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Zhang H, Wang S, Ma S, Zhang C, Wang Z, Yan P. Causal relationship between worry, tension, insomnia, sensitivity to environmental stress and adversity, and erectile dysfunction: a study using Mendelian randomization. Andrology 2024; 12:1272-1279. [PMID: 38131625 DOI: 10.1111/andr.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/17/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND This study aims to investigate the causal relationship between erectile dysfunction (ED) and psychological states including worry, tension, insomnia, sensitivity to environmental stress and adversity (SESA). METHOD This study the used two-sample bi-directional Mendelian randomization (MR) method. The study data was obtained from a pooled dataset of genome-wide association studies (GWAS). The bi-directional MR analysis was performed using inverse variance weighting, weighted median method, and MR-Egger regression analysis to assess the causality between ED and psychological states including worry, tension, insomnia, SESA in terms of odd ratios (OR). The study tested for heterogeneity using the Cochran Q method and for multiple validity using the MR-Egger and MR-PRESSO methods. RESULTS In forward MR analysis correlating worry, tension, insomnia, and SESA as exposures, no causal relationship was found between worry or tension and ED (p < 0.05). However, insomnia (p = 0.001, OR = 3.441, 95%CI = 1.593-7.435) and SESA (p = 0.004, OR = 1.804, 95%CI = 1.203-2.701) were found to have a significant causal effect on ED risk. The reverse MR analysis with ED as the exposure did not show any significant correlation (all p > 0.05). CONCLUSION Individuals with insomnia and SESA are at higher risk for developing ED. Clinical evaluation should be more thorough for these individuals. Insomnia can be treated simultaneously with psychological counseling to reduce the risk of ED. In addition, there is no evidence to suggest that worry and tension increase the risk of ED.
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Affiliation(s)
- Hao Zhang
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, Taipa, Macao SAR, China
| | - Shiqi Wang
- The First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Sicheng Ma
- Zhongjing Academy, Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Chenming Zhang
- The Second Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Zulong Wang
- The First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Peiyu Yan
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, Taipa, Macao SAR, China
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology Zhuhai MUST Science and Technology Research Institute, Macau University of Science and Technology, Macao, Taipa, Macao SAR, China
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Cho Y, Bea S, Bae JH, Kim DH, Lee JH, Shin JY. Cognitive dysfunction following finasteride use: a disproportionality analysis of the global pharmacovigilance database. Expert Opin Drug Saf 2024; 23:1027-1033. [PMID: 38112005 DOI: 10.1080/14740338.2023.2294926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/31/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Finasteride is commonly prescribed for androgenic alopecia and benign prostatic hyperplasia. However, concerns regarding its safety have been growing as cases of cognitive dysfunction have been reported. METHODS A disproportionality analysis was conducted on data collected between 1967 and 2022 to explore the potential association. Cases of cognitive dysfunction associated with finasteride use were identified, and the reporting odds ratio (rOR) was calculated with 95% confidence intervals to determine the strength of the association between the two variables. Sensitivity analyses were conducted to account for confounding by indication. RESULTS Among the 54,766 cases of adverse events reported for finasteride use, 1,624 (2.97%) were associated with cognitive dysfunction. The study found a significant disproportionality for cognitive dysfunction related to finasteride use (rOR 5.43, 95% CI 5.17-5.71). Most cases were considered serious (65.83%), with no signs of recovery (58.37%). Sensitivity analyses showed that patients younger than 45 years (rOR 7.30, 95% CI 6.39-8.35) and those with alopecia (rOR 5.52, 95% CI 5.15-5.91) reported more cognitive dysfunctions than their counterparts. CONCLUSION This study showed an increased reporting of cognitive dysfunction associated with finasteride use, especially among younger alopecia patients. Finasteride should be prescribed with caution, especially to younger alopecia patients.
