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Ke Y, Chai X. Understanding the Effect of External and Internal Assets on Hazardous/Harmful Drinking Among Chinese College Students: A Serial Mediation Model. HEALTH EDUCATION & BEHAVIOR 2024:10901981241255366. [PMID: 38798091 DOI: 10.1177/10901981241255366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Hazardous/harmful drinking among college students is increasingly becoming a global health concern. Previous studies have mostly paid more attention to the prevalence and risk factors of alcohol use disorder based on the public health approach, and less is understood about psychological mechanisms and protective factors of problem drinking behavior. Grounded in the framework of developmental assets, this study explored the predictive effect of external assets (i.e., social connectedness) and internal assets (i.e., self-concept clarity and drinking refusal self-efficacy) on hazardous/harmful drinking among Chinese college students. Participants were 598 college students with a mean age of 19.41 (SD = 1.21) years. The results of structural equation modeling showed that social connectedness negatively predicted college students' hazardous/harmful drinking. Moreover, our path analyses revealed a serial mediation among these variables: students with high social connectedness tended to report high self-concept clarity, which in turn increased drinking refusal self-efficacy, and consequently decreased the level of hazardous/harmful drinking. This study revealed the mechanisms underlying how external and internal assets predict risky drinking among college students. These findings made significant contributions to prevention and precision interventions for college-aged youth with drinking problems.
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Affiliation(s)
- Yuye Ke
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, China
- School of Nursing, Hubei University of Medicine, Shiyan, China
| | - Xiaoyun Chai
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, China
- Department of Applied Psychology, Hubei University of Medicine, Shiyan, China
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2
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Goldstein SC, Newberger NG, Schick MR, Ferguson JJ, Collins SE, Haeny AM, Weiss NH. A systematic meta-epidemiologic review on nonabstinence-inclusive interventions for substance use: inclusion of race/ethnicity and sex assigned at birth/gender. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-15. [PMID: 38411974 DOI: 10.1080/00952990.2024.2308087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024]
Abstract
Background: Minoritized racial/ethnic and sex assigned at birth/gender groups experience disproportionate substance-related harm. Focusing on reducing substance-related harm without requiring abstinence is a promising approach.Objectives: The purpose of this meta-epidemiologic systematic review was to examine inclusion of racial/ethnic and sex assigned at birth/gender in published studies of nonabstinence-inclusive interventions for substance use.Methods: We systematically searched databases (PubMed and PsycINFO) on May 26, 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Articles were eligible for inclusion if they: 1) reported in English language, 2) had a primary goal of investigating a nonabstinence-inclusive intervention to address substance use, 3) used human subjects, and 4) only included adults aged 18 or older. Two coders screened initial articles and assessed eligibility criteria of full text articles. A third consensus rater reviewed all coding discrepancies. For the remaining full-length articles, an independent rater extracted information relevant to study goalsResults: The search strategy yielded 5,759 records. 235 included articles remained. Only 73 articles (31.1%) fully reported on both racial/ethnic and sex assigned at birth/gender, and only seven articles (3.0%) reported subgroup analyses examining treatment efficacy across minoritized groups. Nine articles (3.8%) mentioned inclusion and diversity regarding both racial/ethnic and sex assigned at birth/gender in their discussion and four articles (1.7%) broadly mentioned a lack of diversity in their limitationsConclusion: Findings highlight that little is known about nonabstinence-inclusive interventions to address substance use for individuals from minoritized racial/ethnic and sex assigned at birth/gender groups.
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Affiliation(s)
- Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Noam G Newberger
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Melissa R Schick
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Susan E Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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3
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Birditt KS, Turkelson A, Polenick CA, Cranford JA, Smith JA, Ware EB, Blow FC. Alcohol Use and Mortality Among Older Couples in the United States: Evidence of Individual and Partner Effects. THE GERONTOLOGIST 2024; 64:gnad101. [PMID: 37487060 PMCID: PMC10825846 DOI: 10.1093/geront/gnad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Spouses with concordant (i.e., similar) drinking behaviors often report better quality marriages and are married longer compared with those who report discordant drinking behaviors. Less is known regarding whether concordant or discordant patterns have implications for health, as couples grow older. The present study examined whether drinking patterns among older couples are associated with mortality over time. RESEARCH DESIGN AND METHODS The Health and Retirement Study (HRS) is a nationally representative sample of individuals and their partners (married/cohabiting) over age 50 in the United States, in which participants completed surveys every 2 years. Participants included 4,656 married/cohabiting different-sex couples (9,312 individuals) who completed at least 3 waves of the HRS from 1996 to 2016. Participants reported whether they drank alcohol at all in the last 3 months, and if so, the average amount they drank per week. Mortality data were from 2016. RESULTS Analyses revealed concordant drinking spouses (both indicated they drank in the last 3 months) survived longer than discordant drinking spouses (1 partner drinks and the other does not) and concordant nondrinking spouses. Analysis of average drinks per week showed a quadratic association with mortality such that light drinking predicted better survival rates among individuals and their partners compared with abstaining and heavy drinking. Further, similar levels of drinking in terms of the amount of drinking were associated with greater survival, particularly among wives. DISCUSSION AND IMPLICATIONS This study moves the field forward by showing that survival varies as a function of one's own and one's partner's drinking.
