Temporal trend in patients’ age at first assessment for erectile dysfunction
Capogrosso, P1; Ventimiglia, E1; Boeri, L1; Cazzaniga, W1; Pederzoli, F1; Frego, N1; Chierigo, F1; Pozzi, E1; Moretti, D1; Deho', F1; Gaboardi, F1; Mirone, V2; Montorsi, F1; Salonia, A1
1: San Raffaele Hospital - University Vita-Salute San Raffaele, Italy; 2: University of Naples Federico II, Italy
Objective: We analysed potential differences in patients’ characteristics at first time assessment for erectile dysfunction (ED) in a tertiary academic center throughout the last 12 years.
Materials and Methods: Data from 767 men seeking first medical help for ED at a single center from 2005 to 2017 were analysed. All patients were comprehensively assessed with a detailed medical history and were asked to complete the International Index of Erectile Function-Erectile Function domain (IIEF-EF). Relevant comorbid conditions were scored with the Charlson Comorbidity Index (CCI). Local polynomial regression models explored the relationship between patients’ socio-demographic and clinical characteristics and the year of first time assessment. Linear and logistic regression models estimated the association between predictors and the time at first evaluation. Restricted cubic splines tested the non-linearity between continuous variables and the investigated outcome.
Results: Overall, median (IQR) age at first assessment was 52 (40–61) years. We observed a non-linear correlation between age at first evaluation for ED and year of assessment (p=0.02); patients’ age decreased from a median of 59.5(55–64) in 2006 to a median of 50(23-72) in 2011, with a subsequent slighter increase to a median of 53(33-67) in 2017. Patients assessed over the last period were significantly healthier (OR: 0.9; 95%CI: 0.8-0.9, p=0.005) and were more frequently in a stable couple relationship (OR 1.1; 95%CI: 1.1-1.2, p=0.001) as compared with the earlier periods. A significant correlation emerged between the year of first assessment and the likelihood of being PDE5 inhibitors naïve at first presentation (OR 1.1; 95%CI: 1.1-1.2, p=<0.001). No significant changes over time were observed in terms of baseline IIEF-EF scores and patients’ educational status.
Conclusions: Age at first presentation of patients with ED has significantly decreased over the last decade, thus suggesting a potential raise in the awareness of the disease and in the possibility of receiving a proper treatment, among both patients and physicians. Conversely, this lowering of the age at first seeking medical help could be a worrisome incremental drift of the forms of youth ED.
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