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Affiliation(s)
- Yongtai Cho
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Sungho Bea
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Ji-Hwan Bae
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Dong Hyun Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jong Hee Lee
- Department of Dermatology, Sungkyunkwan University, Seoul, South Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
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Han SL, Liu DC, Tan CC, Tan L, Xu W. Male- and female-specific reproductive risk factors across the lifespan for dementia or cognitive decline: a systematic review and meta-analysis. BMC Med 2023; 21:457. [PMID: 37996855 PMCID: PMC10666320 DOI: 10.1186/s12916-023-03159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Sex difference exists in the prevalence of dementia and cognitive decline. The impacts of sex-specific reproductive risk factors across the lifespan on the risk of dementia or cognitive decline are still unclear. Herein, we conducted this systemic review and meta-analysis to finely depict the longitudinal associations between sex-specific reproductive factors and dementia or cognitive decline. METHODS PubMed, EMBASE, and Cochrane Library were searched up to January 2023. Studies focused on the associations of female- and male-specific reproductive factors with dementia or cognitive decline were included. Multivariable-adjusted effects were pooled via the random effect models. Evidence credibility was scored by the GRADE system. The study protocol was pre-registered in PROSPERO and the registration number is CRD42021278732. RESULTS A total of 94 studies were identified for evidence synthesis, comprising 9,839,964 females and 3,436,520 males. Among the identified studies, 63 of them were included in the meta-analysis. According to the results, seven female-specific reproductive factors including late menarche (risk increase by 15%), nulliparous (11%), grand parity (32%), bilateral oophorectomy (8%), short reproductive period (14%), early menopause (22%), increased estradiol level (46%), and two male-specific reproductive factors, androgen deprivation therapy (18%), and serum sex hormone-binding globulin (22%) were associated with an elevated risk of dementia or cognitive decline. CONCLUSIONS These findings potentially reflect sex hormone-driven discrepancy in the occurrence of dementia and could help build sex-based precise strategies for preventing dementia.
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Affiliation(s)
- Shuang-Ling Han
- Department of Neurology, Qingdao Municipal Hospital Group, Qingdao University, Donghai Middle Road, No.5, Qingdao, 266000, China
- Medical College, Qingdao University, Qingdao, 266000, China
| | - De-Chun Liu
- Department of Obstetrics, Qingdao Municipal Hospital Group, Qingdao, 266000, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital Group, Qingdao University, Donghai Middle Road, No.5, Qingdao, 266000, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital Group, Qingdao University, Donghai Middle Road, No.5, Qingdao, 266000, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital Group, Qingdao University, Donghai Middle Road, No.5, Qingdao, 266000, China.
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Williams ME, Elman JA, Bell TR, Dale AM, Eyler LT, Fennema-Notestine C, Franz CE, Gillespie NA, Hagler DJ, Lyons MJ, McEvoy LK, Neale MC, Panizzon MS, Reynolds CA, Sanderson-Cimino M, Kremen WS. Higher cortical thickness/volume in Alzheimer's-related regions: protective factor or risk factor? Neurobiol Aging 2023; 129:185-194. [PMID: 37343448 PMCID: PMC10676195 DOI: 10.1016/j.neurobiolaging.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023]
Abstract
Some evidence suggests a biphasic pattern of changes in cortical thickness wherein higher, rather than lower, thickness is associated with very early Alzheimer's disease (AD) pathology. We examined whether integrating information from AD brain signatures based on mean diffusivity (MD) can aid in the interpretation of cortical thickness/volume as a risk factor for future AD-related changes. Participants were 572 men in the Vietnam Era Twin Study of Aging who were cognitively unimpaired at baseline (mean age = 56 years; range = 51-60). Individuals with both high thickness/volume signatures and high MD signatures at baseline had lower cortical thickness/volume in AD signature regions and lower episodic memory performance 12 years later compared to those with high thickness/volume and low MD signatures at baseline. Groups did not differ in level of young adult cognitive reserve. Our findings are in line with a biphasic model in which increased cortical thickness may precede future decline and establish the value of examining cortical MD alongside cortical thickness to identify subgroups with differential risk for poorer brain and cognitive outcomes.
