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.
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.
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.
Decreasing sexual health may signal 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.
The Gerontologist. 2022 Oct 04 [Epub ahead of print]
Riki E Slayday, Tyler R Bell, Michael J Lyons, Teresa S Warren, Rosemary Toomey, Richard Vandiver, Martin J Sliwinski, William S Kremen, Carol E Franz
Department of Psychology, San Diego State University, San Diego, CA, USA., Department of Psychiatry, University of California San Diego, La Jolla, CA, USA., Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA., Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.