Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA

Abstract

SUMMARY Aims With self-reporting of erectile dysfunction (ED) in population-based surveys, men with ED may not represent men who are bothered sufficiently to seek an ED diagnosis and treatment. We used real-world observational data to assess: 1) the prevalence of ED diagnosis or treatment by age subgroups; and 2) the relationship of age with ED diagnosis or treatment after controlling for ED-related comorbidities in the United States. Methods This cross-sectional study used de-identified claims data (MarketScan® databases; primary analysis). Sensitivity analysis was conducted using electronic health records (Humedica® database). Inclusion criteria were men aged ≥18 years with a 360-day continuous enrollment before the index date. We assessed the prevalence of ED diagnosis or phosphodiesterase type 5 inhibitor (PDE5I) prescription by age and the risk for ED diagnosis or treatment by age after controlling for comorbidities (hypertension, other cardiovascular disease, diabetes mellitus, depression, and benign prostatic hyperplasia). Results Of 19,833,939 men meeting inclusion criteria in the primary analysis, only 1,108,842 (5.6%) had an ED diagnosis or PDE5I prescription (mean [SD] age: 55.2 [11.2] years). Prevalence of ED diagnosis or treatment increased from age 18–29 years (0.4%) to 60–69 years (11.5%), then decreased in the 7th (11.0%), 8th (4.6%), and 9th (0.9%) decades. Men with ED diagnosis or treatment had a higher prevalence of any comorbidity (63.1% vs 29.3% for men without ED) and of each comorbid condition. In multivariate analyses, age was an independent risk factor for ED diagnosis or treatment. Sensitivity analysis provided consistent results. Conclusions In a real-world setting in the United States, the prevalence of ED diagnosis or PDE5I treatment is generally low, increases with age, decreases in very old men, and is associated with increased prevalence of comorbidities. Age is an independent risk factor for ED diagnosis or treatment after controlling for comorbidities.

Real-world observational results from a database of 48 million men in the United States: Relationship of cardiovascular disease, diabetes mellitus and depression with age and erectile dysfunction

“…Similar age distributions of ED prevalence have been reported in other studies of USA real‐world data . Our analysis also showed that, across the life span, men with ED are more likely to have comorbid CVD, DM and depression than men without ED.…”

“…The methodology has been described previously . Briefly, this was a cross‐sectional, non‐interventional study using claims data from the Truven Health MarketScan ® and Medicare Supplemental Research Databases .…”

“…Community‐based studies such as the multinational Men's Attitudes to Life Events and Sexuality (MALES) study similarly report a prevalence of self‐reported ED that increases with age: 8% among men ages 20‐29 years, 11% among men ages 30‐39 years, 15% among men ages 40‐49 years, 22% among men ages 50‐59 years, 30% among men ages 60‐69 years and 37% among men ages 70‐75 years . However, because of the self‐reporting method used in such studies, findings may not be representative of men sufficiently bothered by their ED to seek treatment in epidemiologic studies . In contrast, health insurance claims databases and electronic health record databases represent more objective real‐world observational data that can augment population survey data …”

Treatment for erectile dysfunction among older men in Northern Ireland

“…This finding is supported by previous studies that have focused on treatment rates of ED compared to its reported prevalence. Observational studies in the USA indicate that significantly fewer men receive ED diagnosis and treatment than the proportion of men who experience it . Despite being a common condition, the proportion of men who seek help for ED from a doctor ranges from 22%‐26%, or 35% from a health professional in general .…”

Erectile dysfunction and cardiovascular disease: a suitable case for treatment and prevention?

“…The prevalence of ED has been estimated as nearly 40% of men >40 years of age1 although these figures are contested 2. ED increases in frequency with age and is estimated to affect 15% of men aged 40–50 years, 45% of men in their 60s and 70% of men older than 70 years 3.…”