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Affiliation(s)
- McKenna E Williams
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Jeremy A Elman
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Tyler R Bell
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA, USA; Department of Neuroscience, University of California San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Carol E Franz
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Mark Sanderson-Cimino
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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Slayday RE, Bell TR, Lyons MJ, Warren , BA TS, Toomey R, Vandiver R, Sliwinski MJ, Kremen WS, Franz CE. Erectile Function, Sexual Satisfaction, and Cognitive Decline in Men From Midlife to Older Adulthood. THE GERONTOLOGIST 2023; 63:382-394. [PMID: 36194190 PMCID: PMC9960031 DOI: 10.1093/geront/gnac151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Vascular 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 METHODS We 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. RESULTS Lower 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 IMPLICATIONS Decreasing 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.
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Affiliation(s)
- Riki E Slayday
- Department of Psychology, San Diego State University, San Diego, California, USA
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania,USA
| | - Tyler R Bell
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Teresa S Warren , BA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Richard Vandiver
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Martin J Sliwinski
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania,USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
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Eglit GML, Elman JA, Panizzon MS, Sanderson-Cimino M, Williams ME, Dale AM, Eyler LT, Fennema-Notestine C, Gillespie NA, Gustavson DE, Hatton SN, Hagler DJ, Hauger RL, Jak AJ, Logue MW, McEvoy LK, McKenzie RE, Neale MC, Puckett O, Reynolds CA, Toomey R, Tu XM, Whitsel N, Xian H, Lyons MJ, Franz CE, Kremen WS. Paradoxical cognitive trajectories in men from earlier to later adulthood. Neurobiol Aging 2022; 109:229-238. [PMID: 34785406 PMCID: PMC8715388 DOI: 10.1016/j.neurobiolaging.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Abstract
Because longitudinal studies of aging typically lack cognitive data from earlier ages, it is unclear how general cognitive ability (GCA) changes throughout the life course. In 1173 Vietnam Era Twin Study of Aging (VETSA) participants, we assessed young adult GCA at average age 20 and current GCA at 3 VETSA assessments beginning at average age 56. The same GCA index was used throughout. Higher young adult GCA and better GCA maintenance were associated with stronger specific cognitive abilities from age 51 to 73. Given equivalent GCA at age 56, individuals who had higher age 20 GCA outperformed those whose GCA remained stable in terms of memory, executive function, and working memory abilities from age 51 to 73. Thus, paradoxically, despite poorer maintenance of GCA, high young adult GCA still conferred benefits. Advanced predicted brain age and the combination of elevated vascular burden and APOE-ε4 status were associated with poorer maintenance of GCA. These findings highlight the importance of distinguishing between peak and current GCA for greater understanding of cognitive aging.
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Affiliation(s)
- Graham M L Eglit
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA.
| | - Jeremy A Elman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mathew S Panizzon
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark Sanderson-Cimino
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; San Diego State University/University of California, San Diego Joint Doctoral Program, San Diego, CA, USA
| | - McKenna E Williams
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; San Diego State University/University of California, San Diego Joint Doctoral Program, San Diego, CA, USA
| | - Anders M Dale
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel E Gustavson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Sean N Hatton
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Donald J Hagler
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Richard L Hauger
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Amy J Jak
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Psychiatry and Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Ruth E McKenzie
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; School of Education and Social Policy, Merrimack College, North Andover, MA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Olivia Puckett
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Xin M Tu
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Nathan Whitsel
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Hong Xian
- Department of Epidemiology and Biostatistics, St. Louis University, St. Louis, MO, USA
| | - Michael J Lyons
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Carol E Franz
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
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7
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Poststroke Erectile Dysfunction in Cameroon: Prevalence, Associated Factors, and Quality of Life. Stroke Res Treat 2021; 2021:9988841. [PMID: 34900216 PMCID: PMC8664533 DOI: 10.1155/2021/9988841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/28/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Stroke is a severe disease due to its morbidity-mortality. It is the first cause of acquired disability including erectile dysfunction (ED). The purpose of this study was to determine the prevalence of ED in stroke patients at the Douala General Hospital, to identify associated factors and to evaluate their quality of life. Materials and Methods A cross-sectional study was conducted over a period of seven months from November 2016 to May 2017 on two groups of patients in neurology, cardiology, and endocrinology units of the Douala General Hospital (Cameroon): stroke patients (stroke+) and nonstroke patients (stroke-). We collected sociodemographic and clinical data using a preestablished questionnaire. Erectile function was assessed using International Index of Erectile Function (IIEF-5). Associated and predictive factors were determined using univariate and multivariate analyses. Results were significant for a p value < 0.05. Results A total of 269 patients were included, among them 87 stroke+ (32.34%) and 182 stroke- (67.66%) (controlled group). The mean age was 56.37 ± 12.89 years and 57.18 ± 10.24 years of stroke+ and stroke-, respectively (p = 0.608). Prevalence of poststroke ED was 64.4% (OR = 3.41, 95% CI: 1.99-5.82, p < 0.001). The average time of occurrence of the poststroke ED was 5 ± 5.85 months. Diabetes and dyslipidemia were the predictive factors of occurrence of poststroke ED. Depression was found both in stroke+ with ED and stroke+ without ED with no difference (p = 0.131). Conclusion About two-thirds of stroke patients developed ED. Diabetes and dyslipidemia were predictive factors of ED in stroke patients.
