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Tevik K, Skråstad RB, Benth JŠ, Selbæk G, Bergh S, Eldholm RS, Krokstad S, Helvik AS. Prevalence and change in alcohol consumption in older adults over time, assessed with self-report and Phosphatidylethanol 16:0/18:1 -The HUNT Study. PLoS One 2024; 19:e0304714. [PMID: 38820445 PMCID: PMC11142565 DOI: 10.1371/journal.pone.0304714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/16/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Changes in alcohol consumption may affect older adults' health. We examined prevalence and changes in the alcohol consumption of older women and men (≥65 years) in Norway over a 24-year period. METHODS Data from three population-based health surveys (The Trøndelag Health Study-HUNT2 1995-97, HUNT3 2006-08, HUNT4 2017-19) were used. Alcohol consumption was measured using self-reported measures and an objective measure of alcohol consumption (Phosphatidylethanol 16:0/18:1, PEth). Self-reported lifetime abstinence, former drinking, current drinking, frequent drinking (≥4 times/week), and risk drinking (≥8 units/week) were measured. The PEth concentrations were stratified: <0.03 μmol/l (abstinence/very low level of alcohol consumption); >0.06 μmol/l (indicating >1 unit/day); >0.10 μmol/l (indicating >3 units/day), and >0.30 μmol/l (heavy alcohol consumption). RESULTS In HUNT4, the prevalence of self-reported lifetime abstinence, frequent drinking, and risk drinking was 5.2%, 4.4%, and 5.6%, respectively, while prevalence of PEth <0.03 μmol/l was 68.1% and PEth >0.06 μmol/l was 21.2%. Over the course of the three surveys, the prevalence of self-reported lifetime abstinence decreased, while the prevalence of frequent drinking and risk drinking increased. Men were less often abstainers and more often frequent and risky drinkers than women in all three surveys. Gender differences for abstinence and current drinking reduced with time. From HUNT3 to HUNT4, the prevalence of PEth <0.03 μmol/l decreased, while the prevalence of PEth >0.06 μmol/l increased. Men compared to women, had less often PEth <0.03 μmol/l and more often PEth >0.06 and >0.10 μmol/l in HUNT3 and HUNT4. Women and men ≥75 years were just as likely to have PEth >0.30 μmol/l in HUNT4. The gender differences in PEth concentrations were reduced in HUNT4 among those aged 70-74 years or ≥75 years. CONCLUSION Alcohol consumption has increased among Norwegian older adults over a 24-year period, but at a slower pace during the last decade.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Geriatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-Sofie Helvik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Yuan K, Haddad Y, Law R, Shakya I, Haileyesus T, Navon L, Zhang L, Liu Y, Bergen G. Emergency Department Visits for Alcohol-Associated Falls Among Older Adults in the United States, 2011 to 2020. Ann Emerg Med 2023; 82:666-677. [PMID: 37204348 PMCID: PMC10950308 DOI: 10.1016/j.annemergmed.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 05/20/2023]
Abstract
STUDY OBJECTIVE The aim of this study was to examine the epidemiology of alcohol-associated fall injuries among older adults aged ≥65 years in the United States. METHODS We included emergency department (ED) visits for unintentional fall injuries by adults from the National Electronic Injury Surveillance System-All Injury Program during 2011 to 2020. We estimated the annual national rate of ED visits for alcohol-associated falls and the proportion of these falls among older adults' fall-related ED visits using demographic and clinical characteristics. Joinpoint regression was performed to examine trends in alcohol-associated ED fall visits between 2011 and 2019 among older adult age subgroups and to compare these trends with those of younger adults. RESULTS There were 9,657 (weighted national estimate: 618,099) ED visits for alcohol-associated falls, representing 2.2% of ED fall visits during 2011 to 2020 among older adults. The proportion of fall-related ED visits that were alcohol-associated was higher among men than among women (adjusted prevalence ratio [aPR]=3.6, 95% confidence interval [CI] 2.9 to 4.5). The head and face were the most commonly injured body parts, and internal injury was the most common diagnosis for alcohol-associated falls. From 2011 to 2019, the annual rate of ED visits for alcohol-associated falls increased (annual percent change 7.5, 95% CI 6.1 to 8.9) among older adults. Adults aged 55 to 64 years had a similar increase; a sustained increase was not detected in younger age groups. CONCLUSION Our findings highlight the rising rates of ED visits for alcohol-associated falls among older adults during the study period. Health care providers in the ED can screen older adults for fall risk and assess for modifiable risk factors such as alcohol use to help identify those who could benefit from interventions to reduce their risk.
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Affiliation(s)
- Keming Yuan
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Yara Haddad
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Royal Law
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Iju Shakya
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Tadesse Haileyesus
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Livia Navon
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lei Zhang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Yang Liu
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gwen Bergen
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
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Alcohol Use in Older Adults: A Systematic Review of Biopsychosocial Factors, Screening Tools, and Treatment Options. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00974-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Patterns of Alcohol Consumption and Associated Factors in a Population-Based Sample of 70-Year-Olds: Data from the Gothenburg H70 Birth Cohort Study 2014-16. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148248. [PMID: 35886099 PMCID: PMC9324895 DOI: 10.3390/ijerph19148248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/18/2022]
Abstract
Older adults of today consume more alcohol, yet knowledge about the factors associated with different consumption levels is limited in this age group. Based on the data from a population-based sample (n = 1156, 539 men and 617 women) in The Gothenburg H70 Birth Cohort Study 2014−16, we examined sociodemographic, social, and health-related factors associated with alcohol consumption levels in 70-year-olds, using logistic regression. Total weekly alcohol intake was calculated based on the self-reported amount of alcohol consumed. Alcohol consumption was categorized as lifetime abstention, former drinking, moderate consumption (≤98 g/week), and at-risk consumption (>98 g/week). At-risk consumption was further categorized into lower at-risk (98−196 g/week), medium at-risk (196−350 g/week), and higher at-risk (≥350 g/week). We found that among the 1156 participants, 3% were lifetime abstainers, 3% were former drinkers, 64% were moderate drinkers, and 30% were at-risk drinkers (20% lower, 8% medium, 2% higher). Among several factors, former drinking was associated with worse general self-rated health (OR 1.65, 95% CI 1.08−2.51) and lower health-related quality of life (measured by physical component score) (OR 0.94, 95% CI 0.91−0.97), higher illness burden (OR 1.16, 95% CI 1.07−1.27), and weaker grip strength (OR 0.96, 95% CI 0.94−0.98). Higher at-risk drinkers more often had liver disease (OR 11.41, 95% CI 3.48−37.37) and minor depression (OR 4.57, 95% CI 1.40−14.95), but less contacts with health care (OR 0.32, 95% CI 0.11−0.92). Our findings demonstrate the importance of classifications beyond abstinence and at-risk consumption, with implications for both the prevention and clinical management of unhealthy consumption patterns in older adults.
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Castellanos-Perilla N, Borda MG, Cataño S, Giraldo S, Vik-Mo AO, Aarsland D, Rao RT. Specific depressive symptoms are related with different patterns of alcohol use in community-dwelling older adults. Arch Gerontol Geriatr 2022; 101:104696. [DOI: 10.1016/j.archger.2022.104696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/01/2022]
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Ellins EA, Harris DE, Lacey A, Akbari A, Torabi F, Smith D, Jenkins G, Obaid D, Chase A, John A, Gravenor MB, Halcox JP. Achievement of European Society of Cardiology/European Atherosclerosis Society lipid targets in very high-risk patients: Influence of depression and sex. PLoS One 2022; 17:e0264529. [PMID: 35213664 PMCID: PMC8880762 DOI: 10.1371/journal.pone.0264529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/11/2022] [Indexed: 12/03/2022] Open
Abstract
AIMS To explore differences in the use of lipid lowering therapy and/or achievement of lipid guideline targets in patients with and without prior depression and influence of sex in very high-risk coronary patients. METHODS & FINDINGS A retrospective observational cohort study was conducted using individual-level linked electronic health record data in patients who underwent percutaneous coronary intervention (2012-2017) in Wales. The cohort comprised of 13,781 patients (27.4% female), with 26.1% having prior depression. Lipid levels were recorded in 10,050 patients of whom 25% had depression. History of depression was independently associated with not having lipids checked (OR 0.79 95%CI 0.72-0.87 p<0.001). Patients with prior depression were less likely to achieve targets for low density lipoprotein cholesterol (LDL-C <1.8mmol/l), non-high density lipoprotein cholesterol (non-HDL-C <2.6mmol/l) and triglycerides (<2.3mmol/l) than patients without depression (OR 0.86 95%CI 0.78-0.96 p = 0.007, OR 0.80 95%CI 0.69-0.92 p = 0.003 & OR 0.69 95CI% 0.61-0.79 p<0.001 respectively). Females were less likely to achieve targets for LDL-C and non-HDL-C than males (OR 0.55 95%CI 0.50-0.61 p<0.001 & OR 0.63 95%CI 0.55-0.73 p<0.001). There was an additive effect of depression and sex; females with depression were not only least likely to be tested (OR 0.74 95%CI 0.65-0.84 p<0.001) but also (where levels were known) less likely to achieve LDL-C (OR 0.47 95%CI 0.41-0.55 p<0.001) and non-HDL-C targets (OR 0.50 95%CI 0.41-0.60 p<0.001). It was not possible to look at the influence of medication adherence on achievement of lipid targets due to limitations of the use of anonymised routinely-held clinical care data. CONCLUSION Patients with prior depression were less likely to have their lipids monitored and achieve guideline targets within 1-year. Females with depression are the least likely to be tested and achieve lipid targets, suggesting not only a greater risk of future events, but also an opportunity to improve care.
