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      Association between Frailty and Erectile Dysfunction among Chinese Elderly Men

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      , , ,
      BioMed Research International
      Hindawi

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          Abstract

          Objective

          This study is aimed at assessing association between frailty and erectile dysfunction among Chinese elderly men.

          Methods

          This community-based study was conducted with a sample of 341 Chinese elderly men (aged 60 to 83 years old) in Fuyang City (Anhui Province, China). Each of the participants completed a standard questionnaire, including demographics (age, height, weight, yearly income, educational status, comorbidity, lifestyle factors, etc.), medical and sexual history, and the Chinese version of Tilburg Frailty Indicator (TFI) and International Index of Erectile Function-5 (IIEF-5) for assessing frailty and erectile dysfunction (ED).

          Results

          The prevalence of ED and frailty in Chinese elderly men was 77.13% and 68.04%, respectively. Compared with the non-ED group, the ED group had increased age, spouse's age, BMI, prevalence of diabetes, and scores of TFI and lower yearly income, educational levels, and ratio of irregular intercourse (less than once per week) (all P < 0.05). Multivariate analysis indicated that age (OR: 0.860, 95% CI: 0.763-0.969), diabetes (OR: 0.330, 95% CI: 0.165-0.661), irregular intercourse (OR: 3.416, 95% CI: 1.874-6.229), and scores of TFI (OR: 0.906, 95% CI: 0.846-0.970) were regarded as independent risk factors for ED (all P < 0.05). And after adjusting for age, the TFI score had a negative significant association with the IIEF score ( r = −0.134, P = 0.013).

          Conclusion

          This study confirmed the strong associations between ED and frailty among elderly men. Sexual health care for elderly men with ED should be assessed and taken addressed on the multidimensional assessments of frailty.

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          Most cited references35

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          Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study

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            The Tilburg Frailty Indicator: psychometric properties.

            To assess the reliability, construct validity, and predictive (concurrent) validity of the Tilburg Frailty Indicator (TFI), a self-report questionnaire for measuring frailty in older persons. Cross-sectional. Community-based. Two representative samples of community-dwelling persons aged 75 years and older (n = 245; n = 234). The TFI was validated using the LASA Physical Activity Questionnaire, BMI, Timed Up & Go test, Four test balance scale, Grip strength test, Shortened Fatigue Questionnaire, Mini-Mental State Examination, Center for Epidemiologic Studies Depression Scale, Anxiety subscale of the Hospital Anxiety and Depression Scale, Mastery Scale, Loneliness Scale, and the Social Support List. Adverse outcomes were measured using the Groningen Activity Restriction Scale and questions regarding health care use. Quality of life was measured using the WHOQOL-BREF. The test-retest reliability of the TFI was good: 0.79 for frailty, and from 0.67 to 0.78 for its domains for a 1-year time interval. The 15 single components, and the frailty domains (physical, psychological, social) of the TFI correlated as expected with validated measures, demonstrating both convergent and divergent construct validity of the TFI. The predictive validity of the TFI and its physical domain was good for quality of life and the adverse outcomes disability and receiving personal care, nursing, and informal care. This study demonstrates that the psychometric properties of the TFI are good, when performed in 2 samples of community-dwelling older people. The results regarding the TFI's validity provide strong evidence for an integral definition of frailty consisting of physical, psychological, and social domains. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
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              Epidemiology of erectile dysfunction: results of the 'Cologne Male Survey'.

              The last few decades have seen a marked increase in mean life expectancy in Central Europe. This has made elderly people and their quality of life a matter of ever-increasing medical concern. Available data from the United States and Scandinavia relating to erectile dysfunction (ED) do not enable us to draw valid conclusions about the current situation in Germany. The aim of the present study was to evaluate the epidemiology of male sexuality in Germany, and the proportion of men who need medical treatment because of increased suffering from this.A newly developed and validated questionnaire on male erectile dysfunction was mailed to a representative population sample of 8000 men, 30-80 y of age in the Cologne urban district. The response included 4489 evaluable replies (56.1%). The response rates in different age groups ranged from 49.2% to 68.4%. Regular sexual activity was reported by 96.0% (youngest age group) to 71.3% (oldest group). There were 31.5%-44% of responders who were dissatisfied with their current sex life. The prevalence of ED was 19.2%, with a steep age-related increase (2.3-53.4%) and a high co-morbidity of ED with hypertension, diabetes, pelvic surgery and 'lower urinary tract symptoms'. When treatment need was defined by co-occurrence of ED and dissatisfaction with sex life, 6.9% men required treatment for ED. Oral treatment of ED was preferred by 73.8% of respondents. There were 46.2% respondents who were willing to contribute more than DM 50 (25 Euro) per month for ED treatment. We conclude that regular sexual activity is a normal finding in advanced age. ED is a frequent disorder, contributing to dissatisfaction with sex life in a considerable proportion of men. The high burden of ED is reflected in willingness to pay for treatment. ED is frequently associated with chronic diseases. Therefore adequate diagnostic workup is essential, to offer patients individually adapted treatment. General non-reimbursability of treatment for ED appears to be unacceptable.
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                Author and article information

                Contributors
                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi
                2314-6133
                2314-6141
                2020
                7 July 2020
                : 2020
                : 9247237
                Affiliations
                Department of Urology and Andrology, The Second Hospital of Fuyang People's Hospital, China
                Author notes

                Academic Editor: Margaret A. Niznikiewicz

                Author information
                https://orcid.org/0000-0001-5211-3400
                Article
                10.1155/2020/9247237
                7366209
                427d884c-bf5e-4d25-b978-df38546a8f6e
                Copyright © 2020 Chengfu Li et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 February 2020
                : 30 June 2020
                Categories
                Research Article

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