This study aims to describe the incidence rate of erectile dysfunction (ED) in older men in the Netherlands according to three definitions. The influence of the duration of follow-up on the incidence rate is also explored. In a large community-based follow-up study, 1661 men aged 50-75 y completed the International Continence Society sex questionnaire and a question on sexual activity, at baseline and at a mean of 2.1 and 4.2 y of follow-up. We defined 'ED' as a report of erections with 'reduced rigidity' or worse; 'Significant_ED' as 'severely reduced rigidity' or 'no erections'; and 'Clinically_Relevant_ED' as either 'ED' reported as 'quite a problem' or 'a serious problem', or 'Significant_ED' reported as at least 'a bit of a problem'. Incidence rates of ED status were calculated in those men who completed at least one period of follow-up and were not diagnosed with prostate cancer (n = 1604). For 'ED' the incidence rate (cases per 1000 person-years) is 99 and ranges over the 10-y age groups from 77 (50-59 y) to 205 (70-78 y); for 'Significant_ED' these rates were 33, 21, and 97, respectively and for 'Clinically_Relevant_ED' 28, 25, and 39, respectively. In general, incidence rates should not vary with the duration of follow-up. However, for 'ED' the 4.2 y incidence rate is about 69% of the 2.1 y incidence rate. This study presents incidence rates, for the general population, as well as based on a definition of ED that takes concern/bother into account. 'Clinically_Relevant_ED' has a lower increase in incidence with increasing age than other definitions that do not take concern/bother into account. The phenomenon of lower incidence rates with longer duration of follow-up may account for the differences in reported incidence rates between different studies. The effects of differences related to the duration of follow-up should be taken into consideration in future incidence reports.

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doi.org/10.1038/sj.ijir.3901264, hdl.handle.net/1765/74158
International Journal of Impotence Research
Department of Urology

Schouten, B., Bosch, R., Bernsen, R., Blanker, M., Thomas, S., & Bohnen, A. (2005). Incidence rates of erectile dysfunction in the Dutch general population. Effects of definition, clinical relevance and duration of follow-up in the Krimpen Study. International Journal of Impotence Research, 17(1), 58–62. doi:10.1038/sj.ijir.3901264