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Affiliation(s)
| | - Daniel E. Harris
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Swansea Bay University Health Board, Port Talbot, United Kingdom
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Arron Lacey
- Swansea University Medical School, Singleton, Swansea, United Kingdom
| | - Ashley Akbari
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Fatemeh Torabi
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
| | - Dave Smith
- Swansea Bay University Health Board, Port Talbot, United Kingdom
| | - Geraint Jenkins
- Swansea Bay University Health Board, Port Talbot, United Kingdom
| | - Daniel Obaid
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Swansea Bay University Health Board, Port Talbot, United Kingdom
| | - Alex Chase
- Swansea Bay University Health Board, Port Talbot, United Kingdom
| | - Ann John
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
- Public Health Wales NHS Trust, Cardiff, United Kingdom
| | | | - Julian P. Halcox
- Swansea University Medical School, Singleton, Swansea, United Kingdom
- Swansea Bay University Health Board, Port Talbot, United Kingdom
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
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Ayalew M, Deribe B, Hussen S, Defar S, Gedefaw A. Quality of life among patients with chronic non-communicable diseases during COVID-19 pandemic in Southern Ethiopia: A cross-sectional analytical study. Front Psychiatry 2022; 13:855016. [PMID: 36213918 PMCID: PMC9532738 DOI: 10.3389/fpsyt.2022.855016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak became a continuing global health agenda. It has a significant impact on individuals' quality of life (QOL). Patients with preexisting medical conditions may have severely reduced QOL. The aim of this study was to assess QOL and its associated factors among patients with chronic non-communicable diseases (NCDs) during COVID-19 pandemic at Sidama Regional State, southern Ethiopia. METHODS We conducted a multicenter, cross-sectional study from 1 June to 1 September 2021. A total of 633 participants took part in the study, using an interviewer-administered structured questionnaire. The QOL was measured using the World Health Organization Quality of Life (WHOQOL-BREF) Scale, which has 12 items. To describe different variables, descriptive statistics were employed. To find independent factors associated with QOL, we used multivariable linear regression analysis. P-value of < 0.05 was declared statistically significant at 95% confidence interval (CI). RESULTS The majority (56.4%) of participants were male and about half (53.1%) had a diagnosis of diabetes mellitus. The multivariable linear regression model showed statistically significant negative association between different independent variables such as age (β = -0.188, 95% CI = -0.238 to -0.139), being female (β = -1.942, 95% CI = -3.237 to -0.647), duration of illness ≤ 5 years (β = -4.222, 95% CI = -6.358 to -2.087), alcohol use in the past 3 months (β = -4.574, 95% CI = -6.905 to -2.243), common mental disorder (CMD) (β = -1.512, 95% CI = -2.924 to -0.100), insomnia (β = -0.274, 95% CI = -0.380 to -0.168), and QOL. Also, there is a statistically significant positive association between QOL and being illiterate (β = 3.919, 95% CI = 1.998-5.841) and living in the rural area (β = 2.616, 95% CI = 1.242-3.990). CONCLUSION In general, the findings confirmed that the COVID-19 pandemic had a negative impact on patients with chronic NCDs QOL. The QOL was significantly influenced by age, gender, educational status, residence area, duration of illness, alcohol use, CMD, and insomnia during COVID-19 pandemic. Thus, this study suggests that addressing insomnia, co-morbidities of mental disorders, and alcohol use has the potential effect to improve the QOL of patients with chronic medical illnesses.
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Affiliation(s)
- Mohammed Ayalew
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Siraj Hussen
- School of Medical Laboratory, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Semira Defar
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Abel Gedefaw
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Qiu Y, Lv X, Wu T, Zhang Y, Wang H, Li B, Yu X. Prevalence and Correlates of Risky Drinking Among the Oldest-Old in China: A National Community-Based Survey. Front Psychiatry 2022; 13:919888. [PMID: 35711592 PMCID: PMC9195865 DOI: 10.3389/fpsyt.2022.919888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
AIMS To investigate the prevalence and correlates of risky drinking in Chinese elderly people aged 80 and over. METHODS Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2018. A total of 10,141 respondents aged 80 years or older were included in this analysis. Risky drinking was defined as drinking > 2 drinks per day. The participants were divided into no risky drinking, past risky drinking, and current risky drinking groups. The prevalence of risky drinking, daily dosage, and type of alcohol beverages were assessed. The correlates of risky drinking were analyzed using logistic regression. RESULTS The prevalence of past and current risky drinking was 6.2 and 4.4%, respectively. A total of 12.2% of males and 2.1% of females reported past risky drinking, and 8.9% of males and 1.4% of females reported current risky drinking. The median of the daily dosage of the past risky drinking group was 4.5 and 4 drinks in males and females, respectively, and were 4 and 3.3, respectively, of the current risky drinking group. Strong liquor was the most popular alcohol beverage in all groups. Men who were older or had white-collar work were less likely to be past risky drinkers, while those with smoking in past or current or heart disease were more likely to be past risky drinkers. Women who smoked in the past were more likely to be past risky drinkers. Men with older age or living in the urban areas or with heart disease were less likely to be current risky drinkers. Women with higher education or with heart disease were less likely to be current risky drinkers. Women with current smoking were more likely to have current risky drinking. CONCLUSIONS Our findings indicated that risky drinking among the oldest-old was not rare in China. The correlates of past and current risky drinking were different. Men and women had various correlates of risky drinking as well. Those with higher socioeconomic status seemed less likely to be risky drinking. More attention should be given to risky drinking among the oldest old, and sex-specific intervention may be needed.
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Affiliation(s)
- Yujia Qiu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Tingfang Wu
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ying Zhang
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Huali Wang
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Bing Li
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xin Yu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
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Cheng Y, Thorpe L, Kabir R, Lim HJ. Latent class growth modeling of depression and anxiety in older adults: an 8-year follow-up of a population-based study. BMC Geriatr 2021; 21:550. [PMID: 34645416 PMCID: PMC8515663 DOI: 10.1186/s12877-021-02501-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions. AIMS This study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics. METHODS Group-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups. RESULTS Four trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into "low-flat (87.0%)", "low-to-middle (8.8%)", "low-to-high (1.3%)" and "high-stable (2.8%)" trajectory groups. Anxiety outcome fell into "low-flat (92.5%)", "low-to-middle (4.7%)", "high-to-low (2.2%)" and "high-curve (0.6%)" trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have "high-to-low" or "high-curved" anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety. CONCLUSIONS Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.
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Affiliation(s)
- Yanzhao Cheng
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Lilian Thorpe
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N2Z4, Canada
| | - Rasel Kabir
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Hyun Ja Lim
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada. .,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N2Z4, Canada.
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Yockey RA. Binge drinking among Hispanic older adults: 2015-2019. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:471-479. [PMID: 33779511 DOI: 10.1080/01634372.2021.1905128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
Previous research has shown that older adults (i.e., individuals 50 years or older) show a high propensity to report unhealthy alcohol habits. Much is to be gleaned regarding these relationships among Hispanic older adults. The purpose of the present study was to examine correlates to binge drinking among a national sample of Hispanic older adults. Pooled data from the 2015-2019 National Survey on Drug Use and Health were analyzed among 4,152 Hispanic individuals. Findings revealed that a sizable percentage (17.9%) of individuals reported binge drinking in the past 30 days. Of the sample, 15.1% of individuals diagnosed with diabetes reported binge drinking and high co-morbid substance use was found. Findings can address critical gaps in Hispanic health care, prevention messaging, and harm reduction.
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Affiliation(s)
- R Andrew Yockey
- School of Human Services, University of Cincinnati, Cincinnati, United States
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Farmer AY, Wang Y, Peterson NA, Borys S, Hallcom DK. Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis. J Gerontol B Psychol Sci Soc Sci 2021; 77:919-929. [PMID: 33959768 DOI: 10.1093/geronb/gbab078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine substance use among older adults based upon their social isolation and loneliness profiles. METHODS Data were derived from the New Jersey Older Adult Survey on Drug Use and Health (OASDUH). Latent profile Analysis (LPA) was used to determine the profiles of older adults (N = 801) based on five dimensions of social isolation and loneliness. Logistic and generalized ordered logistic regressions were conducted to assess the relationship between the latent profiles and substance use. RESULTS LPA identified five social isolation/loneliness profiles. The "connected and active" group had the lowest odds of cigarette use. The "alone but not lonely" group had the highest odds of cigarette use, alcohol use, and high-risk drinking. The "alone and lonely" group had the highest odds of non-medical drug use. DISCUSSION In working with older adults who are using substances, it is important to inquire about their social isolation and loneliness. Cognitive behavioral therapy for the "alone and lonely" group may be beneficial, as it has been deemed effective in reducing loneliness and enhancing social network.
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Affiliation(s)
- Antoinette Y Farmer
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Yuqi Wang
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - N Andrew Peterson
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Suzanne Borys
- Assistant Division Director, Office of Planning, Research, Evaluation, and Prevention, Division of Mental Health and Addiction Services, 120 South Stockton Street, P.O, Box 362, Trenton, New Jersey
| | - Donald K Hallcom
- Director of Prevention and Early Intervention, New Jersey Department of Health, Division of Mental Health and Addiction Services, 120 South Stockton Street, PO Box 362, Trenton, NJ
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12
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Olickal JJ, Saya GK, Selvaraj R, Chinnakali P. Association of alcohol use with quality of life (QoL): A community based study from Puducherry, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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13
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van Gils Y, Franck E, Dierckx E, van Alphen SPJ, Dom G. The Role of Psychological Distress in the Relationship between Drinking Motives and Hazardous Drinking in Older Adults. Eur Addict Res 2021; 27:33-41. [PMID: 32434195 DOI: 10.1159/000507664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/02/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Drinking motives seem to be the most proximal predictors of alcohol outcomes. Consequently, these are an essential factor to consider as they may influence the extent to which alcohol is used in a risky way, even in older adults. OBJECTIVE We studied the moderating effect of distress on the relationship between drinking motives and drinking behaviour in a community-dwelling older adult sample. METHOD In a retrospective cross-sectional research study, participants were community-dwelling older adults aged 65 years and older. All respondents completed a questionnaire covering the Drinking Motives Questionnaire (DMQ), the Alcohol Use Disorders Identification Test (AUDIT), and the General Severity Index (GSI) of the Brief Symptom Inventory (BSI). RESULTS In this sample of 1,148 older adults, drinking motives and hazardous alcohol use were associated (enhancement motives r = 0.478, p < 0.001; coping motives r = 0.367, p < 0.001; and social motives r = 0.235, p < 0.001). Furthermore, moderation analysis showed that older adults drinking predominantly for enhancement or coping motives (respectively, β = 0.433, CI [95%] = 2.557-3.222 and β = 0.327, CI [95%] = 1.077-1.491, p < 0.001), and older adults who had higher levels of psychological distress (β = 2.518, CI [95%] = 2.017-3.019, p < 0.001) were more likely to report higher degree of hazardous alcohol use. CONCLUSION The relations between coping drinking motives and enhancement drinking motives on hazardous drinking depended on the level of distress. The associations between drinking for coping and drinking for enhancement were stronger in high levels of distress. Although causality cannot be interpreted from cross-sectional data, tackling psychological distress and drinking to cope with negative affect or to enhance positive affect might have strong effects on reducing hazardous drinking behaviour among older adults.
