Centre for Big Data Research in Health, UNSW Sydney, Sydney, New South Wales, Australia.
ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Age Ageing. 2018 Nov 1;47(6):900-904. doi: 10.1093/ageing/afy088.
previous cross-sectional studies have reported bidirectional associations between sexual activity and cognitive function among older people. However, the temporal associations have not been studied.
community-dwelling men aged 70+ from the Concord Health and Ageing in Men Project were assessed. This study was based on 986 men at baseline, 829 men at 2 year and 595 men at 5-year follow-up. Sexual function using a standardised questionnaire (erectile function, sexual activity, sexual satisfaction, sexual desire) was analysed by generalised estimating equations to examine associations between changes in sexual function and changes in mini-mental state examination (MMSE) across three time points over 5 years. Age, BMI, comorbidity, self-rated health, smoking, number of medications, country of birth, education, marital status, depression and reproductive hormones were also measured at all time points.
in unadjusted models, declines in erectile function (β = -0.317) and sexual activity (β = -0.575) over time were statistically significantly associated with a decline in MMSE over time. The associations observed in the unadjusted models remained after adjusting for a range of covariables. Declines in sexual satisfaction and sexual desire over time were not associated with changes in MMSE.
our findings provide evidence of a longitudinal temporal relationship between sexual activity and cognitive function. Further studies are warranted to examine whether maintaining a healthy sexual life has a positive effect on cognitive function in older men.
先前的横断面研究报告称，老年人的性行为与认知功能之间存在双向关联。然而，尚未研究其时间关联。
本研究基于 70 岁以上的社区居民男性，来自 Concord 健康与男性衰老研究项目。该研究最初纳入了 986 名男性，在 2 年和 5 年的随访中分别有 829 名和 595 名男性参与。使用标准化问卷评估性功能（勃起功能、性行为、性满意度、性欲望），采用广义估计方程分析性功能变化与 5 年内 3 个时间点的简易精神状态检查（MMSE）变化之间的关联。所有时间点还测量了年龄、BMI、合并症、自我报告的健康状况、吸烟状况、用药数量、出生地、教育程度、婚姻状况、抑郁和生殖激素。
在未调整模型中，勃起功能（β=-0.317）和性行为（β=-0.575）随时间的下降与 MMSE 随时间的下降具有统计学显著相关性。在调整了一系列协变量后，未调整模型中观察到的关联仍然存在。性满意度和性欲望随时间的下降与 MMSE 的变化无关。
我们的研究结果提供了性行为与认知功能之间存在纵向时间关联的证据。需要进一步的研究来检验在老年男性中保持健康的性生活是否对认知功能有积极影响。
