Journal List > Korean J Urol > v.48(12) > 1004842

Yang, Jeong, Jang, Lee, Choi, and Kim: Prevalence and Risk Factors for Erectile Dysfunction in Aging Men: Hallym Aging Study (HAS)

Abstract

Purpose

This study aims to estimate the prevalence of erectile dysfunction (ED) in a population-based sample of Korean men aged 45 or over, and to study its correlation with the sociodemographic, medical and lifestyle factors.

Materials and Methods

385 men in Chunchon City were evaluated by clinical measures and questionnaires. All the participants were evaluated for erectile dysfunction. In conjunction with this evaluation, all the men were asked to complete the International Prostate Symptom Score (IPSS), and they underwent health examinations that included blood pressure, body mass index and waist-to-hip ratio, and the laboratory studies included the fasting blood glucose and total cholesterol levels. The subjects' medical history and health behaviors were investigated.

Results

Out of the 385 men who visited our hospital, 285 completed the questionnaires. The prevalence of moderate or severe ED increased from 5.3% in men aged 45 to 54 years to 87.3% in men aged 75 or over. The standardized prevalence of ED was 41.5%. The IPSS were strongly correlated with ED (age adjusted partial R= ?0.246, p<0.001). An increasing risk of ED was observed among those subjects with total cholesterol higher than 240mg/dl (adjusted odds ratio [aOR]=1.8), hypertension (aOR=2.2) and the ex-smokers (aOR=5.2). Education and family income were not correlated with ED (p>0.05).

Conclusions

The results of this community-based survey confirmed the strong correlation between advancing age and the prevalence of ED. Lower urinary tract symptoms are the major factors affecting erectile function. High blood pressure, high cholesterol levels and ex-smokers are significant risk factors for ED.

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Fig. 1.
Prevalence of erectile dysfunction by age groups. The erectile dysfunction criteria were severe: International Index of Erectile Function-5 (IIEF-5) score≤10, moderate: 11-15, mild: 16-20 and normal: ≥21. The number in the box means the prevalence of erectile dysfunction, including severe, moderate and mild.
kju-48-1258f1.tif
Fig. 2.
Prevalence of low urinary tract symptom. The low urinary tract symptoms' criteria were severe: IPSS≥20 and moderate: 8-19, IPSS: International Prostate Symptom Score.
kju-48-1258f2.tif
Fig. 3.
International Index of Erectile Function-5 (IIEF-5) score and total cholesterol. Age adjusted partial Pearson's correlation coefficient: R= ?0.18 (p=0.044).
kju-48-1258f3.tif
Table 1.
General characteristics of the study participants (n=285, male)
45-54%, mean (SD) 55-64 %, mean (SD) 65-74 %, mean (SD) ≥75 %, mean (SD) Total %, mean (SD)
Person 7.1 15.1 58.2 19.6 100.0
Education year ≤6 36.4 40.4 51.4 71.2 52.4
7-12 18.2 19.2 16.8 10.2 15.9
≥13 45.5 40.4 31.8 18.6 31.6
Married and living together 90.9 95.7 91.1 79.7 89.6
Current smoker 52.0 42.6 24.1 25.0 29.1
Current drinker 64.0 57.8 60.5 46.9 57.7
Body mass index (kg/m2) 25.3 (3.1) 24.8 (2.8) 24.7 (2.9) 24.4 (3.1) 24.7 (2.9)
Blood pressure SBP (mmHg) 132.7 (15.1) 133.6 (15.2) 138.8 (19.3) 135.9 (18.0) 137.0 (18.3)
DBP (mmHg) 86.5 (12.6) 81.3 (9.5) 81.7 (11.9) 79.3 (10.6) 81.6 (11.4)
Total cholesterol (mg %) 199.3 (42.6) 195.0 (30.4) 194.0 (36.4) 187.2 (35.4) 193.3 (35.8)
Fasting blood sugar (mg/dl) 0.4.2 (35.6) 111.3 (35.5) 106.3 (25.8) 108.1 (41.4) 107.2 (31.5)
Self-reported hypertension 21.7 17.0 32.6 31.7 29.4
Self reported DM 14.3 10.0 16.9 8.3 13.9

SD: standard deviation, SBP: systolic blood pressure, DBP: diastolic blood pressure, DM: diabetes mellitus

Table 2.
Factors associated with sexual dysfunction
ED (n=175) Normal (n=109) Odds ratio (95% confidence interval)
Education years ≤6 108 43 1.0
7-12 31 20 0.3 (0.1-1.2)
≥13 37 46 0.2 (0.1-1.0)
Life style
   Smoking Non 26 26 1.0
Ex-smoker 97 40 5.2 (1.3-12.0)
Smoker 55 43 3.0 (0.6-14.1)
   Regular exercise No 145 78 1.0
Yes 31 31 0.8 (0.2-3.1)
   Alcohol intake No 38 23 1.0
Ex-drinker 37 15 1.0 (0.2-4.3)
Drinker 102 70 0.4 (0.1-1.3)
Anthropometry & physiologic markers
   Total cholesterol (mg%) <200 66 54 1.0 p-trend=0.483
200-239 39 32 1.2 (0.5-3.0)
≥240 11 8 1.8 (1.0-5.9)
Body mass index (kg/m2) <25 58 44 1.0
   (n=213) ≥25 58 53 1.7 (0.6-4.9)
FBS (mg/dl)§ (n=256) <126 131 87 1.0
≥126 22 16 1.0 (0.6-4.9)
Blood pressure (mmHg) Normal 22 14 1.0 p-trend=0.603
   (n=263) Prehypertension 47 42 2.0 (0.5-8.6)
Hypertension 87 50 2.2 (1.2-3.3)
Self-reported disease
   Hypertension (base: No.) 16 4 0.1 (0.1-1.0)
   DM (base: No.) 24 13 1.6 (0.3-7.3)

: erectile dysfunction group (IPSS>8),

: age, educational level, marital status and other covariate adjusted odds ratio,

: categorized by Adult Treatment Panel on ATP III, 2002,

§ : fasting blood sugar, categorized by American DM Association (ADA), 1997,

: categorized JNC 7th report, 2003, normal: SBP<120mmHg and DBP<80mmHg, prehypertension: SBP 120-139mmHg or DBP 80-89mmHg, hypertension: SBP≥140mmHg or DBP≥90mmHg, SBP: systolic blood pressure, DBP: diastolic blood pressure, DM: diabetes mellitus

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