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Affiliation(s)
- Yannic van Gils
- Faculty of Medicine and Social Science, University of Antwerp, Wilrijk, Belgium, .,Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium,
| | - Erik Franck
- Faculty of Medicine and Social Science, University of Antwerp, Wilrijk, Belgium
| | - Eva Dierckx
- Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium.,Alexianen Zorggroep Tienen, Psychiatric Hospital, Tienen, Belgium
| | - Sebastiaan P J van Alphen
- Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium.,Clinical Centre of Excellence for Personality Disorders in Older Adults, Mondriaan Hospital, Heerlen-Maastricht, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Geert Dom
- Alexianen Zorggroep Multiversum, Psychiatric Hospital, Boechout, Belgium.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
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14
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Park JE, Hong JP, Jeon HJ, Seong SJ, Sohn JH, Ha TH, Lee DW, Park JI, Cho SJ, Chang SM, Kim BS, Suk HW, Cho MJ, Hahm BJ. Age-related differences in the associations among at-risk drinking, alcohol use disorder, and psychological distress across the adult lifespan: a nationwide representative study in South Korea. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1335-1344. [PMID: 32052102 DOI: 10.1007/s00127-020-01845-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 02/03/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate age-related differences in the relationships among at-risk alcohol consumption, alcohol use disorder (AUD), and psychological distress with a special focus on older adults. METHODS We used a nationwide cross-sectional study of a representative sample of community-dwelling adults from the Korean Epidemiologic Catchment Area study for psychiatric disorders conducted by door-to-door interviews. The Korean version of the Composite International Diagnostic Interview was applied. Subjects were categorized into four age groups: young-to-middle-aged (20-54 years), near-old (55-64 years), early-old (65-74 years), and late-old (≥ 75 years). The associations among at-risk drinking, alcohol use disorder, and psychological distress were examined according to age groups. RESULTS Among a total of 5102 individuals, half of them drank alcohol in the previous year, of whom 20.5% were at-risk drinkers (≥ 100 g/week). Older people were less often diagnosed with AUD than young-to-middle-aged adults with a similar degree of at-risk drinking. They were less likely to meet the DSM-5 AUD criteria in terms of social and vocational role disruption or creation of a physically hazardous situation. However, at-risk drinking showed a stronger association with subjective psychological distress in older adults, particularly in the near-old group (adjusted odds ratio 1.82, 95% confidence interval 1.09-3.03; p = 0.023). CONCLUSIONS These findings indicate the importance of screening for mental health problems in older adults, especially near-old adults, who drink more than 100 g of alcohol per week even when they do not satisfy the criteria for a diagnosis of AUD.
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Affiliation(s)
- Jee Eun Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Su Jeong Seong
- Department of Psychiatry, Hallym University Medical Center, Seoul, South Korea
| | - Jee Hoon Sohn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Dong-Woo Lee
- Department of Psychiatry, Inje University College of Medicine, Seoul, South Korea
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon Medical School, Incheon, South Korea
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Byung-Soo Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hye Won Suk
- Department of Psychology, Sogang University, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea
| | - Bong-Jin Hahm
- Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
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15
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Predictors of Alcohol Use in Safety-Net Primary Care: Classism, Religiosity, and Race. JOURNAL OF ADDICTION 2020; 2020:5916318. [PMID: 32612865 PMCID: PMC7317315 DOI: 10.1155/2020/5916318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 04/07/2020] [Accepted: 05/27/2020] [Indexed: 11/18/2022]
Abstract
Class-based discrimination may impact problematic drinking in low-income populations, which may be buffered by personal religiosity. However, little is known how race may impact this association. The purpose of this study was to examine racial differences in the effect of class-based discrimination on problematic drinking as moderated by comfort with God and determine if there were conditional direct effects of class-based discrimination on problematic drinking by race. In this cross-sectional study, participants (N = 189) were patients of an urban, safety-net primary care clinic who completed questionnaires assessing experiences of class-based discrimination, attitudes toward God, and alcohol use. Data were collected from 2015 to 2016 and analyzed using the Hayes PROCESS macro. There was a significant main effect for class-based discrimination predicting problematic drinking. Two-way interaction analyses identified a significant comfort with God by race interaction with greater comfort with God associated with less problematic drinking among white but not black respondents. Conditional direct effects showed that experiences of class-based discrimination were associated with problematic drinking at low and moderate but not high levels of comfort with God in black participants, whereas none were observed for white participants. This study provides insight on how personal religiosity, class-based discrimination, and race may intertwine to shape problematic alcohol use in primarily low-income, urban patients. Clinicians' awareness of risk and protective factors, as well as how race tempers the effects of such factors, is vital in providing better care for this population.
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16
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Kuiper JS, Smidt N, Zuidema SU, Comijs HC, Oude Voshaar RC, Zuidersma M. A longitudinal study of the impact of social network size and loneliness on cognitive performance in depressed older adults. Aging Ment Health 2020; 24:889-897. [PMID: 30729792 DOI: 10.1080/13607863.2019.1571012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: To examine the association of social network size and loneliness with cognitive performance and -decline in depressed older adults.Method: A sample of 378 older adults [70.7 (7.4) years] with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of current depressive disorder were recruited from primary care and specialized mental health care. Cognitive performance was assessed at baseline and 2 years follow-up with the Stroop colored-word test, a modified version of the Auditory Verbal Learning Task and the Digit Span subtest from the Wechsler Adult Intelligence Scale, encompassing four cognitive domains; processing speed, interference control, memory, and working memory. Social network size was assessed with the Close Person Inventory and loneliness with the de Jong Gierveld Loneliness Scale at baseline.Results: After adjusting for baseline working memory performance, loneliness was associated with impaired working memory after 2 years [B = -0.08 (-0.17 to 0.00)]. This association was no longer significant after adjusting for age, sex, education level, physical activity, alcohol use and depressive symptom severity [B = -0.07 (-0.16 to 0.03)]. A backward elimination procedure revealed education level to be the only covariable to explain this association. Loneliness was not associated with impairments or decline in other cognitive domains. Social network size was not associated with cognitive impairments or decline.Conclusion: Social network size and loneliness do not predict cognitive decline in depressed older adults.
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Affiliation(s)
- Jisca S Kuiper
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Examining the Association Between Alcohol Consumption and Health Conditions in Community Dwelling Older Adults. J Community Health 2020; 46:51-63. [PMID: 32436045 DOI: 10.1007/s10900-020-00842-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Canadian low-risk drinking guidelines were developed for adults, however, the applicability to older adults was not considered in the development of the guidelines. The objectives of this study were to: (1) to examine alcohol use in community dwelling older males and females using the current Canadian guidelines; (2) to test lower limits of alcohol use on various health factors; and (3) to determine health factors associated with high-risk drinking in older males and females. Data on community dwelling older adults (aged 65 +) was used from the Canadian Injury Prevention Survey (n = 2274). Descriptive statistics and comparative analysis were used to compare alcohol consumption categories. Logistic regressions were performed to examine the relationships between health factors and alcohol consumption categories. 70% of the sample reported having at least one drink per week; 4.5% of males and 6.8% of females were high-risk drinkers according to the current guidelines. There were no significant associations between the current alcohol categories with demographics, behavioral risk factors or health conditions. Using the new guidelines, 21% of males and females were classified as high-risk drinkers, respectively. Diabetes and having an illness or disability before retirement was protective of high-risk drinking in males while having diabetes and poorer physical health was protective of high-risk drinking in females. The prevalence of high-risk drinkers is dependent on what alcohol classifications are used. Further studies are needed to determine the causal relationships between health-related factors and alcohol using standardized definitions of alcohol consumption.
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18
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Guertler D, Moehring A, Krause K, Batra A, Eck S, Freyer-Adam J, Ulbricht S, Rumpf HJ, Bischof G, John U, Meyer C. Copattern of depression and alcohol use in medical care patients: cross-sectional study in Germany. BMJ Open 2020; 10:e032826. [PMID: 32381533 PMCID: PMC7223144 DOI: 10.1136/bmjopen-2019-032826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To predict depressive symptom severity and presence of major depression along the full alcohol use continuum. DESIGN Cross-sectional study. SETTING Ambulatory practices and general hospitals from three sites in Germany. PARTICIPANTS Consecutive patients aged 18-64 years were proactively approached for an anonymous health screening (participation rate=87%, N=12 828). Four continuous alcohol use measures were derived from an expanded Alcohol Use Disorder Identification Test (AUDIT): alcohol consumption in grams per day and occasion, excessive consumption in days per months and the AUDIT sum score. Depressive symptoms were assessed for the worst 2-week period in the last 12 months using the Patient Health Questionnaire (PHQ-8). Negative binomial and logistic regression analyses were used to predict depressive symptom severity (PHQ-8 sum score) and presence of major depression (PHQ-8 sum score≥10) by the alcohol use measures. RESULTS Analyses revealed that depressive symptom severity and presence of major depression were significantly predicted by all alcohol use measures after controlling for sociodemographics and health behaviours (p<0.05). The relationships were curvilinear: lowest depressive symptom severity and odds of major depression were found for alcohol consumptions of 1.1 g/day, 10.5 g/occasion, 1 excessive consumption day/month, and those with an AUDIT score of 2. Higher depressive symptom severity and odds of major depression were found for both abstinence from and higher levels of alcohol consumption. Interaction analyses revealed steeper risk increases in women and younger individuals for most alcohol use measures. CONCLUSION Findings indicate that alcohol use and depression in medical care patients are associated in a curvilinear manner and that moderation by gender and age is present.
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Affiliation(s)
- Diana Guertler
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Anne Moehring
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Kristian Krause
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Sandra Eck
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Jennis Freyer-Adam
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Institute of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Sabina Ulbricht
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Ulrich John
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Christian Meyer
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
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19
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Davison KM, Lin S(L, Tong H, Kobayashi KM, Mora-Almanza JG, Fuller-Thomson E. Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051493. [PMID: 32110904 PMCID: PMC7084187 DOI: 10.3390/ijerph17051493] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
The main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010–2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45–65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67–0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79–3.52), being a woman (aOR = 1.25, 95% CI: 1.07–1.46), single status (aOR = 1.27, 95% CI: 1.09–1.48), lower income (aORs = 1.28–2.68), multi-morbidities (aORs = 2.73–5.13), chronic pain (aOR = 1.31, 95% CI: 1.18–1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23–1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20–2.92), body fat ≥ 26% (aORs = 1.28–1.79), fruit and vegetable intake (<3/day; aORs = 1.24–1.26), and pastry consumption (>1/day; aOR = 1.55, 95% CI: 1.12–1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.
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Affiliation(s)
- Karen M. Davison
- Health Science, Kwantlen Polytechnic University, Surrey, BC V3W 2M8, Canada;
- Department of Psychology, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA
- Correspondence: ; Tel.: +1-604-300-0331
| | - Shen (Lamson) Lin
- Factor-Inwentash Faculty of Social Work and Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada (E.F.-T.)
| | - Hongmei Tong
- Faculty of Health and Community Studies, MacEwan University; Edmonton, AB T5J 4S2, Canada;
| | - Karen M. Kobayashi
- Department of Sociology, University of Victoria; Victoria, BC V8W 2Y2, Canada;
| | | | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work and Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada (E.F.-T.)
