BeCare Link, New York, NY (2026)

09/14/2026

𝗖𝗮𝗻 𝗖𝗶𝗴𝗮𝗿𝗲𝘁𝘁𝗲 𝗦𝗺𝗼𝗸𝗲 𝗧𝗿𝗶𝗴𝗴𝗲𝗿 𝗠𝗶𝗴𝗿𝗮𝗶𝗻𝗲𝘀?
For people who live with migraine, triggers can sometimes seem to be everywhere—stress, lack of sleep, bright lights, weather changes, certain smells, and even changes in eating habits. Cigarette smoke is another potential trigger that deserves attention.

Importantly, you don't have to be a smoker yourself. Exposure to someone else's cigarette smoke may be enough to provoke or worsen a migraine in some people.

Ni****ne has complex effects on blood vessels and brain signaling. It also influences neurotransmitters involved in pain processing. These effects may contribute to headache susceptibility in some individuals.

The trigeminal nerve is one of the major nerve pathways involved in migraine. Irritating chemicals in to***co smoke can stimulate sensory nerve endings in the nose, sinuses, and airways. In someone with a migraine-prone nervous system, that irritation may help initiate an attack.

People with migraine frequently have heightened sensitivity to smells, known as osmophobia. Cigarette smoke is a particularly strong and persistent odor, and some patients report developing headache, nausea, or other migraine symptoms shortly after exposure.

Cigarette smoke contains carbon monoxide, which reduces the blood's ability to carry oxygen. Although typical secondhand-smoke exposure generally produces much lower carbon-monoxide levels than active smoking, it may be one of several factors contributing to headache during substantial smoke exposure.
Secondhand smoke is the combination of smoke released from a burning cigarette and smoke exhaled by the person smoking.

For someone susceptible to migraine, sitting near a smoker, spending time in a smoke-filled room, or riding in a car where someone has been smoking may potentially trigger symptoms. The amount of exposure necessary to provoke a migraine varies considerably from person to person.

There is no single exposure level at which everyone with migraine will develop a headache. Some people are extremely sensitive to cigarette smoke, while others notice little or no relationship.
Thirdhand smoke refers to to***co-related chemicals that remain on clothing, furniture, carpets, walls, and other surfaces after a cigarette has been extinguished.

The relationship between thirdhand smoke and migraine is much less established than that of direct smoke exposure. However, the lingering odor can be significant for people who are particularly sensitive to smells.

Research has found associations between cigarette smoking and headache disorders, including migraine, but that does not necessarily prove that smoking directly causes migraine. Smoking, stress, sleep problems, anxiety, caffeine use, alcohol use, and other factors can overlap, making the relationship difficult to untangle.

What is clearer is that cigarette smoke can act as an individual trigger for some people who already have migraine.

One important point is that sensitivity to smells can sometimes be an early symptom of migraine rather than the actual cause of the attack. In other words, a migraine may already be developing when cigarette smoke suddenly becomes particularly unpleasant. This can make identifying true triggers challenging.

Look for a reproducible pattern.If migraine attacks repeatedly occur after exposure to cigarette smoke but are less likely to occur when that exposure is absent, smoke becomes a more convincing trigger.

A headache diary can be helpful. Record when the migraine began, how much smoke exposure occurred, sleep the night before, meals, caffeine and alcohol intake, stress, menstrual-cycle timing when applicable, and other potential triggers.Over several weeks, patterns often become easier to recognize.

The BeCare Headache App can help by tracking your migraine frequency, associated symptoms, and triggers. Be Aware with BeCare. Become a driver in your own headache journey.

08/31/2026

𝗦𝗽𝗵𝗲𝗻𝗼𝗽𝗮𝗹𝗮𝘁𝗶𝗻𝗲 𝗚𝗮𝗻𝗴𝗹𝗶𝗼𝗻 𝗕𝗹𝗼𝗰𝗸 𝗳𝗼𝗿 𝗠𝗶𝗴𝗿𝗮𝗶𝗻𝗲
Migraine can be difficult to treat, particularly when headaches are frequent, severe, or do not respond well to standard medications. One treatment that may be considered for certain patients is a sphenopalatine ganglion (SPG) block. This minimally invasive procedure targets a cluster of nerve cells located deep behind the nose that plays an important role in headache and facial pain.