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8
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Zhao S, Wu W, Wu P, Ding C, Xiao B, Xu Z, Hu Y, Shen M, Feng L. Significant Increase of Erectile Dysfunction in Men With Post-stroke: A Comprehensive Review. Front Neurol 2021; 12:671738. [PMID: 34393971 PMCID: PMC8355431 DOI: 10.3389/fneur.2021.671738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Men with erectile dysfunction (ED) are considered to be at risk from stroke events. Conversely, post-stroke patients are also at high risk of ED, whereas a quantitative result from all the relevant studies has not been previously addressed. Therefore, we have performed a comprehensive review and meta-analysis on this issue. This study was registered on PROSPERO (ID No. CRD42021226618). Twenty studies with a total of 3,382 stroke events were included, of which six studies were included for quantitative analysis, and the remaining 14 studies were calculated for the ratio of ED. Synthetic results from four eligible studies providing the ED cases showed that stroke patients were associated with a significantly higher risk of ED than the general population [pooled relative risk (RR) = 3.32, 95% confidence interval (CI): 1.25–8.82, P = 0.016]. Men with stroke were also found to be associated with a significant decline in International Index of Erectile Function −5 (IIEF-5) score as compared with the healthy controls [three studies, standard mean differences (SMD) = −1.8, 95% CI: −2.94 to −0.67, P = 0.002]. The prevalence of ED in post-stroke patients among 14 studies ranged from 32.1 to 77.8%, which was dramatically higher than that of the general population. The result of the GRADE-pro revealed that the quality of the evidence in this study was moderate. The present study has confirmed the high prevalence of ED in men with stroke. ED in stroke patients is a result of both neurological and psychological factors. Rehabilitative interventions rather than phosphodiesterase-5 (PDE-5) inhibitors are recommended to improve the erectile function for those survivors with ED.
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Affiliation(s)
- Shankun Zhao
- Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Weizhou Wu
- Department of Urology, Maoming People's Hospital, Maoming, China
| | - Panxing Wu
- Department of Neurosurgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Chao Ding
- Department of Neurosurgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Bingxiang Xiao
- Department of Neurosurgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Zhengbao Xu
- Department of Neurosurgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Yan Hu
- Department of Obstetrics and Gynecology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Maolei Shen
- Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Lu Feng
- Department of Neurosurgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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Williams ME, Elman JA, McEvoy LK, Andreassen OA, Dale AM, Eglit GML, Eyler LT, Fennema-Notestine C, Franz CE, Gillespie NA, Hagler DJ, Hatton SN, Hauger RL, Jak AJ, Logue MW, Lyons MJ, McKenzie RE, Neale MC, Panizzon MS, Puckett OK, Reynolds CA, Sanderson-Cimino M, Toomey R, Tu XM, Whitsel N, Xian H, Kremen WS. 12-year prediction of mild cognitive impairment aided by Alzheimer's brain signatures at mean age 56. Brain Commun 2021; 3:fcab167. [PMID: 34396116 PMCID: PMC8361427 DOI: 10.1093/braincomms/fcab167] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
Neuroimaging signatures based on composite scores of cortical thickness and hippocampal volume predict progression from mild cognitive impairment to Alzheimer's disease. However, little is known about the ability of these signatures among cognitively normal adults to predict progression to mild cognitive impairment. Towards that end, a signature sensitive to microstructural changes that may predate macrostructural atrophy should be useful. We hypothesized that: (i) a validated MRI-derived Alzheimer's disease signature based on cortical thickness and hippocampal volume in cognitively normal middle-aged adults would predict progression to mild cognitive impairment; and (ii) a novel grey matter mean diffusivity signature would be a better predictor than the thickness/volume signature. This cohort study was part of the Vietnam Era Twin Study of Aging. Concurrent analyses compared cognitively normal and mild cognitive impairment groups at each of three study waves (ns = 246-367). Predictive analyses included 169 cognitively normal men at baseline (age = 56.1, range = 51-60). Our previously published thickness/volume signature