- Department of Family & Community Medicine and Faculty of Nursing, University of Toronto, Toronto, ON M5G 1V7 & M5T 1P8, Canada
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20
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Noronha BP, Nascimento-Souza MA, Lima-Costa MF, Peixoto SV. [Alcohol consumption patterns and associated factors among elderly Brazilians: National Health Survey (2013)]. CIENCIA & SAUDE COLETIVA 2019; 24:4171-4180. [PMID: 31664390 DOI: 10.1590/1413-812320182411.32652017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/28/2018] [Indexed: 05/30/2023] Open
Abstract
The scope of this study was to analyze the pattern of alcohol consumption among elderly Brazilians (60 years and over) and their association with sociodemographic factors, lifestyle habits and health conditions. This is a cross-sectional study of 10,537 elderly (90.1%) participants from the National Health Survey of 2013. The consumption of alcoholic beverages was classified as non-use, mild / moderate use and risk use. The multinomial regression model was used to study the associated factors. The prevalence for mild / moderate and risk use was 9.4% (95% CI: 8.4- 10.6%) and 4.6% (95%CI: 4.0-5.3%), respectively. The two consumption patterns were inversely associated with age and more frequent among men, better schooling, smokers and physical activity practitioners. Mild / moderate consumption was less frequent among non-whites and those with a history of stroke and diabetes, whereas risk use was less frequent among the elderly diagnosed for heart disease and more frequent among those suffering from depression. This result identifies profiles of greater vulnerability, with small differences between two patterns of consumption. This information should be considered in the preparation of proposals to promote healthy habits and control of alcohol use among the elderly.
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Affiliation(s)
- Beatriz Prado Noronha
- Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002. Belo Horizonte, MG, Brasil.
| | - Mary Anne Nascimento-Souza
- Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002. Belo Horizonte, MG, Brasil.
| | - Maria Fernanda Lima-Costa
- Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002. Belo Horizonte, MG, Brasil.
| | - Sérgio Viana Peixoto
- Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002. Belo Horizonte, MG, Brasil.
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Solomon CA, Laditka SB, Forthofer M, Racine EF. Alcohol consumption among older women in the United States. J Women Aging 2019; 33:100-117. [PMID: 31657279 DOI: 10.1080/08952841.2019.1684176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Few studies have examined alcohol consumption among older women. Using the nationally representative National Survey on Drug Use and Health, we examined binge, moderate, and no alcohol consumption among women ages 50+ (n = 21,178). We calculated population prevalence by age and used multivariate logistic regression, controlling for seven sociodemographic factors. In adjusted results, women ages 65+ were more likely to have moderate or no alcohol consumption than those 50-64; Hispanic and African American women were more likely to engage in binge consumption than whites (all p < .01). More research is needed to understand binge alcohol consumption among older women in racial/ethnic minorities.
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Affiliation(s)
- Corliss A Solomon
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - Melinda Forthofer
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - Elizabeth F Racine
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
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Substance misuse in later life: challenges for primary care: a review of policy and evidence. Prim Health Care Res Dev 2019; 20:e117. [PMID: 32799962 PMCID: PMC6650788 DOI: 10.1017/s1463423618000440] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Substance misuse in older people represents a growing clinical and public health problem within primary care. AIM The aim of article is to explore policy and research evidence for informing best practice in the assessment, treatment effectiveness, treatment implementation and approaches to recovery for older people with substance misuse in primary care. METHODS Relevant search terms were used to examine the databases MEDLINE, EMBASE, CINAHL and PsychINFO up to January 2016. RESULTS An age-sensitive approach is required to overcome barriers to assessment. Training is essential for developing relevant knowledge, skills and attitudes. Clinical audit be used to develop care pathways, particularly for older people with dual diagnosis. There is also a need to develop closer links between primary care and the secondary care specialties, as well as added value in working with carers and voluntary agencies. DISCUSSION Further research is needed to inform more effective approaches to treatment. Adequate funding for workforce development and quality improvement in service development are also essential to improve health outcomes and quality of life in older people with substance misuse.
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men - the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study. BMC Geriatr 2019; 19:113. [PMID: 30999872 PMCID: PMC6472008 DOI: 10.1186/s12877-019-1114-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/24/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Little is known about factors associated with alcohol consumption and use of drugs with addiction potential in older adults. The aim of this study was to explore the association between socio-demographic variables, physical and mental health and the later (11 years) use of frequent drinking, prescribed drugs with addiction potential and the possible combination of frequent drinking and being prescribed drugs with addiction potential in older adults (≥ 65 years). METHODS In this longitudinal study, we used data from two surveys of the Nord-Trøndelag Health Study (HUNT2 1995-1997 and HUNT3 2006-2008), a population based study in Norway. We totally included 10,656 individuals (5683 women) aged 54 years and older when they participated in HUNT2. Frequent drinking was defined as drinking alcohol 4 days or more per week. Data on prescribed drugs with addiction potential were drawn from the Norwegian Prescription Database. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. RESULTS The typical frequent drinker in HUNT3 was younger, more educated, lived in urban areas, and reported smoking and drinking frequently in HUNT2 compared to the non-frequent drinker in HUNT3. The typical user of prescribed drugs with addiction potential in HUNT3 was an older woman who smoked and was in poor health, suffered from anxiety, had been hospitalized in the last 5 years and used anxiety or sleep medication every week or more often in HUNT2. The typical individual in HUNT3 with the possible combination of frequent drinking and being prescribed drugs with addiction potential had more education, smoked, drank frequently and used anxiety or sleep medication in HUNT2. CONCLUSION Individuals who were identified as frequent drinkers in HUNT2 were more likely to be frequent drinkers in HUNT3, and to have the possible combination of frequent drinking and being prescribed drugs with addiction potential in HUNT3. Health care professionals need to be aware of use of alcohol among older adults using drugs with addiction potential.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Mortality in older adults with frequent alcohol consumption and use of drugs with addiction potential - The Nord Trøndelag Health Study 2006-2008 (HUNT3), Norway, a population-based study. PLoS One 2019; 14:e0214813. [PMID: 30990815 PMCID: PMC6467384 DOI: 10.1371/journal.pone.0214813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate whether frequent drinking, use of drugs with addiction potential and the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older adults. Methods We used data from the Nord-Trøndelag Health Study (HUNT3 2006–08), a population-based study in Norway. A total of 11,545 (6,084 women) individuals 65 years and older at baseline participated. We assessed frequent drinking (≥ 4 days a week), occasional drinking (i.e. a few times a year), never drinking and non-drinking in the last year. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. This information was drawn from the Norwegian Prescription Database. The main outcome was all-cause mortality with information drawn from the Norwegian Cause of Death Registry. Follow-up continued until death or latest at 31 December 2013. Logistic regression analyses were used to investigate all-cause mortality since date of study entry and exact age at time of death was unknown. Results The adjusted logistic regression analyses showed that frequent drinking was not associated with all-cause mortality compared to occasional drinking. Men who reported to be never drinkers and non-drinkers in the last year had higher odds of mortality compared to those who drank occasionally. Use of prescribed drugs with addiction potential was associated with increased mortality in men, but not in women. No association was found between the possible combination of frequent drinking and use of prescribed drugs with addiction potential and mortality. Conclusion Neither frequent drinking nor the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older women and men. Use of prescribed drugs with addiction potential was associated with higher odds of mortality in men. This finding should lead to more caution in prescribing drugs with addiction potential to this group.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
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Agahi N, Dahlberg L, Lennartsson C. Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample. Drug Alcohol Depend 2019; 196:40-45. [PMID: 30660938 DOI: 10.1016/j.drugalcdep.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Today's older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people's drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men. METHODS Longitudinal nationally representative data of older Swedish women and men aged over 65 - the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) - from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. RESULTS Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group. CONCLUSIONS Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
| | - Lena Dahlberg
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden; Dalarna University, School of Education, Health and Social Studies, 791 88, Falun, Sweden.
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
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Abstract
SummaryThe clinical and public mental health aspects of alcohol misuse in older people (both men and women) have increasing relevance for both old age and addiction psychiatrists. Clinical presentations are often complex and involve a number of different psychiatric, physical and psychosocial factors. The assessment, treatment and aftercare of alcohol-related and comorbid other mental disorders will also involve a broad range of interventions from a wide range of practitioners. Given its growing clinical relevance, there are particular areas, such as alcohol-related brain damage and drug interactions with alcohol, that deserve special attention.
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Kim S, Spilman SL, Liao DH, Sacco P, Moore AA. Social networks and alcohol use among older adults: a comparison with middle-aged adults. Aging Ment Health 2018; 22:550-557. [PMID: 28006983 PMCID: PMC5523450 DOI: 10.1080/13607863.2016.1268095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study compared the association between social networks and alcohol consumption among middle-aged (MA) and older adults (OA) to better understand the nature of the relationship between those two factors among OA and MA. METHOD We examined Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Current drinkers aged over 50 were subdivided into two age groups: MA (50-64, n = 5214) and OA (65 and older, n = 3070). Each age group was stratified into drinking levels (low-risk vs. at-risk) based on alcohol consumption. The size and diversity of social networks were measured. Logistic regression models were used to examine age differences in the association between the social networks (size and diversity) and the probability of at-risk drinking among two age groups. RESULTS A significant association between the social networks diversity and lower odds of at-risk drinking was found among MA and OA. However, the relationship between the diversity of social networks and the likelihood of at-risk drinking was weaker for OA than for MA. The association between social networks size and at-risk drinking was not significant among MA and OA. CONCLUSION The current study suggests that the association between social networks diversity and alcohol use among OA differs from the association among MA, and few social networks were associated with alcohol use among OA. In the future, research should consider an in-depth exploration of the nature of social networks and alcohol consumption by using longitudinal designs and advanced methods of exploring drinking networks.
