Marianne Weber | Risk factors for erectile dysfunction in a cohort of 108 477 Australian men


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Marianne Weber gave an update on her research using the 45 and Up Study data at the Sax Institute's 45 and Up Study Collaborators' Meeting.

This meeting is an annual event that offers our research partners, supporters and other interested parties the opportunity to receive a comprehensive update on the 45 and Up Study’s progress and updates on research projects that are using the Study resource. The meeting is also an opportunity for researchers, health decision makers and evaluators to engage and discuss the potential for maximising the Study’s value.

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Marianne Weber | Risk factors for erectile dysfunction in a cohort of 108 477 Australian men

  1. 1. Age-related patterns of erectile dysfunction among older men Marianne Weber, David Smith, Dianne O’Connell, Manish Patel, Paul de Souza, Freddy Sitas, Emily Banks 45 and Up Study Annual Collaborator’s Meeting, 11th October, 2013 Med J Aust 2013, 199:107-111
  2. 2. Erectile Dysfunction (ED) • The first major community-based study on ED was the Massachusetts Male Aging Study (1987 – 89) • This study yielded, for the first time, an understandable concept of ED which could be captured in a single question:
  3. 3. Correlates of Erectile Dysfunction Lower urinary tract symptoms education prostatectomy vascular disease neurological & psychiatric disease psychological stress digoxin income thyroid disorders thiazide diurectics diabetes urethroplasty unemployment psoriasis disk herniation physical inactivity hypertension restless leg syndrome depression metabolic syndrome obesity being single antidepressants smoking rectal surgery/chemoradiation cycling alcohol haemodialysis
  4. 4. ED and Cancer?? • ED is important to understand in relation to treatment outcomes for prostate cancer • Around 75% of men are impotent after treatment with radical prostatectomy • Treatment? Or Active surveillance? • The 45 and Up Study provided a way of “bench marking” ED in terms of age, co-morbid conditions and lifestyle
  5. 5. Analyses • Unconditional logistic regression was used to estimate the odds ratios of complete/moderate ED (vs. no/minimal) in relation to demographic, health, and lifestyle characteristics • A focus on lifestyle factors within 10 year age strata
  6. 6. Distribution of ED How often are you able to get and keep an erection that is firm enough for satisfactory sexual activity? 35 30 25 % 20 15 10 5 0 32.6 21.2 16.4 17.5 8.9 3.4 Always (no ED) Usually (minimal/episodic ED) Sometimes (moderate ED) Never (complete ED) I would rather not answer the question Missing/Invalid
  7. 7. Age, Disease & Lifestyle Proportion moderate/complete ED Group Percent (Std Err) 22.3 1.26 1.20-1.33 44.3 1.96 1.87-2.06 62.5 4.08 3.83-4.34 Prostate Cancer 60 Ref Diabetes 70 1 Co-morbidity 80 23.1 Risk Factors 90 OR* 95% CI Healthy 100 % 85.1 9.24 8.50-10.05 *Adjusted for age, education, income, health insurance status, place of residence, & relationship status 50 40 30 Healthy men without risk factors (n=15475) The Healthy of ED increased 11% with odds men with risk factors (n=34187) Co-morbidity (n=41381) every year increase in age. Diabetes (n=10631) Prostate Cancer (n=6803) 20 10 0 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 85+ vs. 45-49: OR = 150.8 (126.2-180.3) Age Group Co-morbidity: heart disease, stroke, Parkinson‟s disease, asthma, high blood pressure, high blood cholesterol, osteoporosis, depression, anxiety, thyroid problems, arthritis, blood clotting problems, cancer (not prostate)
  8. 8. ED: Demographic characteristics
  9. 9. ED and morbidity Minimal Adjustment: age, education, incom e, place of residence, health insurance status, relationship status
  10. 10. Lifestyle Risk Factors in 10 year age strata All models adjusted for socio-demographic characteristics and all other lifestyle risk factors
  11. 11. Conclusions • Age is the largest independent risk factor for ED – The odds of severe/moderate ED increased by 11% with every year increase in age • Lifestyle beneficial up to a point – Physical activity seemed to be effective at all ages • Results very similar to other population-based studies in Australia
  12. 12. Where to next? „Healthy men last longer‟ • Brochure for GPs • prescribe appropriate treatments and monitor heart health • prevent the use of „quick-fix‟ companies offering unproven and costly alternatives • Infographic • perceived sexual inadequacy among younger men could be a powerful tool to motivate them to stop smoking, lose some weight and exercise regularly – for a longer lasting, cancer-free life!