Effect of chronic diseases on incidence of erectile dysfunction

To estimate the incidence of erectile dysfunction (ED) in a population-based sample during 5 years' follow-up and determine how the rate was affected by age and medical conditions.

The target population comprised all men aged 50, 60, or 70 years residing in the study area at the time the study began. Questionnaires were mailed to 3143 men in 1994 and to 2864 men in 1999. The follow-up sample consisted of the 1442 men who responded to both the baseline and the follow-up questionnaires. ED was assessed by two questions concerning the subject's ability to achieve and maintain an erection sufficient for intercourse. We estimated the incidence of minimal ED among the 391 men free of ED, of moderate ED in the 1130 with no or minimal ED, and of complete ED among the 1323 men free of complete ED at baseline.

The incidence of minimal ED was 127 cases per 1000 person-years (95% confidence interval 110 to 148). For moderate ED, it was 41 (95% confidence interval 36 to 47) and for complete ED, it was 18 (95% confidence interval 15 to 22). The incidence of minimal ED increased 40% and moderate ED 80% with each decade increment in age; the incidence of complete ED increased 190%. The incidence of ED was increased in men with diabetes (rate ratio 2.4 for minimal, 2.6 for moderate, and 3.4 for complete ED). Hypertension, heart disease, arthritis, pulmonary disease, and cerebrovascular disease had little or no effect on the incidence of ED.

ED is a commonly occurring disorder that increases in incidence strongly between 50 and 75 years of age. Diabetes is a major determinant of ED, but hypertension, heart disease, arthritis, and cerebrovascular disease increase the incidence of ED only marginally.