Prevalence of Sexual Dysfunction and Its Association with Depression Among Adults Aged Above 45 Years: A Cross-Sectional Study from a Tertiary Care Centre in Western India

Vishal Shirke, Nilesh Naphade, Jyoti Shetty, Manjiri Datar, Asmita Jagtap
Author(s)
1Junior Resident, Department of Psychiatry, Bharati Vidyapeeth (Deemed to be University) Medical College and Research Centre, Pune, Maharashtra, India. 2Professor and Guide, Department of Psychiatry, Bharati Vidyapeeth (Deemed to be University) Medical College and Research Centre, Pune, Maharashtra, India. 3Professor and Head, Department of Psychiatry, Bharati Vidyapeeth (Deemed to be University) Medical College and Research Centre, Pune, Maharashtra, India. 4Associate Professor, Department of Psychiatry, Bharati Vidyapeeth (Deemed to be University) Medical College and Research Centre, Pune, Maharashtra, India. 5MD Psychiatric, Bharati Vidyapeeth (Deemed to be University) Medical College and Research Centre, Pune, Maharashtra, India.

Abstract

Background: Sexual dysfunction (SD) is common among middle-aged and older adults yet remains under-recognised in clinical practice. Its bidirectional association with depression is well documented in Western literature but poorly characterised in Indian tertiary-care settings. The aim is to estimate the prevalence of SD among adults above 45 years attending a Medicine outpatient department (OPD) and to examine its association with depression. Settings and Designdescriptive cross-sectional study in the Medicine OPD of a tertiary care teaching hospital in western India. Material and Methods: One hundred consenting adults (56 males, 44 females) above 45 years were enrolled. SD was assessed using the Arizona Sexual Experience Scale (ASEX), International Index of Erectile Function (IIEF-15; males) and Female Sexual Function Index (FSFI-19; females); depression using the Hamilton Depression Rating Scale (HDRS-17). Statistical analysis used Chi-square test, Pearson’s correlation and multivariate linear regression (SPSS v25.0); p<0.05 considered significant. Results: SD was present in 67% of participants (males 67.86%, females 65.91%; p=0.838), rising from 45.83% (45–54 years) to 81.25% (≥75 years; p=0.005). Erectile dysfunction was the commonest male dysfunction (92.86%); 81.82% of females met FSFI criteria for SD. Depression was present in 70.15% of those with SD versus 27.27% without (χ²=16.84, OR=6.27, 95% CI 2.48–15.86, p<0.001). ASEX scores correlated with HDRS-17 (r=0.63, p<0.001). SD severity and age were the only independent predictors of HDRS score. Conclusion: SD is highly prevalent among adults above 45 years and strongly associated with depression. Routine structured assessment of sexual health in this age group in Medicine OPD settings is warranted.

Keywords: Arizona Sexual Experience Scale, depression, erectile dysfunction, Female Sexual Function Index, International Index of Erectile Function, sexual dysfunction.

Outline