Affection and sexuality were studied longitudinally for two groups of
couples, one with an Alzheimer's disease (AD) afflicted spouse and the
other spouse the primary caregiver, and a second group with both spou
ses relatively healthy. Affectional expressions were not different for
the two groups prior to illness onset but declined significantly for
the AD group five years into the illness trajectory; affection remaine
d stable for the well group. Based on follow-up data obtained two year
s later outcomes for afflicted spouses were taken into consideration,
and the pattern for affection was lie reexamined. Affection increased
significantly after nursing home placement of an ill spouse. Fewer AD
than well couples were sexually active five years into the illness tra
jectory. The problem of hypersexuality in a few male afflicted spouses
had abated two years later. The number of well couples who were sexua
lly active also declined over time, but several couples continued at t
he same or higher levels of sexual intimacy. The study contrasts norma
l aging from pathological deviations within a human developmental pers
pective.