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Affiliation(s)
- Seungyoun Kim
- UCLA Integrated Substance Abuse Programs, University of California,
Los Angeles, CA, USA
| | - Samantha L. Spilman
- David Geffen School of Medicine, Division of Geriatrics, University
of California, Los Angeles, CA, USA
| | - Diana H. Liao
- David Geffen School of Medicine, Division of Geriatrics, University
of California, Los Angeles, CA, USA
| | - Paul Sacco
- School of Social Work, University of Maryland, Baltimore, MD,
USA
| | - Alison A. Moore
- School of Medicine, Division of Geriatrics, University of
California, San Diego, CA, USA
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Paulson D, Shah M, Herring D, Scott R, Herrera M, Brush D, Bassett R. The relationship between moderate alcohol consumption, depressive symptomatology, and C-reactive protein: the Health and Retirement Study. Int J Geriatr Psychiatry 2018; 33:316-324. [PMID: 28612359 DOI: 10.1002/gps.4746] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/02/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Moderate alcohol use has been broadly associated with health benefits among older adults, including improved mood. Aims of this study were to evaluate the relationship of moderate alcohol use and depressive symptomatology over a period of eight years, and to examine inflammation, indicated by C-reactive protein (CRP), as one mechanism by which this relationship functions. METHODS The study included 3177 community-dwelling participants over the age of 65 in 2008 drawn from the Health and Retirement Study. Data from the 2006, 2008, 2012, and 2014 waves were used. Alcohol use was measured via self-report and was dichotomized as abstinent (0 drinks per week) and moderate (1-14 drinks per week). Inflammation was measured using CRP, which was collected using an enzyme-linked immunosorbent assay and provided in units of μg/mL. Control variables included gender, age, body mass index (BMI), and medical burden. RESULTS A latent growth curve model with full information maximum likelihood was used, with results revealing that moderate drinkers endorsed fewer depressive symptoms at baseline and a steeper rate of change over time. Abstinent respondents' depressive symptomatology was characterized by a more linear change rate. Further, moderate drinkers had lower CRP levels suggesting that inflammation partially mediates the relationship between moderate alcohol use and depressive symptomatology. CONCLUSIONS Moderate alcohol use predicts fewer depressive symptoms among older adults. This relationship is partially moderated by CRP and is eroded by the passage of time. Future research should identify additional mechanisms relating alcohol to positive health outcomes and less depressive symptomatology. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Daniel Paulson
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Mona Shah
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Danielle Herring
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Rosanna Scott
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Manuel Herrera
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - David Brush
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Rachel Bassett
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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Calhoun PS, Wilson SM, Dedert EA, Cunningham KC, Burroughs TK, Hicks TA, Beckham JC, Kudler HS, Straits-Troster K. The association of alcohol consumption patterns with self-rated physical health and psychiatric distress among Afghanistan- and Iraq-era U.S. veterans. Psychiatry Res 2018; 259:142-147. [PMID: 29045920 PMCID: PMC5742062 DOI: 10.1016/j.psychres.2017.09.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/21/2017] [Accepted: 09/24/2017] [Indexed: 01/05/2023]
Abstract
Alcohol misuse is associated with negative mental and physical health outcomes, which presents a public health concern in veterans. However, less is known regarding outcomes among veterans with low to moderate alcohol consumption. This study included veterans with military service in Iraq and/or Afghanistan (N = 1083) who resided in the VA Mid-Atlantic region catchment area (North Carolina, Virginia, and parts of West Virginia). Participants completed a mailed survey that inquired about demographics, past-year alcohol consumption, self-rated physical health, and psychiatric symptoms. Logistic regression was used to evaluate associations between alcohol consumption and posttraumatic stress disorder (PTSD), depression, and self-rated physical health. In both bivariate results and adjusted models, non-drinkers and hazardous drinkers were more likely to endorse clinically significant PTSD and depression symptoms than moderate drinkers. Moderate drinkers were also less likely to report fair/poor health, after adjusting for demographics and psychiatric symptoms. Results overall showed a U-shaped curve, such that moderate alcohol use was associated with lower rates of mental health problems and fair/poor health. While the VA routinely screens for alcohol misuse, current results suggest that non-drinkers are also at risk for poor mental and physical health.
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Affiliation(s)
- Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA; Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC 27705, USA.
| | - Sarah M Wilson
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Eric A Dedert
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Katherine C Cunningham
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Thomas K Burroughs
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA; Hunter Holmes McGuire VA Medical Center, Richmond, VA 23249, USA
| | - Terrell A Hicks
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Harold S Kudler
- Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Kristy Straits-Troster
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA; Phoenix VA Healthcare System, Phoenix, AZ 85012, USA
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Alcohol and other drug use in older adults: results from a community needs assessment. Aging Clin Exp Res 2017; 29:1149-1155. [PMID: 28181205 DOI: 10.1007/s40520-016-0718-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND With the "Baby Boomer" generation reaching older adulthood, substance abuse treatment providers find themselves needing to address the unique needs of this population. Heavy drinking in adults ages 65 and over is strongly correlated with depression, anxiety, decreased social support, and poor health. However, while alcohol misuse has been shown to be predictive of a lower quality of life in older adults, the generalizability of these findings to urban dwelling, lower socioeconomic status individuals remains unclear. AIMS To identify potential treatment needs of this population, a city-funded needs assessment was conducted. METHODS Subjects were 249 individuals (44% male) who voluntarily completed measures of quality of life (QOL), depression, and substance abuse. Measures used included the Psychological General Well-Being Schedule, the Geriatric Depression Scale-15, and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS Alcohol or substance abuse was reported by over 20% of respondents, with 3.4% of respondents engaged in maladaptive alcohol use. Scores on the AUDIT were predictive of increased depression (r = - .209, p = .01), anxiety (r = - .201, p = .002), lower general well-being (r = - .154, p = .019), and decreased self-control (r = - .157, p = .017). DISCUSSION A substantial percentage of the sample reported alcohol and substance misuse. Alcohol use was predictive of depression, global psychological distress, and decreased quality of life. CONCLUSIONS This needs assessment reinforces findings from previous studies and addresses the added dimension of examining this in an urban, lower socioeconomic population.
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Dreher-Weber M, Laireiter AR, Kühberger A, Kunz I, Yegles M, Binz T, Rumpf HJ, Hoffmann R, Praxenthaler V, Lang S, Wurst FM. Screening for Hazardous Drinking in Nursing Home Residents: Evaluating the Validity of the Current Cutoffs of the Alcohol Use Disorder Identification Test-Consumption Questions by Using Ethyl Glucuronide in Hair. Alcohol Clin Exp Res 2017; 41:1593-1601. [DOI: 10.1111/acer.13449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 07/10/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Monika Dreher-Weber
- Department of Psychosomatic Medicine and Psychotherapy; Medical Park Chiemseeblick; Bernau-Felden Germany
| | | | - Anton Kühberger
- Department of Psychology; University of Salzburg; Salzburg Austria
| | - Isabella Kunz
- Department of Psychiatry and Psychotherapy; Christian-Doppler-Hospital; Paracelsus Medical University; Salzburg Austria
| | - Michel Yegles
- Laboratoire National de Santé - Toxicology; Dudelange Luxembourg
| | - Tina Binz
- Institute for Forensic Medicine; University of Zürich; Zürich Switzerland
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy; Medical University of Lübeck; Lübeck Germany
| | | | | | | | - Friedrich M. Wurst
- Paracelsus Medical University; Salzburg Austria
- Psychiatric University Hospital Basel; Basel Switzerland
- Center for Interdisciplinary Addiction Research; Hamburg Germany
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Bellos S, Skapinakis P, Rai D, Zitko P, Araya R, Lewis G, Lionis C, Mavreas V. Longitudinal association between different levels of alcohol consumption and a new onset of depression and generalized anxiety disorder: Results from an international study in primary care. Psychiatry Res 2016; 243:30-4. [PMID: 27344590 DOI: 10.1016/j.psychres.2016.05.049] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 03/17/2016] [Accepted: 05/29/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several studies that have examined the full range of alcohol consumption have pointed to a possible non-linear association between alcohol use and the common mental disorders. Most of these studies are cross sectional and assessed psychiatric morbidity using non-specific instruments. Our aim was to investigate the longitudinal association between varying levels of alcohol consumption at baseline and the new-onset of depression and generalized anxiety disorder (GAD), in a large international primary care sample. METHODS The sample consisted of 3201 primary care attenders from 14 countries in the context of WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use at baseline was assessed using AUDIT and the mental disorders were assessed with the Composite International Diagnostic Interview. RESULTS Light to moderate alcohol consumption at baseline was associated with a lower incidence of depression and GAD compared to abstinence while excessive alcohol consumption was associated with a higher incidence of depression but not GAD. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables. CONCLUSION Any causal interpretation of this association is difficult in the context of an observational study and further combined and consistent evidence from different sources is needed.
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Affiliation(s)
- Stefanos Bellos
- Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece.
| | - Petros Skapinakis
- Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece
| | - Dheeraj Rai
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, Oakfield House, UK
| | - Pedro Zitko
- Research Unit, Barros Luco General Hospital, Santiago, Chile
| | - Ricardo Araya
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Glyn Lewis
- Mental Health Sciences Unit, University College London, Charles Bell House, UK
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece
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Cheng HG, Chen S, McBride O, Phillips MR. Prospective relationship of depressive symptoms, drinking, and tobacco smoking among middle-aged and elderly community-dwelling adults: Results from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2016; 195:136-43. [PMID: 26895091 DOI: 10.1016/j.jad.2016.02.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 01/24/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous studies in Western countries have consistently documented positive associations of smoking and heavy drinking with depressive symptoms but a prospective analysis of these relationships among middle-aged and elderly community members in China have not previously been reported. METHODS Using data from the China Health and Retirement Longitudinal Study, a two-wave nationally representative survey conducted in 15,628 adults 45 years of age and older, we estimated the prospective association between depressive symptoms and an array of smoking and drinking behaviors. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) short form. RESULTS Inverse associations were the dominant pattern of association. For the population as a whole, individuals with baseline depressive symptoms were less likely to start drinking (OR=0.7, 95% CI=0.5, 0.9) or smoking (OR=0.6, 95% CI=0.4, 0.8). Similarly, baseline drinkers and smokers were less likely to develop depressive symptoms (ORdrinkers=0.6, 95% CI=0.5, 0.7; ORsmokers=0.7, 95% CJ=0.6, 0.9). No evidence was found for an increased incidence or persistence of depressive symptoms among high-frequency drinkers or heavy smokers or vice versa. Males who had never smoked prior to the onset of depressive symptoms tended to have more rapid onset of tobacco dependence compared to those without such symptoms. Males and females had different association patterns. LIMITATIONS The study is observational in nature and provides limited evidence for causality. DISCUSSION The results are inconsistent with previous findings in Western countries, throwing into question the presumed universality of the association between alcohol drinking or tobacco use and depression among middle-aged and elderly adults.
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Affiliation(s)
- Hui G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
| | - Shengnan Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Orla McBride
- School of Psychology, University of Ulster, Londonderry, Northern Ireland
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Global Health, Emory University, Atlanta, GA, USA
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Rentsch C, Tate JP, Akgün KM, Crystal S, Wang KH, Ryan Greysen S, Wang EA, Bryant KJ, Fiellin DA, Justice AC, Rimland D. Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011. AIDS Behav 2016; 20:555-64. [PMID: 25711299 DOI: 10.1007/s10461-015-1025-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Individuals with HIV infection are living substantially longer on antiretroviral therapy, but hospitalization rates continue to be relatively high. We do not know how overall or diagnosis-specific hospitalization rates compare between HIV-infected and uninfected individuals or what conditions may drive hospitalization trends. Hospitalization rates among United States Veterans were calculated and stratified by HIV serostatus and principal diagnosis disease category. Because alcohol-related diagnoses (ARD) appeared to have a disproportional effect, we further stratified our calculations by ARD history. A multivariable Cox proportional hazards model was fitted to assess the relative risk of hospitalization controlling for demographic and other comorbidity variables. From 1997 to 2011, 46,428 HIV-infected and 93,997 uninfected patients were followed for 1,497,536 person-years. Overall hospitalization rates decreased among HIV-infected and uninfected patients. However, cardiovascular and renal insufficiency admissions increased for all groups while gastrointestinal and liver, endocrine, neurologic, and non-AIDS cancer admissions increased among those with an alcohol-related diagnosis. After multivariable adjustment, HIV-infected individuals with an ARD had the highest risk of hospitalization (hazard ratio 3.24, 95 % CI 3.00, 3.49) compared to those free of HIV infection and without an ARD. Still, HIV alone also conferred increased risk (HR 2.08, 95 % CI 2.04, 2.13). While decreasing overall, risk of all-cause hospitalization remains higher among HIV-infected than uninfected individuals and is strongly influenced by the presence of an ARD.