The sphenopalatine ganglion is a collection of nerve cells located behind the nasal passages. It is connected to the trigeminal nerve, one of the major nerves involved in migraine. It also contains autonomic nerve fibers that can contribute to symptoms such as tearing, nasal congestion, and facial pressure that sometimes accompany severe headaches.Because of these connections, temporarily reducing activity in the SPG may interrupt some of the pain signals involved in a migraine attack.

Despite the name “nerve block,” an SPG block usually does not require an injection through the face or skull. For migraine treatment, a physician typically administers a local anesthetic, such as lidocaine, through the nostril. Depending on the technique, the medication may be delivered using a small catheter or applicator designed to reach the back of the nasal cavity, close to the SPG.

The procedure generally takes only a few minutes and is usually performed in the office. Patients remain awake, and sedation is typically unnecessary.

An SPG block may provide relatively rapid relief for some patients with an acute migraine. Studies have reported reductions in headache pain shortly after treatment, although results vary considerably from person to person.Some physicians also use a series of SPG blocks in patients with frequent or chronic migraine. However, the evidence for long-term migraine prevention is less established than it is for standard preventive treatments such as CGRP-targeting medications, certain oral medications, or Botox for chronic migraine.

For this reason, SPG blocks are generally considered one potential tool in a broader migraine treatment plan rather than a cure for migraine.

Patients may notice temporary numbness in the nose, throat, or roof of the mouth. A bitter taste, watery eyes, or mild nasal irritation can also occur. Occasionally, a small nosebleed develops. Because the treatment uses a local anesthetic and does not involve surgery, serious complications are uncommon.

An SPG block may be worth discussing if migraines are severe, prolonged, or difficult to control with usual rescue medications. It may also be considered when medication side effects or other medical circumstances limit treatment choices.

The most important point is that migraine treatment should be individualized. An SPG block will not work for everyone, but for selected patients it may offer a relatively quick, minimally invasive option for reducing migraine pain—without adding another daily medication.

The BeCare Headache App can help by tracking your headaches and associated symptoms, response to medications, a supportive online community and interactive AI assistant to answer your questions. Be Aware with BeCare. Become a driver in your own headache journey.

08/17/2026

𝗡𝗲𝘄 𝗣𝗮𝗿𝗸𝗶𝗻𝘀𝗼𝗻’𝘀 𝗠𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀 𝗶𝗻 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗧𝗿𝗶𝗮𝗹𝘀: 𝗥𝗲𝗮𝘀𝗼𝗻𝘀 𝗳𝗼𝗿 𝗛𝗼𝗽𝗲

For decades, medications for Parkinson’s disease (PD) have focused primarily on replacing dopamine or helping the brain use dopamine more effectively. Levodopa remains the most effective treatment for many PD symptoms. But an important shift is occurring in Parkinson’s research: scientists are increasingly testing treatments designed not simply to improve symptoms, but potentially to slow the underlying disease itself.

GLP-1 receptor agonists are best known as medications used for diabetes and weight management. Researchers became interested in them after laboratory studies suggested they might also reduce inflammation and protect nerve cells in the brain.

One drug, lixisenatide, was studied in 156 people with early PD. After 12 months, participants receiving lixisenatide had less worsening of motor symptoms than those receiving placebo. However, nausea and vomiting were common, and researchers emphasized that larger and longer studies are necessary to determine whether the drug truly slows Parkinson’s progression.
The findings are encouraging, but they do not yet establish GLP-1 medications as Parkinson’s treatments.

Another major strategy focuses on alpha-synuclein, a protein that accumulates abnormally in the brains of many people with Parkinson’s disease.

