Identifying the Factors Associated with Sexual Dissatisfaction in Spouse Caregivers of Persons with Dementia: The Importance of Conjugal Satisfaction.

Sexuality plays an important role for couples confronted with dementia and may support them to cope with the disease, to sustain the couple relationship and sustain a better experience of the caregiving situation. Nevertheless, the majority of spouse caregivers report a decline in their sexual satisfaction. The objective of this study was to investigate the personal, interpersonal, social, and cultural factors related to sexual dissatisfaction (SD) in spouse caregivers of persons with dementia, as well as the relationships between these factors. This online study included 64 participants who completed questionnaires assessing these variables. A multivariate path analysis approach was used to examine the complex associations between factors. Results showed that conjugal satisfaction was the only factor directly associated with SD. Two indirect pathways through conjugal satisfaction were identified: first, between positive dyadic coping and SD; secondly, between intra-individual vulnerability and SD. Social support was directly associated with intra-individual vulnerability and resources. The severity of the persons with dementia's symptoms was related to intra-individual vulnerability. Age was not associated with SD. Overall, the findings highlight the importance of clinicians making an assessment of conjugal satisfaction and facilitating improvements in the quality of spousal interactions and degree of agreement, in order to increase the sexual satisfaction of spouse caregivers. Conjugal satisfaction may indirectly be reinforced through promoting more supportive dyadic coping and decreasing emotional vulnerability.