Korean J Intern Med.  2020 Sep;35(5):1245-1253. 10.3904/kjim.2019.148.

Sarcopenia is associated with severe erectile dysfunction in older adults: a population-based cohort study

  • 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2Pyeongchang Health Center & Country Hospital, Pyeongchang, Korea
  • 3Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 4Division of Geriatrics, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 5Hinda and Arthur Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
  • 6Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA


Sarcopenia and erectile dysfunction (ED) are associated with poor health and quality of life in older men. We investigate the association between sarcopenia and severe ED in community-dwelling older men.
We prospectively assessed sarcopenia and ED in 519, community-dwelling, older men (mean age, 74.0) in Pyeongchang, Korea, in 2016 to 2017. Sarcopenia was based on muscle mass, grip strength, and gait speed according to the Asian Working Group consensus algorithm. Severe ED was defined as 5-item International Index of Erectile Function questionnaire score under 8. Logistic regressions were used to study associations between incident severe ED and sarcopenia, after adjusting age, cardiovascular risk factors, depression, and polypharmacy.
The prevalence of severe ED was 52.4% and that of sarcopenia was 31.6%.At baseline, the prevalence of severe ED was higher in men with sarcopenia than in those without (73.2% vs. 42.8%; adjusted odds ratio [aOR], 1.89; 95% confidence interval [CI], 1.18 to 3.03; p = 0.008). Slow gait speed (aOR, 2.80; 95% CI, 1.18 to 6.62;p = 0.019) and decreased muscle mass (aOR, 2.54; 95% CI, 1.11 to 5.81; p = 0.027) were associated with the incidence of severe ED, while decreased grip strength (aOR, 0.76; 95% CI, 0.30 to 1.91;p = 0.564) was not.
Sarcopenia was associated with severe ED. Slow gait speed, and decreased muscle mass was independently associated with incident severe ED at 1 year. Further research is warranted to examine whether an intervention targeting these components can prevent severe ED.


Erectile dysfunction; Geriatric assessment; Longitudinal study; Public health practice; Sarcopenia
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