derived from independent data, a novel mean diffusivity signature using the same regions and weights as the thickness/volume signature, age, and an Alzheimer's disease polygenic risk score were used to predict incident mild cognitive impairment an average of 12 years after baseline (follow-up age = 67.2, range = 61-71). Additional analyses adjusted for predicted brain age difference scores (chronological age minus predicted brain age) to determine if signatures were Alzheimer-related and not simply ageing-related. In concurrent analyses, individuals with mild cognitive impairment had higher (worse) mean diffusivity signature scores than cognitively normal participants, but thickness/volume signature scores did not differ between groups. In predictive analyses, age and polygenic risk score yielded an area under the curve of 0.74 (sensitivity = 80.00%; specificity = 65.10%). Prediction was significantly improved with addition of the mean diffusivity signature (area under the curve = 0.83; sensitivity = 85.00%; specificity = 77.85%; P = 0.007), but not with addition of the thickness/volume signature. A model including both signatures did not improve prediction over a model with only the mean diffusivity signature. Results held up after adjusting for predicted brain age difference scores. The novel mean diffusivity signature was limited by being yoked to the thickness/volume signature weightings. An independently derived mean diffusivity signature may thus provide even stronger prediction. The young age of the sample at baseline is particularly notable. Given that the brain signatures were examined when participants were only in their 50 s, our results suggest a promising step towards improving very early identification of Alzheimer's disease risk and the potential value of mean diffusivity and/or multimodal brain signatures.
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Affiliation(s)
- McKenna E Williams
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Jeremy A Elman
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo 0316, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 0372, Norway
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Graham M L Eglit
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, CA 92093, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Carol E Franz
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Sean N Hatton
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Richard L Hauger
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Amy J Jak
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Mark W Logue
- National Center for PTSD: Behavioral Science Division, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry and the Biomedical Genetics Section, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Ruth E McKenzie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- School of Education and Social Policy, Merrimack College, North Andover, MA 01845, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Olivia K Puckett
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA 92521, USA
| | - Mark Sanderson-Cimino
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Xin M Tu
- Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan Whitsel
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Hong Xian
- Department of Biostatistics, St. Louis University, St. Louis, MO 63103, USA
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
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10
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Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int 2019; 124:587-599. [PMID: 31267639 DOI: 10.1111/bju.14813] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterise discrepancies caused by the use of different ED screening tools. METHODS The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population-based studies investigating the prevalence of ED and the association between ED and CVD, BPH, and dementia in the general population. RESULTS The global prevalence of ED was 3-76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)-derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all-cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01-1.57), as well as CVD mortality OR 1.43 (95% CI 1.00-2.05). Men with ED are 1.33-6.24-times more likely to have BPH then men without ED, and 1.68-times more likely to develop dementia than men without ED. CONCLUSION ED screening tools in population-based studies are a major source of discrepancy. Non-validated questionnaires may be less sensitive than the IIEF and MMAS-derived questionnaire. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia, and all-cause mortality.