One experimental treatment, prasinezumab, is an antibody designed to target alpha-synuclein. Its initial Phase 2 trial did not meet its primary endpoint, meaning it did not clearly slow overall Parkinson’s progression. However, subsequent analyses suggested that some patients—particularly those whose disease was progressing more rapidly—might experience slower worsening of motor symptoms.

These intriguing findings have kept alpha-synuclein therapies an active area of investigation.

Researchers are also developing treatments directed at specific genetic pathways.One important target is LRRK2, a gene associated with some inherited and sporadic cases of Parkinson’s. Researchers have been studying experimental treatments designed to reduce activity of the LRRK2 pathway, including antisense oligonucleotide approaches.

Early-stage trials are primarily designed to evaluate safety and whether these treatments have the intended biological effects. Much more research is needed before we know whether targeting LRRK2 can slow Parkinson’s disease.

Researchers are also investigating drugs already used for other conditions. Ambroxol, for example, is a respiratory medication used in some countries that affects an enzyme called glucocerebrosidase, or GCase. Clinical trials are evaluating whether ambroxol could have a role in slowing Parkinson’s progression.

None of these experimental approaches has yet replaced standard Parkinson’s therapy, and there is currently no medication proven to stop Parkinson’s disease. But the direction of research is changing. Instead of treating Parkinson’s as one identical disease in everyone, researchers are increasingly using genetics and biological markers to identify different types of Parkinson’s and match treatments to the biology driving an individual patient’s disease.

For patients, this represents an important reason for optimism. The next generation of Parkinson’s medications may not simply provide more dopamine. The ultimate goal is much bigger: to protect brain cells, slow progression, and eventually change the course of Parkinson’s disease itself.

The BeCare Parkinson’s App can help you track your disease for worsening symptoms and cognitive decline. Become aware with BeCare. Be a driver in your own neurologic health journey.

08/10/2026

𝐏𝐚𝐫𝐤𝐢𝐧𝐬𝐨𝐧’𝐬 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐇𝐚𝐬 𝐂𝐡𝐚𝐧𝐠𝐞𝐝: 𝐖𝐡𝐲 𝐃𝐨𝐜𝐭𝐨𝐫𝐬 𝐀𝐫𝐞 𝐔𝐬𝐢𝐧𝐠 𝐋𝐞𝐯𝐨𝐝𝐨𝐩𝐚 𝐄𝐚𝐫𝐥𝐢𝐞𝐫

For many years, people newly diagnosed with Parkinson’s disease were often started on a dopamine agonist rather than levodopa. Today, that approach has changed. For many patients—particularly adults over age 60—carbidopa/levodopa (Sinemet) is now the preferred first treatment when Parkinson’s symptoms begin to interfere with daily life.

The Old Concern: “Save Levodopa for Later”

Parkinson’s disease causes symptoms such as slowness, stiffness and tremor because the brain gradually loses cells that produce dopamine. Levodopa is converted into dopamine in the brain and is generally the most effective medication for improving these movement symptoms.

In the past, doctors sometimes delayed levodopa because of concerns that long-term treatment would lead to dyskinesias, or involuntary extra movements, and fluctuations in how well the medication worked. There was also a belief that starting levodopa early might cause it to “stop working” sooner.

Because of these concerns, younger patients in particular were often started on dopamine agonists such as pramipexole (Mirapex), ropinirole (Requip), or rotigotine (Neupro). These medications stimulate dopamine receptors directly and can improve Parkinson’s symptoms without using levodopa.

What Have We Learned?

Over time, research has changed how neurologists think about levodopa.

We now know that levodopa does not simply “wear out” because someone starts taking it early. Motor fluctuations and dyskinesias appear to be strongly related to the progression of Parkinson’s itself, as well as the dose and duration of levodopa exposure.
Importantly, levodopa generally provides better improvement in movement symptoms than dopamine agonists.

This has shifted the balance toward treating symptoms effectively now rather than withholding the most effective medication because it might be needed later.