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Chavez LJ, Liu CF, Tefft N, Hebert PL, Clark BJ, Rubinsky AD, Lapham GT, Bradley KA. Unhealthy alcohol use in older adults: Association with readmissions and emergency department use in the 30 days after hospital discharge. Drug Alcohol Depend 2016; 158:94-101. [PMID: 26644137 PMCID: PMC4749399 DOI: 10.1016/j.drugalcdep.2015.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Unhealthy alcohol use could impair recovery of older patients after medical or surgical hospitalizations. However, no prior research has evaluated whether older patients who screen positive for unhealthy alcohol use are at increased risk of readmissions or emergency department (ED) visits within 30 days after discharge. This study examined the association between AUDIT-C alcohol screening results and 30-day readmissions or ED visits. METHODS Veterans Affairs (VA) patients age 65 years or older, were eligible if they were hospitalized for a medical or surgical condition (2/1/2009-10/1/2011) and had an AUDIT-C score documented in their VA electronic medical record in the year before they were hospitalized. VA and Medicare data identified VA or non-VA index hospitalizations, readmissions, and ED visits. Primary analyses adjusted for demographics, comorbid conditions, and past-year health care utilization. RESULTS Among 579,330 hospitalized patients, 13.7% were readmitted and 12.0% visited an ED within 30 days of discharge. In primary analyses, high-risk drinking (n=7,167) and nondrinking (n=357,086) were associated with increased probability of readmission (13.8%, 95% CI 13.0-14.6%; and 14.2%, 95% CI 14.1-14.3%, respectively), relative to low-risk drinking (12.9%; 95% CI 12.7-13.0%). Only nondrinkers had increased risk for ED visits. CONCLUSIONS Alcohol screening results indicating high-risk drinking that were available in medical records were modestly associated with risk for 30-day readmissions and were not associated with risk for ED visits.
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Affiliation(s)
- Laura J. Chavez
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States,Departments of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States,Corresponding author at: University of Washington, Department of Health Services, 1959 NE Pacific Street, Box 357660, Seattle, WA 98195, United States. Tel.: +1 678 371 2197; fax: +1 206 543 3964
| | - Chuan-Fen Liu
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States; Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States.
| | - Nathan Tefft
- Bates College, 2 Andrews Rd, Lewiston, ME 04240, United States.
| | - Paul L Hebert
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States; Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States.
| | - Brendan J. Clark
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, 12700 East 19th Ave, Aurora, CO 80045, United States
| | - Anna D. Rubinsky
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States,Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States
| | - Gwen T. Lapham
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States,Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States
| | - Katharine A. Bradley
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States,Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, United States,Departments of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States,Departments of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States,Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, United States
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Rao R, Schofield P, Ashworth M. Alcohol use, socioeconomic deprivation and ethnicity in older people. BMJ Open 2015; 5:e007525. [PMID: 26303334 PMCID: PMC4550718 DOI: 10.1136/bmjopen-2014-007525] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 07/15/2015] [Accepted: 07/17/2015] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study explores the relationship between alcohol consumption, health, ethnicity and socioeconomic deprivation. PARTICIPANTS 27,991 people aged 65 and over from an inner-city population, using a primary care database. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures were alcohol use and misuse (>21 units per week for men and >14 for units per week women). RESULTS Older people of black and minority ethnic (BME) origin from four distinct ethnic groups comprised 29% of the sample. A total of 9248 older drinkers were identified, of whom 1980 (21.4%) drank above safe limits. Compared with older drinkers, older unsafe drinkers contained a higher proportion of males, white and Irish ethnic groups and a lower proportion of Caribbean, African and Asian groups. For older drinkers, the strongest independent predictors of higher alcohol consumption were younger age, male gender and Irish ethnicity. Independent predictors of lower alcohol consumption were Asian, black Caribbean and black African ethnicity. Socioeconomic deprivation and comorbidity were not significant predictors of alcohol consumption in older drinkers. For older unsafe drinkers, the strongest predictor variables were younger age, male gender and Irish ethnicity; comorbidity was not a significant predictor. Lower socioeconomic deprivation was a significant predictor of unsafe consumption whereas African, Caribbean and Asian ethnicity were not. CONCLUSIONS Although under-reporting in high-alcohol consumption groups and poor health in older people who have stopped or controlled their drinking may have limited the interpretation of our results, we suggest that closer attention is paid to 'young older' male drinkers, as well as to older drinkers born outside the UK and those with lower levels of socioeconomic deprivation who are drinking above safe limits.
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Affiliation(s)
- Rahul Rao
- Department of Old Age Psychiatry, Institute of Psychiatry, London, UK
| | - Peter Schofield
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Mark Ashworth
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
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Abstract
OBJECTIVES This paper looks into the socioeconomic determinants of risk of harmful alcohol drinking and of the transitions between risk categories over time among the population aged 50 or over in England. SETTING Community-dwellers across England. PARTICIPANTS Respondents to the English Longitudinal Survey of Ageing, waves 4 and 5. RESULTS (Confidence level at 95% or higher, except when stated): ▸ Higher risk drinking falls with age and there is a non-linear association between age and risk for men, peaking in their mid-60s. ▸ Retirement and income are positively associated with a higher risk for women but not for men. ▸ Education and smoking are positively associated for both sexes. ▸ Loneliness and depression are not associated. ▸ Caring responsibilities reduce risk among women. ▸ Single, separated or divorced men show a greater risk of harmful drinking (at 10% confidence level). ▸ For women, being younger and having a higher income at baseline increase the probability of becoming a higher risk alcohol drinker over time. ▸ For men, not eating healthily, being younger and having a higher income increase the probability of becoming a higher risk alcohol drinker. Furthermore, the presence of children living in the household, being lonely, being older and having a lower income are associated with ceasing to be a higher risk alcohol drinker over time. CONCLUSIONS Several socioeconomic factors found to be associated with high-risk alcohol consumption behaviour among older people would align with those promoted by the 'successful ageing' policy framework.
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Barnes AJ, Xu H, Tseng CH, Ang A, Tallen L, Moore AA, Marshall DC, Mirkin M, Ransohoff K, Duru OK, Ettner SL. The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study. J Subst Abuse Treat 2015; 60:14-20. [PMID: 26254687 DOI: 10.1016/j.jsat.2015.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/10/2015] [Accepted: 06/23/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND At-risk drinking, defined as alcohol use that is excessive or potentially harmful in combination with select comorbidities or medications, affects about 10% of older adults in the United States and is associated with higher mortality. The Project SHARE intervention, which uses patient and provider educational materials, physician counseling, and health educator support, was designed to reduce at-risk drinking among this vulnerable population. Although an earlier study showed that this intervention was successful in reducing rates of at-risk drinking, it is unknown whether these reductions translate into improved health and health-related quality of life (HRQL). OBJECTIVE The aim of this study was to examine changes in health and HRQL of older adult at-risk drinkers resulting from a patient-provider educational intervention. RESEARCH DESIGN A randomized controlled trial to compare the health and HRQL outcomes of patients assigned to the Project SHARE intervention vs. care as usual at baseline, 6- and 12-months post assignment. Control patients received usual care, which may or may not have included alcohol counseling. Intervention group patients received a personalized patient report, educational materials on alcohol and aging, a brief provider intervention, and a telephone health educator intervention. SUBJECTS Current drinkers 60years and older accessing primary care clinics around Santa Barbara, California (N=1049). MEASUREMENTS Data were collected from patients using baseline, 6- and 12-month mail surveys. Health and HRQL measures included mental and physical component scores (MCS and PCS) based on the Short Form-12v2 (SF-12v2), the SF-6D, which is also based on the SF-12, and the Geriatric Depression Scale (GDS). Adjusted associations of treatment assignment with these outcomes were estimated using generalized least squares regressions with random provider effects. Regressions controlled for age group, sex, race/ethnicity, marital status, education, household income, home ownership and the baseline value of the dependent variable. RESULTS After regression adjustment, the intervention was associated with a 0.58 point (95% CI: -0.06, 1.21) increase in 6-month MCS and a 0.14 point (95% CI: 0.01, 0.26) improvement in 12-month GDS score, compared to the control group. The intervention also increased adjusted SF-6D scores by 0.01 points at both 6 and 12months (6-month 95% CI: 0.01, 0.02; 12-month 95% CI: 0.01, 0.01). CONCLUSIONS Despite the previously shown effectiveness of the Project SHARE intervention to reduce at-risk drinking among older adults, this effect translated into effects on health and HRQL that were statistically but not necessarily clinically significant. Effects were most prominent for patients who received physician discussions, suggesting that provider counseling may be a critical component of primary care-based interventions targeting at-risk alcohol use.
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Affiliation(s)
- Andrew J Barnes
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Haiyong Xu
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chi-Hong Tseng
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alfonso Ang
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Louise Tallen
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alison A Moore
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Deborah C Marshall
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Department of Radiation Medicine and Applied Science, University of California, San Diego, CA, USA
| | - Michelle Mirkin
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - O Kenrik Duru
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Susan L Ettner
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Helgadottir B, Moller J, Laflamme L. Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden. Age Ageing 2015; 44:604-10. [PMID: 25904445 PMCID: PMC4476848 DOI: 10.1093/ageing/afv051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 02/18/2015] [Indexed: 11/14/2022] Open
Abstract
AIM we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall. METHODS we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort (N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case-control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most 'protective' health behaviour profile as the reference. RESULTS five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women. CONCLUSION health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.
