Erectile Function, Sexual Satisfaction, and Cognitive Decline in Men From Midlife to Older Adulthood.
Erectile Function, Sexual Satisfaction, and Cognitive Decline in Men From Midlife to Older Adulthood.
复制标题
中年到老年男性的勃起功能、性满意度和认知能力下降。
DOI：
10.1093/geront/gnac151
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Franz,CarolE
中科院分区：
文献类型：
--
作者：
Slayday,RikiE;Bell,TylerR;Lyons,MichaelJ;WarrenBa,TeresaS;Toomey,Rosemary;Vandiver,Richard;Sliwinski,MartinJ;Kremen,WilliamS;Franz,CarolE
背景和目的认知衰老的血管学说主要集中在大血管改变和认知功能减退方面。然而，根据动脉大小假说，微血管的变化，例如那些导致勃起功能变化的微血管变化，也可能在导致认知能力下降方面发挥重要作用。因此，我们研究了从中年开始的勃起功能、性满意度和认知之间的关系，因为这代表着这些区域出现下降的过渡期。研究设计和方法我们调查了越南时期双胞胎研究中的818名男性，平均年龄为56岁、61岁和68岁。用勃起功能国际指数测量勃起功能和性满意度。使用情景记忆、执行功能和处理速度的因素分数来衡量认知表现。我们对多水平模型进行了分层测试，调整了人口统计学、性行为频率以及生理和心理健康的混杂因素，以检验勃起功能和性满意度的变化如何与认知表现的变化相关。结果基线勃起功能较低与基线时所有认知领域的较差表现和处理速度随时间的较快下降有关。然而，基准性满意度与认知表现无关。勃起功能和性满意度的下降都与记忆力下降有关。讨论和暗示性健康下降可能预示着认知能力下降的风险增加。我们讨论了可能的机制，包括微血管变化和心理痛苦。讨论和跟踪中年男性的性健康状况可能有助于识别那些可能面临记忆力衰退的人。
Background and ObjectivesVascular theories of cognitive aging have focused on macrovascular changes and cognitive decline. However, according to the artery-size hypothesis, microvascular changes, such as those that underlie changes in erectile function, may also play an important role in contributing to cognitive decline. Thus, we examined associations between erectile function, sexual satisfaction, and cognition starting in middle age because this represents a transition period where declines in these areas emerge.Research Design and MethodsWe examined 818 men from the Vietnam Era Twin Study of Aging across three waves at mean ages 56, 61, and 68. Erectile function and sexual satisfaction were measured using the International Index of Erectile Function. Cognitive performance was measured using factor scores for episodic memory, executive function, and processing speed. We tested multilevel models hierarchically, adjusting for demographics, frequency of sexual activity, and physical and mental health confounders to examine how changes in erectile function and sexual satisfaction related to changes in cognitive performance.ResultsLower erectile function at baseline was related to poorer performance in all cognitive domains at baseline and faster declines in processing speed over time. However, baseline sexual satisfaction was unrelated to cognitive performance. Decreases in erectile function and sexual satisfaction were both associated with memory decline.Discussion and ImplicationsDecreasing sexual health may signal an increased risk for cognitive decline. We discuss potential mechanisms, including microvascular changes and psychological distress. Discussing and tracking sexual health in middle-aged men may help to identify those likely to face memory decline.