Dopamine Agonists Have Their Own Risks

Another important change has been greater recognition of dopamine agonist side effects.

These drugs can cause sleepiness, dizziness, swelling of the legs, hallucinations and confusion. Of particular concern are impulse-control disorders. Some people develop new or unusually strong urges involving gambling, shopping, eating or sexual behavior. These changes can sometimes be difficult for the person taking the medication to recognize.

The risk of hallucinations and confusion can also make dopamine agonists less attractive for older adults or people who already have cognitive difficulties.

Are Dopamine Agonists Still Used?

Absolutely. Dopamine agonists remain useful medications for selected patients. They may be used alone in some younger people with relatively mild symptoms or added to levodopa when symptoms are no longer controlled throughout the day.
The difference is that doctors are generally less focused on avoiding levodopa at all costs.

The Bottom Line

For many people with Parkinson’s disease today, carbidopa/levodopa is the preferred initial medication when movement symptoms require treatment. Dopamine agonists still have an important role, but their potential behavioral, cognitive and sleep-related side effects are considered more carefully than they were in the past.

The goal of Parkinson’s treatment has evolved: rather than “saving” levodopa for the future, treatment is increasingly individualized to provide the best symptom control and quality of life right now.

The BeCare Neuro and Parkinson's apps can help by tracking neurological function and mental health issues that can be due to Parkinson's meds or to the disease itself. Be Aware with BeCare. Become a driver in your own neurologic care.

08/02/2026

𝗧𝗵𝗲 𝗙𝘂𝘁𝘂𝗿𝗲 𝗼𝗳 𝗕𝗹𝗼𝗼𝗱 𝗧𝗲𝘀𝘁𝘀 𝘁𝗼 𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗲 𝗮𝗻𝗱 𝗠𝗼𝗻𝗶𝘁𝗼𝗿 𝗠𝘂𝗹𝘁𝗶𝗽𝗹𝗲 𝗦𝗰𝗹𝗲𝗿𝗼𝘀𝗶𝘀
If you have multiple sclerosis (MS), you are probably familiar with MRI scans and neurological examinations. These tools remain the foundation for diagnosing MS and monitoring disease activity. But researchers are now studying blood tests that may one day give doctors additional information about what is happening inside the brain and spinal cord. Although these tests are promising, it is important to understand that they are still emerging tools. They do not replace MRI scans, neurological exams, or conversations with your MS specialist.

A biomarker is something that can be measured in the body to provide information about a disease. For MS, scientists are searching for biomarkers that can help estimate disease activity, monitor treatment response, or identify nerve damage earlier than current methods.

Neurofilament light chain, often called NfL, is a protein found inside nerve cells. When nerves are damaged, small amounts of NfL are released into the cerebrospinal fluid and eventually into the bloodstream.
Research has shown that people with active MS often have higher NfL levels than healthy individuals. NfL levels may also rise during a relapse or when new inflammatory lesions develop on MRI. In some studies, NfL levels decrease after effective treatment with disease-modifying therapies, suggesting that the test may reflect reduced disease activity.
However, NfL is not specific to MS. Levels can also increase with normal aging and in other neurological conditions, such as stroke, traumatic brain injury, Alzheimer's disease, or other disorders that injure nerve cells. Because of this, doctors cannot diagnose MS using NfL alone.
Another biomarker being studied is glial fibrillary acidic protein (GFAP). Unlike NfL, which reflects damage to nerve fibers, GFAP is released by astrocytes, a type of support cell in the brain and spinal cord.
Early research suggests that GFAP may provide information about disease progression, particularly in progressive forms of MS. Scientists are still learning exactly how this marker can be used in clinical practice.
Will these blood tests replace MRI?