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Affiliation(s)
- Anna Kessler
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Sam Sollie
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Ben Challacombe
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Briggs
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
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11
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Choi JB, Cho KJ, Kim JC, Kim CH, Chung YA, Jeong HS, Shim YS, Koh JS. The Effect of Daily Low Dose Tadalafil on Cerebral Perfusion and Cognition in Patients with Erectile Dysfunction and Mild Cognitive Impairment. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:432-437. [PMID: 31352710 PMCID: PMC6705107 DOI: 10.9758/cpn.2019.17.3.432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/15/2022]
Abstract
Objective The aims of this study were to investigate the effects of daily low-dose tadalafil on cognitive function and to examine whether there was a change in cerebral blood flow (CBF) in patients with erectile dysfunction (ED) and mild cognitive impairment. Methods Male patients aged 50 to 75 years with at least three months of ED (International Index of Erectile Function [IIEF]-5 score ≤ 21) and mild cognitive impairment (Montreal Cognitive Assessment [MoCA] score ≤ 22) were included in the study. The subjects were prescribed a low-dose PDE5 inhibitor (tadalafil 5 mg) to be taken once daily for eight weeks. Changes in MoCA score and single-photon emission computed tomography (SPECT) study between the two time-points were assessed by paired t tests. Results Overall, 30 male patients were assigned to the treatment group in this study and 25 patients completed the eight-week treatment course. Five patients were withdrawn due to adverse events such as myalgia and dizziness. Mean baseline IIEF and MoCA scores were 7.52 ± 4.84 and 18.92 ± 1.78. After the eight-week treatment, mean IIEF and MoCA scores were increased to 12.92 ± 7.27 (p < 0.05) and 21.8 ± 1.71 (p < 0.05), respectively. Patients showed increased relative regional CBF in the postcentral gyrus, precuneus, and brainstem after tadalafil administration versus at baseline (p < 0.001). Conclusion The results of this prospective clinical study suggest that daily use of tadalafil 5 mg increases some regional CBF and improves cognitive function in patients with ED and mild cognitive impairment.
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Affiliation(s)
- Jin Bong Choi
- Departments of Urology College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang Jun Cho
- Departments of Urology College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon Chul Kim
- Departments of Urology College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chung Ho Kim
- Departments of Nuclear Medicine The Catholic University of Korea, Seoul, Korea
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeonseok S Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Soo Shim
- Neurology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun Sung Koh
- Departments of Urology College of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Kaup AR, Toomey R, Bangen KJ, Delano-Wood L, Yaffe K, Panizzon MS, Lyons MJ, Franz CE, Kremen WS. Interactive Effect of Traumatic Brain Injury and Psychiatric Symptoms on Cognition among Late Middle-Aged Men: Findings from the Vietnam Era Twin Study of Aging. J Neurotrauma 2019; 36:338-347. [PMID: 29978738 PMCID: PMC6338572 DOI: 10.1089/neu.2018.5695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and depressive symptoms each increase the risk for cognitive impairment in older adults. We investigated whether TBI has long-term associations with cognition in late middle-aged men, and examined the role of current PTSD/depressive symptoms. Participants were 953 men (ages 56-66) from the Vietnam Era Twin Study of Aging (VETSA), who were classified by presence or absence of (1) history of TBI and (2) current elevated psychiatric symptoms (defined as PTSD or depressive symptoms above cutoffs). TBIs had occurred an average of 35 years prior to assessment. Participants completed cognitive testing examining nine domains. In mixed-effects models, we tested the effect of TBI on cognition including for interactions between TBI and elevated psychiatric symptoms. Models adjusted for age, pre-morbid cognitive ability assessed at average age 20 years, apolipoprotein E genotype, and substance abuse; 33% (n = 310) of participants had TBI, mostly mild and remote; and 23% (n = 72) of those with TBI and 18% (n = 117) without TBI had current elevated psychiatric symptoms. TBI and psychiatric symptoms had interactive effects on cognition, particularly executive functioning. Group comparison analyses showed that men with both TBI and psychiatric symptoms demonstrated deficits primarily in executive functioning. Cognition was largely unaffected in men with either risk factor in isolation. Among late middle-aged men, the combination of even mild and very remote TBI with current elevated psychiatric symptoms is associated with deficits in executive function and related abilities. Future longitudinal studies should investigate how TBI and psychiatric factors interact to impact brain aging.
