Erectile dysfunction (ED) is a well-known predictor for
future cardiovascular and cerebrovascular disease. However, the relationship
between ED and dementia has rarely been examined. This study investigates the
longitudinal risk for Alzheimer's disease and non-Alzheimer dementia in
patients with ED.
We collected a random sample of 1,000,000 individuals from
Taiwan's National Health Insurance database. From this sample, we identified
4153 patients with newly diagnosed ED between 2000 and 2009 and compared them
with a matched cohort of 20,765 patients without ED. All patients were tracked
for 7 years from the index date to identify which of them subsequently
developed dementia.
During the 7-year follow-up period, the incidence rate of
dementia in the ED cohort was 35.33 per 10,000 person-years. In the comparison
groups, it was 21.67 per 10,000 person-years. After adjustment for patients
characteristics and comorbidities, patients with ED were 1.68-times more likely
to develop dementia than patients without ED (95% CI = 1.34–2.10, P < 0.0001). In
addition, older patients and those with diabetes, hypertension, chronic kidney
disease, stroke, depression, and anxiety were found to be at increased risk for
dementia. Analyzing the data by dementia type, we found the hazard risk for Alzheimer's
disease and non-Alzheimer dementia to be greater in patients with ED (adjusted
HR 1.68, 95% CI = 1.31–2.16, P < 0.0001
and 1.63, 95% CI = 1.02–2.62, P = 0.0429,
respectively). Log-rank test revealed that patients with ED had significantly
higher cumulative incidence rates of dementia than those without (P < 0.0001).
Patients with ED are at an increased risk for dementia later
in life.
Below: The cumulative incidence rate for dementia for patients with erectile dysfunction (ED) and without ED (log-rank P value < 0.0001)
Below: The cumulative incidence rate for Alzheimer's disease for patients with erectile dysfunction (ED) and without ED (log-rank P value = 0.0001)
Below: The cumulative incidence rate for non-Alzheimer dementia for patients with erectile dysfunction (ED) and without ED (log-rank P value = 0.0533)
From the
Department of Neurology, Chi Mei Medical Center, Tainan (C-MY); Department of
Urology, Kaohsiung Chang Gung Memorial Hospital (Y-CS); Cheng Shiu University,
Kaohsiung (Y-CS); Department of Medical Research, Chi Mei Medical Center (S-FW,
J-JW); Department of Hospital and Health Care Administration, Chia Nan
University of Pharmacy and Science (S-FW); Division of Endocrinology and
Metabolism, Department of Internal Medicine, Chi Mei Medical Center (K-JT); and
Department of Senior Citizen Service Management, Chia Nan University of
Pharmacy and Science, Tainan, Taiwan (K-JT).
Correspondence: Kai-Jen Tien, Department of Endocrinology
and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, No.
901, Zhonghua Rd., Yongkang Dist., Tainan City 710, Taiwan, R.O.C. (e-mail: moc.liamg@jktcmmc).