The short answer is no—at least not with today's evidence.
MRI remains the best tool for detecting new MS lesions and monitoring changes over time. Blood biomarkers are more likely to become an additional piece of the puzzle rather than a replacement for imaging. They may help neurologists identify subtle disease activity, guide discussions about treatment effectiveness, or determine when closer monitoring is needed.
While these tests are becoming increasingly available in research settings and some specialty centers, they are not yet considered standard care for every person with MS. As more studies are completed, doctors will better understand when and how to use them to improve patient care.
BeCare MS App can be an additional tool to diagnose and monitor MS. With a quantified neurologic examination, tracking of individual performance over time and compared with the general population, and calculation of gold standard disability scores, the BeCare App can empower patients to become a partner in their own MS journey. Be Aware with BeCare.

07/26/2026

𝗪𝗵𝗲𝗻 𝘁𝗼 𝗪𝗼𝗿𝗿𝘆 𝗧𝗵𝗮𝘁 𝗬𝗼𝘂𝗿 𝗣𝗮𝗿𝗸𝗶𝗻𝘀𝗼𝗻'𝘀 𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀 𝗠𝗮𝘆 𝗔𝗰𝘁𝘂𝗮𝗹𝗹𝘆 𝗕𝗲 𝗦𝗼𝗺𝗲𝘁𝗵𝗶𝗻𝗴 𝗘𝗹𝘀𝗲

Hearing that you have Parkinson's disease (PD) can be overwhelming. Fortunately, many people with PD respond well to treatment and continue to lead active, fulfilling lives for many years. However, PD is not the only condition that causes tremor, stiffness, or slow movement. Several disorders can look similar, especially early on. So, how do you know if your diagnosis is correct?

The good news is that most people diagnosed with PD do have the condition. However, there are situations where it is worth discussing your diagnosis with a neurologist—particularly a movement disorders specialist.

Poor Response to Parkinson's Medication

Levodopa is the most effective medication for PD, and most patients experience at least some improvement. If your symptoms do not improve despite taking an adequate dose exactly as prescribed, your neurologist may consider whether another condition is responsible.

Frequent Falls Early in the Disease

Balance problems usually develop gradually in PD. Repeated falls within the first year or two of symptoms may suggest another condition, such as progressive supranuclear palsy (PSP) or multiple system atrophy (MSA).

Early Severe Blood Pressure or Bladder Problems

Severe dizziness when standing, fainting, urinary incontinence, or difficulty emptying the bladder early in the illness may point toward MSA rather than typical PD.

Problems Moving Your Eyes

Difficulty looking up or down or unexplained falls related to impaired eye movements are not typical early Parkinson's features and should prompt further evaluation.

Rapid Progression

If walking, speech, swallowing, or daily functioning worsens dramatically over months instead of years, your neurologist may want to reassess the diagnosis.

Memory or Hallucinations Early On

Significant memory problems or visual hallucinations that occur before or within the first year of movement symptoms may suggest dementia with Lewy bodies rather than PD.

Not Every Tremor Is Parkinson's Disease

Essential tremor often occurs during activities such as writing or eating, while Parkinson's tremor is usually most noticeable at rest. A careful neurological examination helps distinguish the two.

A PD diagnosis is based on your symptoms, examination, and how they change over time. If your symptoms are unusual, progress much faster than expected, or fail to respond to medication, discuss your concerns with your neurologist. When uncertainty remains, a second opinion from a movement disorders specialist can help ensure you receive the most accurate diagnosis and the most appropriate treatment.

BeCare Neuro and BeCare Parkinson’s App can help by quantitatively evaluating your neuro exam and monitoring for change. Be Aware with BeCare. Become a driver in your own neurologic journey.

07/19/2026

𝗠𝗶𝗴𝗿𝗮𝗶𝗻𝗲 𝗠𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀, 𝗣𝗿𝗲𝗴𝗻𝗮𝗻𝗰𝘆, 𝗮𝗻𝗱 𝗕𝗿𝗲𝗮𝘀𝘁𝗳𝗲𝗲𝗱𝗶𝗻𝗴: 𝗪𝗵𝗮𝘁 𝗬𝗼𝘂 𝗡𝗲𝗲𝗱 𝘁𝗼 𝗞𝗻𝗼𝘄
If you have migraine and are thinking about becoming pregnant, one of the most important conversations to have with your healthcare provider is about your medications. Many women worry that they will have to stop all migraine treatments, but the answer is often more nuanced. Some medications should be discontinued well before conception, while others can sometimes be used during breastfeeding.