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Affiliation(s)
- Allison R. Kaup
- Research Service, San Francisco VA Health Care System and Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California.,Address correspondence to: Allison R. Kaup, PhD, Research Service, San Francisco VA Health Care System and Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 4150 Clement Street (116B), San Francisco, CA, 94121
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Katherine J. Bangen
- Veterans Affairs San Diego Healthcare System, San Diego, California.,Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Lisa Delano-Wood
- Veterans Affairs San Diego Healthcare System, San Diego, California.,Department of Psychiatry, University of California, San Diego, La Jolla, California.,Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, La Jolla, California
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco and San Francisco VA Health Care System, San Francisco, California
| | - Matthew S. Panizzon
- Veterans Affairs San Diego Healthcare System, San Diego, California.,Department of Psychiatry, University of California, San Diego, La Jolla, California.,Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Carol E. Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, California.,Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California
| | - William S. Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, California.,Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, California
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13
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Stein RA, Schmid K, Bolivar J, Swick AG, Joyal SV, Hirsh SP. Kaempferia parviflora ethanol extract improves self-assessed sexual health in men: a pilot study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 16:249-254. [PMID: 29880257 DOI: 10.1016/j.joim.2018.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 04/25/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sexual health positively correlates with overall wellbeing. Existing therapeutics to enhance male sexual health are limited by factors that include responsiveness, adherence and adverse effects. As the population ages, safe and effective interventions that preserve male sexual function are needed. Published research suggests that various preparations of Kaempferia parviflora, a plant in the Zingiberaceae (ginger) family, support cardiovascular health and may ameliorate erectile function. OBJECTIVE The aim of this study was to examine the effects of KaempMax™, an ethanol extract of the K. parviflora rhizome, on erectile function in healthy middle-aged and older men. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS We conducted an open-label, one-arm study on 14 generally healthy males aged 50-68 years with self-reported mild erectile dysfunction, who were not using prescription treatments. Participants took 100 mg KaempMax™ daily for 30 days. MAIN OUTCOME MEASURES Evaluations were conducted at baseline and on the final study assessment. Primary efficacy analyses included the International Index of Erectile Function (IIEF); secondary efficacy analyses included the Global Assessment Question about erectile function. RESULTS Thirteen participants completed the 30-day study. Supplementation with KaempMax™ resulted in statistically significant improvements in erectile function, intercourse satisfaction and total scores on the IIEF questionnaire. KaempMax™ was well tolerated and exhibited an excellent safety profile. CONCLUSION Our results suggest that KaempMax™ may improve erectile function in healthy middle-aged and older men. While the effects were not as pronounced as what might be seen with prescription medication, most participants found them satisfactory. Additional, longer and placebo-controlled clinical trials will be needed. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT03389867.
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Affiliation(s)
- Richard A Stein
- Life Extension, 3600 West Commercial Blvd, Fort Lauderdale, FL 33309, USA.
