title: Sexual Function and Mortality in Older Men: The Concord Health and Ageing in Men Project.
abstract: BACKGROUND
  The longitudinal association between progressive temporal change in sexual (dys)function and mortality in older men.
  
  
  METHODS
  Community-dwelling men aged 70 years and older from the Concord Health and Ageing in Men Project were assessed at baseline (2005-2007, n = 1,705), 2-years follow-up (n = 1,367), and 5-years follow-up (n = 958). Self-reported sexual function (erectile function and sexual activity) using standardized questions were analyzed by generalized estimating equations to examine the longitudinal prediction of mortality according to change in sexual function across three time-points.
  
  
  RESULTS
  Men reported to have erectile dysfunction increased from 64% to 80%, and to be sexually inactive increased from 56% to 59% over the course follow-up. In univariate analyses, erectile dysfunction (hazard ratio: 2.02, 95% confidence interval [CI]: 1.45-2.81) or having no sexual activity (hazard ratio: 2.31, 95% CI: 1.82-2.93) at baseline predicted increased mortality over the subsequent 7 years. Models adjusted for multivariate and major reproductive hormones had negligible impact on mortality prediction, but neither statistically significantly predicted mortality after adjusting for depression. Similarly, change in erectile dysfunction over time was associated with mortality over 7 years in univariate (odds ratio: 1.69, 95% CI: 1.34-2.14) and multivariate analysis, including hormones, but not after adjusting for depression (odds ratio: 1.24, 95% CI: 0.95-1.62). Change in sexual activity was associated with mortality over 7 years in univariate analysis (odds ratio: 2.37, 95% CI: 1.33-4.20) but not after adjusting for age (odds ratio: 1.45, 95% CI: 0.79-2.64).
  
  
  CONCLUSIONS
  Our analyses suggest sexual dysfunction was not an independent risk factor of, but rather may be a biomarker for, all-cause mortality in older men.
authors.affiliation: ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.|School of Public Health, University of Sydney, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.|ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia.
authors.forename: Benjumin
authors.initials: B
authors.lastname: Hsu
authors.affiliation: School of Public Health, University of Sydney, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.|ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia.|School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Australia.
authors.forename: Vasant
authors.initials: V
authors.lastname: Hirani
authors.affiliation: Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.affiliation: Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Blyth
authors.affiliation: ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.affiliation: ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.affiliation: Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.affiliation: ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
authors.affiliation: ANZAC Research Institute, University of Sydney and Concord Hospital, New South Wales, Australia.|School of Public Health, University of Sydney, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, New South Wales, Australia.|ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales Australia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D006801:Humans; D008297:Male; D009026:Mortality; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D019529:Sexuality / Q000502:physiology*
keywords: Depression; Epidemiology; Erectile dysfunction; Mortality; Sexual function