Correlates of chronic disease and patient-provider discussions among middle-aged and older adult males: Associations with sexual dysfunction

Background: Erectile difficulties become more prevalent as men age; however, effective treatments are available. Little is known about patient-provider discussions concerning sexual well-being among older adult males.

Methods: Using 2010 National Social Life, Health and Aging Project data (n=1,382), multinomial logistic regression was performed on data from males age 55 years and older comparing factors associated with being "healthy" (without CVD/diabetes; 39.1%), CVD-only (42.2%), and co-morbid CVD/diabetes (CVD&D; 18.7%). Logistic regression compared factors associated with having ever discussed sexual issues with physicians.

Results: Participants averaged 68.7 (±7.70) years of age and self-reported minority-status (28.7%), obesity (35.0%), sexual intercourse in the previous year (61.9%), and previous patient-provider discussion about sexual issues (38.5%). CVD-only participants were more likely to be ≥75 years [OR=1.90, p=0.003] and smoke [OR=1.56, p=0.032]; CVD&D participants were more likely to report daily activity limitations [OR=1.15, p=0.001] and less likely to have sex within the previous year [OR=0.47, p=0.005]. Compared to CVD-only, men with CVD&D were more likely to be minorities [OR=1.69, p=0.026], obese [OR=1.59, p=0.021], have daily activity limitations [OR=1.09, p=0.013], and report erectile difficulties [OR=2.18, p=0.007]. Males discussing sexual issues with physicians were more likely to be ≥75 years [OR=1.47, p=0.047], report higher education [OR=1.73, p<0.011], have sex in previous year [OR=1.75, p=0.004], and have erectile difficulties [OR=2.29, p<0.001].

Discussion: These findings affirm chronically-ill older males are subject to sexual dysfunctions but do not generally discuss with their physicians. Interventions integrating sexual health into primary care settings are recommended to improve quality of life for older men.