| | - Kira Schmid
- Life Extension, 3600 West Commercial Blvd, Fort Lauderdale, FL 33309, USA
| | - Jowell Bolivar
- Life Extension, 3600 West Commercial Blvd, Fort Lauderdale, FL 33309, USA
| | - Andrew G Swick
- Life Extension, 3600 West Commercial Blvd, Fort Lauderdale, FL 33309, USA
| | - Steven V Joyal
- Life Extension, 3600 West Commercial Blvd, Fort Lauderdale, FL 33309, USA
| | - Steven P Hirsh
- Life Extension Clinical Research, Inc., 5990 North Federal Highway, Fort Lauderdale, FL 33308, USA
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14
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Xu X, Chen C, Abdullah AS, Sharma M, Liu H, Zhao Y. Knowledge about and sources of smoking-related knowledge, and influencing factors among male urban secondary school students in Chongqing, China. SPRINGERPLUS 2016; 5:1879. [PMID: 27833838 PMCID: PMC5081986 DOI: 10.1186/s40064-016-3589-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 10/20/2016] [Indexed: 11/14/2022]
Abstract
Objectives This study examined smoking-related knowledge, sources of smoking-related knowledge and its influencing factor among male urban secondary school students. Methods We conducted a cross-sectional survey, using a self-administered questionnaire, among 1297 male secondary school students in municipal areas of Chongqing, China. Results Non-smokers had a better knowledge of smoking hazards than smokers. Less than 20% of students knew that smoking can cause heart disease, peptic ulcer, and cerebral stroke. Sources of smoking-related knowledge differed between smokers and non-smokers, respectively: TV (76.5 vs. 76.7%), teacher (70.1 vs. 62.4%), social network (66.6 vs. 73.1%), parents (57.0 vs. 59.2%), newspaper (55.4 vs. 61.6%), and friends (37.7 vs. 33.9%). Non-smokers’ hobbies of reading were significantly higher than smokers’ (χ2 = 11.5845, p = 0.0007). Smokers’ hobbies of online games (χ2 = 14.9106, p = 0.0001), and sports (χ2 = 4.8609, p = 0.0275) were significantly higher than non-smokers’. Generalized estimating equations (GEE) found that students whose both father and mother smoke were unable to receive tobacco-related knowledge. GEE also found that students in high school, with affluent family economic condition and with an opposing attitude towards father smoking possessed a better smoking-related knowledge. However, male students with disagreement or neutral attitude towards friends smoking were negatively associated with the knowledge of smoking hazards. Conclusions The findings of the present study suggest that a significant proportion of male secondary school students in urban Chongqing lack specific knowledge about smoking-related diseases. Targeted educational programs for secondary school students in China are needed to promote tobacco control and tobacco use reduction and cessation among students.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Cheng Chen
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China ; Xiangya School of Public Health, Central South University, Changsha, 410001 Hunan Province China
| | - Abu S Abdullah
- Global Health Program, Duke Kunshan University, Kunshan, 215347 Jiangsu Province China ; Department of General Internal Medicine, School of Medicine, Boston University Medical Center, Boston, MA 02118 USA
| | - Manoj Sharma
- Behavioral and Environmental Health, Jackson State University, Jackson, MS USA
| | - Hengyi Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
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15
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Hip Fracture in People with Erectile Dysfunction: A Nationwide Population-Based Cohort Study. PLoS One 2016; 11:e0153467. [PMID: 27078254 PMCID: PMC4831780 DOI: 10.1371/journal.pone.0153467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/30/2016] [Indexed: 01/30/2023] Open
Abstract
The aims of this study were to investigate the risk of hip fracture and contributing factors in patients with erectile dysfunction(ED). This population-based study was performed using the Taiwan National Health Insurance Research Database. The analysis included4636 patients aged ≥ 40 years who had been diagnosed with ED (International Classification of Diseases, Ninth Revision, Clinical Modification codes 302.72, 607.84) during 1996–2010. The control group included 18,544 randomly selected age-matched patients without ED (1:4 ratio). The association between ED and hip fracture risk was estimated using a Cox proportional hazard regression model. During the follow-up period, 59 (1.27%) patients in the ED group and 140 (0.75%) patients in the non-ED group developed hip fracture. After adjusting for covariates, the overall incidence of hip fracture was 3.74-times higher in the ED group than in the non-ED group (2.03 vs. 0.50 per 1000 person-years, respectively). The difference in the overall incidence of hip fracture was largest during the 3-year follow-up period (hazard ratio = 7.85; 95% confidence interval = 2.94–20.96; P <0.0001). To the best of our knowledge, this nationwide population-based study is the first to investigate the relationship between ED and subsequent hip fracture in an Asian population. The results showed that ED patients had a higher risk of developing hip fracture. Patients with ED, particularly those aged 40–59 years, should undergo bone mineral density examinations as early as possible and should take measures to reduce the risk of falls.
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16
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Yang CM, Shen YC, Weng SF, Wang JJ, Tien KJ. Increased Risk of Dementia in Patients With Erectile Dysfunction: A Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study. Medicine (Baltimore) 2015; 94:e990. [PMID: 26091478 PMCID: PMC4616558 DOI: 10.1097/md.0000000000000990] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
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.
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Affiliation(s)
- Chun-Ming Yang
- 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)
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