TRIPTANS, such as sumatriptan (Imitrex®), rizatriptan (Maxalt®), and eletriptan (Relpax®), are among the most effective medications for treating an acute migraine attack.

Fortunately, triptans do not need to be stopped months before pregnancy. Because they leave the body quickly, they can generally be discontinued once pregnancy is recognized or when actively trying to conceive. Sumatriptan has been studied the most and has not been associated with an increased risk of major birth defects when used occasionally during pregnancy.

During breastfeeding, sumatriptan is considered one of the preferred migraine medications. Only a very small amount passes into breast milk. While some manufacturers recommend waiting 12 hours after taking a dose before nursing, many headache specialists believe this is unnecessary for most mothers because infant exposure is extremely low. There is also reassuring, though more limited, data for eletriptan and rizatriptan.

GEPANTS—including ubrogepant (Ubrelvy®), rimegepant (Nurtec ODT®), and zavegepant (Zavzpret®)—have become increasingly popular because they effectively treat migraine without causing blood vessel constriction.

Unfortunately, there is very little human pregnancy data available. Because of this uncertainty, experts generally recommend stopping gepants before attempting pregnancy. Since these medications have relatively short half-lives, stopping them several days before conception is generally sufficient, although many clinicians recommend discontinuing them once pregnancy is being actively planned.

There is also very limited information regarding breastfeeding. Until more safety data become available, gepants are generally not recommended during lactation, particularly while nursing newborn or premature infants.

INJECTABLE CGRP MONOCLONAL ANTIBODIES—including erenumab (Aimovig®), fremanezumab (Ajovy®), galcanezumab (Emgality®), and eptinezumab (Vyepti®)—have transformed migraine prevention for many patients.

These medications remain in the body for a long time. Because they have half-lives of approximately one month, most headache specialists recommend stopping them five to six months before trying to conceive. This allows enough time for nearly all of the medication to be eliminated before pregnancy begins.

There are currently insufficient data to recommend their use during pregnancy or breastfeeding. Although very little of these large antibody molecules is expected to enter breast milk—and even less is likely to be absorbed by the infant—the absence of robust human safety studies means they are generally avoided while breastfeeding, especially during the first few months after delivery.

DITANS
Lasmiditan (Reyvow®) is the only approved ditan and is used to treat acute migraine attacks.

Because human pregnancy data are extremely limited, lasmiditan should generally be discontinued before attempting pregnancy. Fortunately, it is cleared from the body within about one day, so it does not require a prolonged washout period.

Breastfeeding is also not recommended immediately after taking lasmiditan. Current prescribing information advises avoiding breastfeeding for 24 hours after each dose because it is unknown how much medication passes into breast milk.

PLANNING AHEAD
If you are planning a pregnancy, don't stop your migraine medications without first speaking with your neurologist or obstetric provider. An individualized treatment plan can help minimize migraine attacks while keeping both mother and baby as safe as possible.

For many women, migraine actually improves during the second and third trimesters of pregnancy, although this is not true for everyone. Safe treatment options—including lifestyle strategies, acetaminophen, selected anti-nausea medications, magnesium, and in some cases sumatriptan—can often provide relief when needed.

BeCare Migraine can help with a headache calendar, tracker of triggers and symptoms, neurologic exam, community of headache sufferers and an AI assistant . Understanding the frequency and triggers for your headaches is key for optimal headache management. Be Aware with BeCare. Become a driver in your own headache journey.

