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Design: Cross-sectional, population-based study seeking data on health, sociodemographic and lifestyle factors by questionnaire the 45 and Up Study.
Main outcome measures: Self-reported ED. Moderate alcohol consumption was associated with a significantly reduced risk of ED in men aged 45—54 years, but not in older men. Conclusions: In a large population-based cross-sectional study, ED increased considerably with age. There are a range of potentially modifiable risk factors for ED, including smoking, low physical activity, and high body mass index.
Erectile dysfunction ED confronts many men as they age. Its causes can be both organic and psychogenic. Men participating in the 45 and Up Study — a population-based cohort study of people aged 45 and over, resident in New South Wales 5 — provided an excellent source for a population-wide description of ED. We hypothesised that the association between lifestyle risk factors and ED may vary according to age. Methods Participants in the 45 and Up Study were randomly sampled from the Medicare enrolment database, with twofold oversampling of men aged 80 years and over and of regional residents.
All residents in remote areas were invited to participate. Statistical analyses The study sample was stratified according to self-report of prostate cancer diagnoses or other diseases Box 3. For subsequent analyses we excluded men who reported ever having had prostate cancer because prostate cancer treatments are known to increase the likelihood of ED. We examined variation in the relation of ED to each lifestyle factor according to age using appropriate interaction terms. In an additional analysis, we restricted sampling to men with no physical limitation ie, those who scored on the MOS-PF to estimate the association between physical activity and ED among men without physical limitations to account for men who were unable to exercise due to illness.
We used SAS version 9. The men who were excluded were significantly older, less likely to be university educated and had lower incomes than included men. Overall, The men with prior prostate cancer comprised 6. These men were excluded from further analyses. Increasing levels of physical activity were associated with decreasing odds of ED. All diseases were significantly associated with ED, except high blood cholesterol level which was associated with ED after adjustment for sociodemographic characteristics, but not after adjustment for all other diseases.
Of the other self-reported diseases examined, men with diabetes had the highest odds of ED, even after taking into account the effects of other diseases. Men who reported treatment for depression or anxiety in the past month also had a high risk of ED, which may be due to the deleterious effect of some antidepressants on erectile function. When we analysed the effects of each of the lifestyle risk factors separately across year age strata, associations with ED were significant for all groups except men aged over 75 years.
Because capacity for physical activity may be an indicator of general good health, we reanalysed the data on a subset of men with no physical limitations, and the association of physical activity and ED remained. Although potential bias in our study cannot be excluded entirely, intervention studies have shown that physical activity improves both erectile and endothelial function.
Like many previous studies, 18 we showed a positive association between smoking and ED, with heavier smokers having higher odds of ED. Former smokers who had quit more than 25 years previously had the same odds of ED as men who had never smoked, and those who quit in the past 5 years had similar odds to current smokers.
These data add to the literature on the health risks of smoking, and reinforce the idea that the threat of ED and perceived sexual inadequacy among younger men could be a powerful tool to motivate them to quit smoking. However, prospective studies have found that alcohol consumption has no effect on the risk of ED. It is in keeping with and expands on previous Australian studies of self-reported ED and lifestyle factors, such as the nationally representative Men in Australia Telephone Survey.
Since the National Institutes of Health consensus conference on ED 20 years ago 7 and the Massachusetts Male Aging Study, which was the first study of this kind, 8 there has been much research on possible causes of and cures for ED. Given that ED may be an early symptom of disease and not just a quality-of-life issue means that health professionals have a crucial role in opening a dialogue about ED with men as they age.
Design: Cross-sectional, population-based study seeking data on health, sociodemographic and lifestyle factors by questionnaire the 45 and Up Study. Main outcome measures: Self-reported ED. Moderate alcohol consumption was associated with a significantly reduced risk of ED in men aged 45—54 years, but not in older men. Conclusions: In a large population-based cross-sectional study, ED increased considerably with age.
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Use of planning obligations and process for changing obligations. Planning obligations What are planning obligations? Planning obligations are legal obligations entered into to mitigate the impacts of a development proposal. This can be via a planning agreement entered into under section of the Town and Country Planning Act by a person with an interest in the land and the local planning authority; or via a unilateral undertaking entered into by a person with an interest in the land without the local planning authority. Planning obligations run with the land, are legally binding and enforceable.