249964 Correlates of chronic disease and patient-provider discussions among middle-aged and older adult males: Associations with sexual dysfunction

Monday, October 31, 2011

Matthew Lee Smith, PhD, MPH, CHES , Department of Health Promotion and Behavior, The University of Georgia, College of Public Health, Athens, GA
SangNam Ahn, PhD, MPSA , Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN
Heather H. Goltz, PhD, LMSW , Department of Social Sciences, University of Houston-Downtown, Houston, TX
Mindy Menn, MS , Health Education & Behavior, University of Florida, Gainsville, FL
Justin Dickerson, MBA , Department of Health Policy & Management, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX
Marcia G. Ory, PhD, MPH , Social & Behavioral Health, Texas A&M HSC School of Rural Public Health, College Station, TX
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.

Learning Areas:
Chronic disease management and prevention
Other professions or practice related to public health
Public health or related research

Learning Objectives:
1. Identify socio-demographics, health indicators, and sexual dysfunctions associated with self-reported chronic disease (i.e., cardiovascular disease and diabetes) among middle-aged and older adult males 2. Identify socio-demographics, health indicators, and sexual dysfunctions associated with patient-provider communication concerning sexual issues among middle-aged and older adult males with chronic disease (i.e., cardiovascular disease and diabetes) 3. Assess chronic disease-related differences in health indicators, sexual dysfunction and patient-provider communication among middle-aged and older adult males

Keywords: Aging, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Have have been a health educator and aging researcher for the past 3 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.