title: Depression and lower urinary tract symptoms: Two important correlates of erectile dysfunction in middle-aged men in Hong Kong, China.
abstract: OBJECTIVE
  To evaluate the correlates of erectile dysfunction (ED) in Hong Kong middle-aged Chinese men aged 45-64 years.
  
  
  METHODS
  A community-based cross-sectional household survey was performed in Hong Kong. The Chinese abridged version of the International Index of Erectile Function (IIEF-5) was used to measure erectile function. The International Prostate Symptom Score (IPSS) was used to measure lower urinary tract symptoms (LUTS) and depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Demographic and lifestyle data were also collected. The association between ED and its correlates was analyzed using bivariate and multivariate analyses.
  
  
  RESULTS
  Of the 545 subjects who agreed to participate in the survey, 75 refused to answer questions about their sexual activities and function. Out of those who responded, 118 (22%) subjects were not sexually active (not sexually active over the past 4 weeks). Out of 352 subjects, 60.3% suffered from some degree of ED. Age, presence of depression defined by CES-D and moderate LUTS were associated with increased odds of having ED. In multivariate analysis, depressive symptoms identified by CES-D (OR = 2.3, CI: 1.2-4.6) and moderate LUTS (OR = 3.7, CI: 1.6-8.3) were independently associated with increased odds of having ED.
  
  
  CONCLUSIONS
  ED is an important public health problem in Chinese middle-aged men, with more than half suffering from some degree of ED. Depression and LUTS were significant and important risk factors associated with ED.
authors.affiliation: Department of Community and Family Medicine, The Chinese University of Hong Kong, School of Public Health, Prince of Wale Hospital, Shatin, Hong Kong. yeungshanwong@cuhk.edu.hk
authors.forename: Samuel Yeung Shan
authors.initials: SY
authors.lastname: Wong
authors.forename: Dicken
authors.initials: D
authors.lastname: Chan
authors.forename: Athena
authors.initials: A
authors.lastname: Hong
authors.forename: Ping Chung
authors.initials: PC
authors.lastname: Leung
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000150:complications* / Q000453:epidemiology