title: Incidence rates of erectile dysfunction in the Dutch general population. Effects of definition, clinical relevance and duration of follow-up in the Krimpen Study.
abstract: This study aims to describe the incidence rate of erectile dysfunction (ED) in older men in the Netherlands according to three definitions. The influence of the duration of follow-up on the incidence rate is also explored. In a large community-based follow-up study, 1661 men aged 50-75 y completed the International Continence Society sex questionnaire and a question on sexual activity, at baseline and at a mean of 2.1 and 4.2 y of follow-up. We defined 'ED' as a report of erections with 'reduced rigidity' or worse; 'Significant_ED' as 'severely reduced rigidity' or 'no erections'; and 'Clinically_Relevant_ED' as either 'ED' reported as 'quite a problem' or 'a serious problem', or 'Significant_ED' reported as at least 'a bit of a problem'. Incidence rates of ED status were calculated in those men who completed at least one period of follow-up and were not diagnosed with prostate cancer (n = 1604). For 'ED' the incidence rate (cases per 1000 person-years) is 99 and ranges over the 10-y age groups from 77 (50-59 y) to 205 (70-78 y); for 'Significant_ED' these rates were 33, 21, and 97, respectively and for 'Clinically_Relevant_ED' 28, 25, and 39, respectively. In general, incidence rates should not vary with the duration of follow-up. However, for 'ED' the 4.2 y incidence rate is about 69% of the 2.1 y incidence rate. This study presents incidence rates, for the general population, as well as based on a definition of ED that takes concern/bother into account. 'Clinically_Relevant_ED' has a lower increase in incidence with increasing age than other definitions that do not take concern/bother into account. The phenomenon of lower incidence rates with longer duration of follow-up may account for the differences in reported incidence rates between different studies. The effects of differences related to the duration of follow-up should be taken into consideration in future incidence reports.
authors.affiliation: General Practice, Erasmus MC, Rotterdam, The Netherlands. bschouten@erasmusmc.nl
authors.forename: B W V
authors.initials: BW
authors.lastname: Schouten
authors.forename: J L H R
authors.initials: JL
authors.lastname: Bosch
authors.forename: R M D
authors.initials: RM
authors.lastname: Bernsen
authors.forename: M H
authors.initials: MH
authors.lastname: Blanker
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: A M
authors.initials: AM
authors.lastname: Bohnen
mesh_terms: D000367:Age Factors; D000368:Aged; D003625:Data Collection; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D013997:Time Factors