkka-Liisa, Sulkava Raimo
Department of Public Health and General Practice, University of Kuopio, Finland.
Int Psychogeriatr. 2002 Mar;14(1):47-58. doi: 10.1017/s104161020200827x.
To investigate what kind of changes spouse caregivers of demented patients experience after the onset of dementia (a) in the general atmosphere, happiness, and relations of marriage and (b) in the sexual side of marriage.
Semistructured telephone interviews of spouse caregivers of demented patients.
Community-living demented patients and their spouse caregivers in eastern Finland.
The spouse caregivers of 42 demented patients recruited from a previous intervention study.
The questionnaire covered different areas of marriage from the time before and after the onset of dementia.
A statistically significant decline had occurred in extent of happiness (p = .012), in equal relations (p = .001), and in patients' expressions of sexual needs (p < .001) when compared the time before and after dementia. Twenty-five (60%) of the caregivers reported that the demented patient had shown at least one negative sexual behavioral change during the course of dementia. Seven male patients (24%) had shown the behavioral symptom of constantly expressing need for making love. One in 10 caregivers had experienced positive sexual behavioral changes. In one third of the patients, the expressions of tenderness towards the caregiver had increased. Dementia did not affect significantly the general atmosphere of the marriage. Out of those still in home care, at 3 years from the onset of dementia, 19 couples (46%) continued to practice intercourse, at 5 years the number was 15 couples (41%), and at 7 years it had declined to 7 couples (28%).
Dementing illness has a major negative impact on many dimensions of marriage. However, there are also positive changes and preserved aspects of marriage. Dementia seems to have a surprisingly little impact on whether the couple continues to have intercourse when compared with the general aging population.
调查痴呆患者的配偶照顾者在痴呆发病后，（a）在婚姻的总体氛围、幸福感及关系方面，以及（b）在婚姻的性方面，经历了何种变化。
对痴呆患者的配偶照顾者进行半结构化电话访谈。
芬兰东部社区生活的痴呆患者及其配偶照顾者。
从先前一项干预研究中招募的42名痴呆患者的配偶照顾者。
问卷涵盖了痴呆发病前后婚姻的不同方面。
与痴呆发病前相比，幸福感程度（p = 0.012）、平等关系（p = 0.001）以及患者性需求的表达（p < 0.001）均出现了具有统计学意义的下降。25名（60%）照顾者报告称，痴呆患者在痴呆病程中至少出现了一种负面性行为变化。7名男性患者（24%）出现了持续表达性需求的行为症状。十分之一的照顾者经历了积极的性行为变化。三分之一的患者对照顾者的柔情表达有所增加。痴呆对婚姻的总体氛围没有显著影响。在仍接受家庭护理的患者中，痴呆发病3年后，19对夫妻（46%）仍有性生活，5年后这一数字为15对夫妻（41%），7年后降至7对夫妻（28%）。
痴呆疾病对婚姻的多个方面有重大负面影响。然而，婚姻中也存在积极变化和保留的方面。与一般老年人群相比，痴呆似乎对夫妻是否继续有性生活的影响出奇地小。