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Affiliation(s)
- Bjorg Helgadottir
- Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sverige, Sweden
| | - Jette Moller
- Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sverige, Sweden
| | - Lucie Laflamme
- Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institutet, Stockholm, Sweden
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Fernandez AC, Claborn KR, Borsari B. A systematic review of behavioural interventions to reduce preoperative alcohol use. Drug Alcohol Rev 2015; 34:508-520. [PMID: 26120973 DOI: 10.1111/dar.12285] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 03/21/2015] [Indexed: 11/29/2022]
Abstract
ISSUES Preoperative alcohol use is associated with an increase in postoperative morbidity and mortality. Short-term abstinence prior to elective surgery has been shown to reduce postoperative risks. Therefore, behavioural intervention (BI) targeting risky drinking may have significant utility in preventing surgical complications. APPROACH The literature was systematically reviewed to identify the scope and outcomes of BIs aiming to reduce alcohol use in risky drinkers before they underwent surgery. Five databases were searched using PRISMA criteria. Of 1243 studies identified, four met pre-established inclusion criteria: (i) implementation of a BI prior to an elective surgery; (ii) the BI-targeted alcohol use among risky drinkers; and (iii) printed in English. KEY FINDINGS Two studies indicated significant reductions in alcohol use at follow ups, and one study demonstrated reductions in postoperative risks. These findings are encouraging, but in light of methodological limitations, the efficacy of preoperative BIs for risky drinking could not be determined. IMPLICATIONS Future efforts to screen and implement BIs addressing alcohol use in preoperative patients should carefully define risky drinking, allow ample time for recruitment prior to surgery, implement empirically supported interventions, examine the impact of relevant covariates, and consider the statistical power needed to detect change in postoperative complications. CONCLUSION Given the strong link between preoperative alcohol use and postoperative risks, additional research on preoperative BIs is critically needed. Existing research suggests several promising directions for research that may enhance future intervention efforts with this high-risk population. [Fernandez AC, Claborn KR, Borsari B. A systematic review of behavioural interventions to reduce preoperative alcohol use. Drug Alcohol Rev 2015;34:508-20].
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Affiliation(s)
- Anne C Fernandez
- Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA
| | - Kasey R Claborn
- Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA
| | - Brian Borsari
- Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA.,Mental Health and Behavioral Sciences Service, Providence Veteran's Affairs Medical Center, Providence, USA
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Duru OK, Xu H, Moore AA, Mirkin M, Ang A, Tallen L, Tseng CH, Ettner SL. Examining the Impact of Separate Components of a Multicomponent Intervention Designed to Reduce At-Risk Drinking Among Older Adults: The Project SHARE Study. Alcohol Clin Exp Res 2015; 39:1227-35. [PMID: 26033430 DOI: 10.1111/acer.12754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 04/14/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Health promotion interventions often include multiple components and several patient contacts. The objective of this study was to examine how participation within a multicomponent intervention (Project SHARE) is associated with changes in at-risk drinking among older adults. METHODS We analyzed observational data from a cluster-randomized trial of 31 primary care physicians and their patients aged ≥60 years, at a community-based practice with 7 clinics. Recruitment occurred between 2005 and 2007. At-risk drinkers in a particular physician's practice were randomly assigned as a group to usual care (n = 640 patients) versus intervention (n = 546 patients). The intervention included personalized reports, educational materials, drinking diaries, in-person physician advice, and telephone counseling by health educators (HEs). The primary outcome was at-risk drinking at follow-up, defined by scores on the Comorbidity Alcohol Risk Evaluation Tool (CARET). Predictors included whether a physician-patient alcohol risk discussion occurred, HE call occurred, drinking agreement with the HE was made, and patients self-reported keeping a drinking diary as suggested by the HE. RESULTS At 6 months, there was no association of at-risk drinking with having had a physician-patient discussion. Compared to having had no HE call, the odds of at-risk drinking at 6 months were lower if an agreement was made or patients reported keeping a diary (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.37 to 0.90), or if an agreement was made and patients reported keeping a diary (OR 0.52, CI 0.28 to 0.97). At 12 months, a physician-patient discussion (OR 0.61, CI 0.38 to 0.98) or an agreement and reported use of a diary (OR 0.45, CI 0.25) were associated with lower odds of at-risk drinking. CONCLUSIONS Within the Project SHARE intervention, discussing alcohol risk with a physician, making a drinking agreement, and/or self-reporting the use of a drinking diary were associated with lower odds of at-risk drinking at follow-up. Future studies targeting at-risk drinking among older adults should consider incorporating both intervention components.
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Affiliation(s)
- Obidiugwu K Duru
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Haiyong Xu
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Alison A Moore
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Michelle Mirkin
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Alfonso Ang
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Louise Tallen
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.,Ahava Center for Spiritual Living, Lexington, Kentucky
| | - Chi-Hong Tseng
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Susan L Ettner
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.,Fielding School of Public Health, University of California, Los Angeles, California
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Tadros A, Mason M, Davidov DM, Davis SM, Layman SM. Visits by the elderly to United States EDs for alcohol-related disorders. Am J Emerg Med 2015; 33:1126-8. [PMID: 26022753 DOI: 10.1016/j.ajem.2015.04.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/19/2015] [Accepted: 04/22/2015] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The objectives are to estimate the number of elderly patients presenting to emergency departments (EDs) in the United States from 2006 to 2011 for alcohol-related disorders and examine their demographic and clinical features. METHODS This study used 2006 to 2011 data from the Nationwide ED Sample, a stratified, multistage sample designed to give national estimates of US ED visits each year. Clinical Classifications Software 660 code ("alcohol-related disorders") was used. The clinical and demographic features that were examined were as follows: number of admissions, disposition, sex, age, expected payer, income, geographic region, charges, and primary diagnoses and procedures performed. RESULTS From 2006 to 2011, there were 1620345 ED visits for alcohol-related disorders in elderly patients. Roughly one-third were discharged from the ED, whereas 66% (1078677) were admitted to the hospital. Approximately 73% were male, and the mean age was 73 years. Most patients used Medicare (84%), resided in neighborhoods with the lowest median income national quartile (29%), and lived in the South (36.4%). The average charge for discharged patients was $4274.95 (4050.30-4499.61) and $37857.20 (36813.00-38901.40) for admitted patients. The total charges for all patients treated and released from the ED were $2166082965.40 and admitted was $40835690924.40. CONCLUSIONS This study provided insight not only into the sociodemographic characteristics of this patient population but also the health care costs related to alcohol-related ED visits. These results may contribute to the development of future interventions targeted toward this population.
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Affiliation(s)
- Allison Tadros
- Department of Emergency Medicine, West Virginia University, School of Medicine Morgantown, WV.
| | - Meredith Mason
- Department of Emergency Medicine, West Virginia University, School of Medicine Morgantown, WV
| | - Danielle M Davidov
- Department of Emergency Medicine, West Virginia University, School of Medicine Morgantown, WV
| | - Stephen M Davis
- Department of Emergency Medicine, West Virginia University, School of Medicine Morgantown, WV
| | - Shelley M Layman
- Department of Emergency Medicine, West Virginia University, School of Medicine Morgantown, WV.
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Marti CN, Choi NG, DiNitto DM, Choi BY. Associations of lifetime abstention and past and current alcohol use with late-life mental health: a propensity score analysis. Drug Alcohol Depend 2015; 149:245-51. [PMID: 25725932 DOI: 10.1016/j.drugalcdep.2015.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Compared to the extensive research on the effects of alcohol intake on physical health, little research has been done on the effects of alcohol use/nonuse patterns on mental disorders in late life. This study examined associations between mental disorders and alcohol use/nonuse patterns among individuals aged 65+ years. METHODS Data came from the public use files of the 2008 to 2012 National Survey on Drug Use and Health. Alcohol use/nonuse groups were lifetime abstainers, ex-drinkers, bingers, and nonbingers. Mental health problems were lifetime major depressive episode (MDE) and anxiety disorder, past-year MDE and anxiety disorder, and past-year serious suicidal ideation. To minimize selection biases resulting from a complex array of covariates, we implemented a generalized boosted model to generate propensity score weights on covariates. Then we employed logistic regression models with mental health outcomes as the dependent variables. RESULTS The four alcohol use/nonuse groups did not differ in past-year MDE. However, odds ratios show that, relative to non-binge drinking, lifetime abstention decreased the odds of lifetime MDE by more than 60% (OR = 0.39, 95% CI = 0.23-0.68, p = .001) and the odds of lifetime anxiety disorder by almost half (OR = 0.55, 95% CI = 0.38-0.79, p = .002). Ex-drinkers were more likely than nonbingers to report past-year serious suicidal thoughts (OR = 2.29, 95% CI = 1.45-3.62, p < .001). CONCLUSIONS While lifetime abstainers had significantly better lifetime mental health histories than nonbingers, ex-drinkers had worse past-year mental health status. Since lifetime abstainers and ex-drinkers have significantly different characteristics, researchers should distinguish between these groups.
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Affiliation(s)
- C Nathan Marti
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA
| | - Namkee G Choi
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA.
| | - Diana M DiNitto
- University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, 02906, USA
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Klemenc-Ketiš Z, Kersnik J. Focus points in prevention actions against legal substances' abuse. Wien Klin Wochenschr 2015; 127 Suppl 5:S241-6. [PMID: 25787211 DOI: 10.1007/s00508-015-0706-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/16/2015] [Indexed: 12/28/2022]
Abstract
AIM To determine the factors associated with alcohol and tobacco abuse in Slovenian general population. MATERIAL AND METHODS We performed an observational cross-sectional study in a representative sample of 1002 Slovenian inhabitants in June 2011. It was performed using a method of computer-assisted telephone interview. The telephone interview consisted of questions about the prevalence and duration of preselected health-related symptoms in the past month, questions about the presence of chronic diseases, question about the presence of current smoking, EQ-5D questionnaire and AUDIT-C questionnaire. RESULTS Risky drinking was found in 103 (14.3 %) of the sample and smoking was found in 226 (22.6 %) of the sample. Men reported risky drinking more often when compared with women (17.7 vs. 10.5 %, P = 0.007). Multivariate analysis showed that male sex, current tobacco smoking, lower education level, self-reported presence of anxiety/depression and self-reported presence of muscle pain and excessive fatigue in the past month were independently associated with risky drinking and that male sex, lower education and income, the presence of chronic disease, self-reported problems in daily activities, risky drinking, self-reported troubles in sleeping and restless leg syndrome were independently associated with current tobacco smoking. CONCLUSION Risky alcohol drinking and smoking are still major public health problems in Slovenia and are associated with known demographic risk factors but also with some symptoms of somatoform disorders. These findings should be incorporated into the guidelines for family physicians as the important focus points for screening and intervening against legal substances' abuse in their patients.
