title: Clinical characteristics of older male military veterans seeking treatment for erectile dysfunction.
abstract: BACKGROUND
  Male sexual dysfunction is a significant international public health issue affecting both middle-aged and older adults. To date, however, no studies have compared age differences in psychiatric issues, frequency of sexual activity and treatment recommendations between older and middle-aged male military Veterans seeking treatment for erectile dysfunction (ED) in the U.S.A.
  
  
  METHODS
  Data were collected between 1982 and 2003 at the Palo Alto Veterans Affairs Andrology Clinic. The 1,250 participants, aged 22 to 87 years (median = 63), completed a semi-structured interview. Using multiple linear regressions, we examined age differences in five domains: medical and endocrine risk factors; psychiatric and psychosocial risk factors; frequency of sexual behaviors; self-reported and objectively measured erectile function; and treatment recommendations.
  
  
  RESULTS
  Compared with middle-aged adults, older adults were more likely to present for ED treatment with medical risk factors and were more often recommended a vacuum pump treatment. Middle-aged male Veterans were more likely to experience psychiatric risk factors for ED and were more sexually active than older Veterans. Despite greater objective erectile ability in middle-aged adults, there were no age differences in maximum self-reported erectile functioning.
  
  
  CONCLUSIONS
  These results provide some evidence of age-related characteristics and treatment needs of male patients seeking treatment for sexual dysfunction. We encourage health care professionals working with adults across the lifespan to consider ways to individualize psychoeducation and brief psychotherapy for the treatment of ED to the specific needs of the patient, which may vary between middle-aged and older cohorts of patients.
authors.affiliation: Palo Alto VA Health Care System, and Sierra Pacific Mental Research Education and Clinical Centers, Palo Alto, CA 94304, USA. sherryb@stanford.edu
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Beaudreau
authors.forename: Tiffany
authors.initials: T
authors.lastname: Rideaux
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zeiss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D007172:Erectile Dysfunction / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*; D055815:Young Adult