07/13/2026

𝗨𝗻𝗱𝗲𝗿𝘀𝘁𝗮𝗻𝗱𝗶𝗻𝗴 𝗛𝘆𝗽𝗲𝗿𝘀𝗲𝘅𝘂𝗮𝗹𝗶𝘁𝘆 𝗶𝗻 𝗗𝗲𝗺𝗲𝗻𝘁𝗶𝗮: 𝗔 𝗚𝘂𝗶𝗱𝗲 𝗳𝗼𝗿 𝗣𝗮𝘁𝗶𝗲𝗻𝘁𝘀 𝗮𝗻𝗱 𝗖𝗮𝗿𝗲𝗴𝗶𝘃𝗲𝗿𝘀
It’s universally known that dementia is associated with memory loss, confusion, and changes in thinking. But dementia also affects behavior and personality in unexpected ways. One of the most striking and not commonly known behavior is hypersexuality, also called sexually inappropriate behavior. Although it can be distressing or embarrassing to families, it is important to remember that these behaviors are usually caused by changes in the brain and not a reflection of a change in the person's character.
Hypersexuality refers to an increase in sexual thoughts, urges, or behaviors that are out of character or inappropriate for the situation. This may include making sexually explicit comments, attempts to touch others inappropriately, exposing oneself, excessive ma********on, or making repeated requests for sexual activity. While these behaviors are relatively uncommon, they can occur in several types of dementia, including Alzheimer's disease, frontotemporal dementia, Lewy body dementia, and vascular dementia.
Why does this happen? The parts of the brain that control judgment, impulse control, and social awareness can become damaged by dementia. As these areas deteriorate, people may lose the ability to recognize social boundaries or control impulses. In some cases, a person may misinterpret affection, become confused about relationships, or simply be unable to appreciate that their behavior is inappropriate. It may be helpful to think of the analogy of your favorite cake placed in front of you. Normally, you would take a reasonably sized slice and save the rest for later. But, if you had the similar loss of impulse control (frontal disinhibition), you would eat the whole cake in one sitting.
Not all sexual behaviors in dementia are abnormal. Many people continue to enjoy healthy intimacy with their spouse or partner. Problems arise when behaviors become distressing, unsafe, or socially inappropriate.
For caregivers, hypersexuality can be particularly difficult to manage because companions hired to help may quit and nursing homes may decide to discharge the patient. Feelings of embarrassment, frustration, anger, or guilt are common. It is important to remember that the individual is usually not acting deliberately or trying to upset others. Responding with punishment, criticism, or arguments is rarely helpful and may increase agitation.
Instead, caregivers can often reduce inappropriate behaviors by remaining calm and redirecting the person's attention to another activity. Providing meaningful activities, exercise, music, or social engagement may help reduce boredom, which can sometimes trigger inappropriate behaviors. Maintaining a predictable daily routine and avoiding situations that may be confusing or overstimulating can also be beneficial.
Sometimes what appears to be hypersexuality has another explanation. A person may remove clothing because they are uncomfortable, too warm, or need to use the bathroom. Touching the ge***al area may be caused by itching, a urinary tract infection, skin irritation, or poorly fitting clothing rather than sexual desire. Identifying and treating these underlying medical issues is an important first step.
Healthcare providers should also review medications, as certain drugs—including some used to treat Parkinson's disease or other neurological conditions—can occasionally increase impulsive behaviors.
When behavioral strategies are not enough and the behaviors place the patient or others at risk, medications may be considered. These decisions should be individualized and made carefully because all medications carry potential side effects, particularly in older adults with dementia.
If hypersexuality develops, families should discuss it openly with their healthcare provider. Although it may feel uncomfortable, these conversations are an important part of dementia care. Early recognition allows caregivers to receive guidance, identify possible medical causes, and develop practical strategies that improve safety and quality of life for everyone involved.
Above all, remember that hypersexuality is a symptom of brain disease—not a reflection of the person's values, morals, or lifelong personality. With understanding, compassion, and appropriate medical care, many families can successfully manage this challenging aspect of dementia while preserving the dignity of their loved one.
BeCare Neuro app can help by detecting cognitive impairment early on and monitoring progression of cognitive impairment and its response to medication. Be Aware with BeCare. Become a driver in your and your loved one’s neurologic journey.

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