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Affiliation(s)
- Zalika Klemenc-Ketiš
- Department of Family Medicine, Medical School, University of Maribor, Maribor, Slovenia. .,Department of Family Medicine, Medical School, University of Ljubljana, Ljubljana, Slovenia. .,, Kersnikova 1, 3320, Velenje, Slovenia.
| | - Janko Kersnik
- Department of Family Medicine, Medical School, University of Maribor, Maribor, Slovenia.,Department of Family Medicine, Medical School, University of Ljubljana, Ljubljana, Slovenia
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Canham SL, Kaufmann CN, Mauro PM, Mojtabai R, Spira AP. Binge drinking and insomnia in middle-aged and older adults: the Health and Retirement Study. Int J Geriatr Psychiatry 2015; 30:284-91. [PMID: 24798772 PMCID: PMC4221579 DOI: 10.1002/gps.4139] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 04/04/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alcohol use in later life has been linked to poor sleep. However, the association between binge drinking, which is common among middle-aged and older adults, and insomnia has not been previously assessed. METHODS We studied participants aged 50 years and older (n = 6027) from the 2004 Health and Retirement Study who reported the number of days they had ≥4 drinks on one occasion in the prior 3 months. Participants also reported the frequency of four insomnia symptoms. Logistic regression analyses assessed the association between binge drinking frequency and insomnia. RESULTS Overall, 32.5% of participants had >0 to ≤2 binge drinking days/week; and 3.6% had >2 binge drinking days/week. After adjusting for demographic variables, medical conditions, body mass index, and elevated depressive symptoms, participants who binged >2 days/week had a 64% greater odds of insomnia than non-binge drinkers (adjusted odds ratio [aOR] = 1.64, 95% confidence interval [CI] = 1.09-2.47, p = 0.017). Participants reporting >0 to ≤2 binge days/week also had a 35% greater odds of insomnia than non-binge drinkers (aOR = 1.35, 95% CI = 1.15-1.59, p = 0.001). When smoking was added to the regression model, these associations fell just below the level of significance. CONCLUSIONS Results suggest that binge drinking is associated with a greater risk of insomnia among adults aged 50 years and older, although this relationship may be driven in part by current smoking behavior. The relatively high prevalence of both binge drinking and sleep complaints among middle-aged and older populations warrants further investigation into binge drinking as a potential cause of late-life insomnia.
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Affiliation(s)
- Sarah L. Canham
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Christopher N. Kaufmann
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Pia M. Mauro
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
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Sacco P, Unick GJ, Zanjani F, Camlin EAS. Hospital outcomes in major depression among older adults: differences by alcohol comorbidity. J Dual Diagn 2015; 11:83-92. [PMID: 25671685 PMCID: PMC4718396 DOI: 10.1080/15504263.2014.993295] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The prevalence of depression in older adults has been increasing over the last 20 years and is associated with economic costs in the form of treatment utilization and caregiving, including inpatient hospitalization. Comorbid alcohol diagnoses may serve as a complicating factor in inpatient admissions and may lead to overutilization of care and greater economic cost. This study sought to isolate the comorbidity effect of alcohol among older adult hospital admissions for depression. METHODS We analyzed a subsample (N = 8,480) of older adults (65+) from the 2010 Nationwide Inpatient Sample who were hospitalized with primary depression diagnoses, 7,741 of whom had depression only and 739 of whom also had a comorbid alcohol disorder. To address potential selection bias based on drinking and health status, propensity score matching was used to compare length of stay, total costs, and disposition between the two groups. RESULTS Bivariate analyses showed that older persons with depression and alcohol comorbidities were more often male (59.9% versus 34.0%, p <.001) and younger (70.9 versus 75.9 years, p <.001) than those with depression only. In terms of medical comorbidities, those with depression and alcohol disorders experienced more medical issues related to substance use (e.g., drug use diagnoses, liver disease, and suicidality; all p <.001), while those with depression only experienced more general medical problems (e.g., diabetes, renal failure, hypothyroid, and dementia; all p <.001). Propensity score matched models found that alcohol comorbidity was associated with shorter lengths of stay (on average 1.08 days, p <.02) and lower likelihood of post-hospitalization placement in a nursing home or other care facility (OR = 0.64, p <.001). No significant differences were found in overall costs or likelihood of discharge to a psychiatric hospital. CONCLUSIONS In older adults, depression with alcohol comorbidity does not lead to increased costs or higher levels of care after discharge. Comorbidity may lead to inpatient hospitalization at lower levels of severity, and depression with alcohol comorbidity may be qualitatively different than non-comorbid depression. Additionally, increased costs and negative outcomes in this population may occur at other levels of care such as outpatient services or emergency department visits.
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Affiliation(s)
- Paul Sacco
- a School of Social Work , University of Maryland , Baltimore , Maryland , USA
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Ivan MC, Amspoker AB, Nadorff MR, Kunik ME, Cully JA, Wilson N, Calleo J, Kraus-Schuman C, Stanley MA. Alcohol use, anxiety, and insomnia in older adults with generalized anxiety disorder. Am J Geriatr Psychiatry 2014; 22:875-83. [PMID: 23973253 PMCID: PMC3842378 DOI: 10.1016/j.jagp.2013.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/20/2013] [Accepted: 04/06/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To examine alcohol consumption among older primary care patients with generalized anxiety disorder (GAD); its relationship to demographic variables, insomnia, worry, and anxiety; and its moderating role on the anxiety-insomnia relationship. We expected alcohol use to be similar to previous reports, correlate with higher anxiety and insomnia, and worsen the anxiety-insomnia relationship. DESIGN Baseline data from a randomized controlled trial. SETTING Michael E. DeBakey VA Medical Center and Baylor College of Medicine. PARTICIPANTS 223 patients, 60 years and older, with GAD. MEASUREMENTS Frequency of alcohol use, insomnia (Insomnia Severity Index), worry (Penn State Worry Questionnaire - Abbreviated, Generalized Anxiety Disorder Severity Scale), and anxiety (State-Trait Anxiety Inventory - Trait subscale, Structured Interview Guide for the Hamilton Anxiety Rating Scale [SIGH-A]). RESULTS Most patients endorsed alcohol use, but frequency was low. Presence and frequency were greater than in previous reports of primary care samples. Alcohol use was associated with higher education, female gender, less severe insomnia, and lower worry (Generalized Anxiety Disorder Severity Scale) and anxiety (State-Trait Anxiety Inventory-Trait subscale; SIGH-A). Whites reported more drinks/week than African-Americans. More drinks/week were associated with higher education and lower anxiety (SIGH-A). Weaker relationships between worry/anxiety and insomnia occurred for those drinking. Drink frequency moderated the positive association between the Penn State Worry Questionnaire-Abbreviated and insomnia, which was lower with higher frequency of drinking. CONCLUSIONS Older adults with GAD use alcohol at an increased rate, but mild to moderate drinkers do not experience sleep difficulties. A modest amount of alcohol may minimize the association between anxiety/worry and insomnia among this group.
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Affiliation(s)
- M Cristina Ivan
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX
| | - Amber B Amspoker
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX
| | - Michael R Nadorff
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX
| | - Mark E Kunik
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX
| | - Jeffrey A Cully
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX
| | - Nancy Wilson
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX
| | - Jessica Calleo
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX
| | - Cynthia Kraus-Schuman
- Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX
| | - Melinda A Stanley
- Houston VA HSR&D Center of Excellence, Houston, TX; Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX.
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van den Berg JF, Kok RM, van Marwijk HWJ, van der Mast RC, Naarding P, Oude Voshaar RC, Stek ML, Verhaak PFM, de Waal MWM, Comijs HC. Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO study. Am J Geriatr Psychiatry 2014; 22:866-74. [PMID: 23891365 DOI: 10.1016/j.jagp.2013.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 04/09/2013] [Accepted: 04/10/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. DESIGN Cross-sectional study. SETTING Netherlands Study of Depression in Older Persons (NESDO). PARTICIPANTS A total of 373 participants (mean [standard deviation] age: 70.6 [7.3] years; 66% women) diagnosed with a depressive disorder, and 128 nondepressed participants. MEASUREMENTS Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT). Participants were categorized into abstainers (AUDIT score: 0), moderate drinkers (AUDIT score: 1-4), and at-risk drinkers (AUDIT score: ≥5). Multinomial logistic regression analysis was performed with AUDIT categories as outcome, and demographic, social, somatic, and psychological variables as determinants. RESULTS The depressed group consisted of 40.2% abstainers, 40.8% moderate drinkers, and 19.0% at-risk drinkers. The depressed participants were more often abstinent and less often moderate drinkers than the nondepressed participants; they did not differ in at-risk drinking. Depressed abstainers more often used benzodiazepines but less often used antidepressants, and they had a poorer cognitive function than depressed moderate drinkers. Depressed at-risk drinkers were more often smokers and had fewer functional limitations but more severe depressive symptoms than depressed moderate drinkers. CONCLUSIONS Although alcohol abstinence was more common in depressed than in nondepressed older adults, 19% of depressed persons were at-risk drinkers. Because at-risk drinking is associated with more severe depression and may have a negative impact on health and treatment outcome, it is important that physicians consider alcohol use in depressed older adults.
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Affiliation(s)
| | - Rob M Kok
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Harm W J van Marwijk
- EMGO+ Institute for Care and Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Naarding
- Department of Old Age Psychiatry, GGNet Center for Mental Health, Apeldoorn, The Netherlands; Department of Psychiatry, UMC St. Radboud, Nijmegen, The Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry & Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands
| | - Max L Stek
- EMGO+ Institute for Care and Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Peter F M Verhaak
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands
| | - Margot W M de Waal
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hannie C Comijs
- EMGO+ Institute for Care and Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
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Gilson KM, Bryant C, Judd F. Exploring risky drinking and knowledge of safe drinking guidelines in older adults. Subst Use Misuse 2014; 49:1473-9. [PMID: 24827868 DOI: 10.3109/10826084.2014.912233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Risky drinking criteria in older adults lack consistency across the literature. The variable definitions of risk have contributed in part, to widely differing prevalence estimates for risky drinking, ranging from 1% to 15%. OBJECTIVES (1) To identify the prevalence of different types of risky drinking by applying several different criteria, (2) To investigate whether older adults have knowledge of the National Health and Medical Research Council recommended guidelines for safe drinking. METHODS The study population consisted of community dwelling past-year drinkers (n = 292) aged ≥ 60 years. Participants completed a postal survey on alcohol consumption using the AUDIT-C. RESULTS Applying multiple risky drinking criteria indicated that 6.6% to 31.7% of women and 21.6% to 44.8% of men were risky drinkers. Men were more likely than women to have inaccurate knowledge of the NHMRC guidelines, and nearly 59.2% of men who exceeded 14 drinks per week reported either not knowing the recommended limits or reported limits that exceeded the guidelines. Conclusions/Importance: A substantial number of older men drank at risky levels and overestimated safe drinking limits. Greater education on the vulnerability to alcohol-related harm together with greater screening practice by health professionals and service providers is recommended. Findings illustrate how different risky drinking criteria vary in their average AUDIT-C scores, with the NHMRC criteria showing greater average scores compared to other criteria. RESULTS also imply that cutoff scores of ≥ 4 for women and ≥ 6 for men are consistent with a range of risky drinking criteria in older adults.
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Affiliation(s)
- Kim-Michelle Gilson
- 1Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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