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Affiliation(s)
- Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James A Cranford
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer A Smith
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Erin B Ware
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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4
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Wickersham M, Bartelo N, Kulm S, Liu Y, Zhang Y, Elemento O. USING MACHINE LEARNING METHODS TO ASSESS THE RISK OF ALCOHOL MISUSE IN OLDER ADULTS. RESEARCH SQUARE 2023:rs.3.rs-3154584. [PMID: 37886491 PMCID: PMC10602059 DOI: 10.21203/rs.3.rs-3154584/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
The population of older adults, defined in this study as those 50 years of age or older, continues to increase every year. Substance misuse, particularly alcohol misuse, is often neglected in these individuals. To better identify older adults who might not be properly assessed for alcohol misuse, we have derived a risk assessment tool using patients from the United Kingdom Biobank (UKB), which was validated on patients in the Weill Cornell Medicine (WCM) electronic health record (EHR). The model and tooling created stratifies the risk of alcohol misuse in older adults using 10 features that are commonly found in most EHR systems. We found that the area under the receiver operating curve (AUROC) to correctly predict alcohol misuse in older adults for the UKB and WCM models were 0.84 and 0.78, respectively. We further show that of those who self-identified as having ongoing alcohol misuse in the UKB cohort, only 12.5% of these patients had any alcohol-related F.10 ICD-10 code. Extending this to the WCM cohort, we forecast that 7,838 out of 12,360 older adults with no F.10 ICD-10 code (63.4%) may be missed as having alcohol misuse in the EHR. Overall, this study importantly prioritizes the health of older adults by being able to predict alcohol misuse in an understudied population.
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Affiliation(s)
- Matthew Wickersham
- Weill-Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, New York, New York, United States
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, United States
| | - Nicholas Bartelo
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, United States
| | - Scott Kulm
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, United States
| | - Yifan Liu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
| | - Yiye Zhang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Olivier Elemento
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, United States
- Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York, United States
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Downs AM, Catavero CM, Kasten MR, McElligott ZA. Tauopathy and alcohol consumption interact to alter locus coeruleus excitatory transmission and excitability in male and female mice. Alcohol 2023; 107:97-107. [PMID: 36150608 DOI: 10.1016/j.alcohol.2022.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 12/23/2022]
Abstract
Alcohol use disorder is a major public health concern in the United States. Recent work has suggested a link between chronic alcohol consumption and the development of tauopathy disorders, such as Alzheimer's disease and frontotemporal dementia. However, relatively little work has investigated changes in neural circuitry involved in both tauopathy disorders and alcohol use disorder. The locus coeruleus (LC) is the major noradrenergic nucleus in the brain and is one of the earliest sites to be affected by tau lesions. The LC is also implicated in the rewarding effects of ethanol and alcohol withdrawal. In this study we assessed effects of long-term ethanol consumption and tauopathy on the physiology of LC neurons. Male and female P301S mice, a humanized transgenic mouse model of tauopathy, underwent 16 weeks of intermittent access to 20% ethanol from 3 to 7 months of age. We observed higher total alcohol consumption in female mice regardless of genotype. Male P301S mice consumed more ethanol and had a greater preference for ethanol than wild-type (WT) males. At the end of the drinking study, LC function was assessed using ex vivo whole cell electrophysiology. We found significant changes in excitatory inputs to the LC due to both ethanol and genotype. We found significantly increased excitability of the LC due to ethanol with greater effects in female P301S mice than in female WT mice. Our study identifies significant changes in the LC due to interactions between tauopathy and long-term ethanol use. These findings could have important implications regarding LC activity and changes in behavior due to both ethanol- and tauopathy-related dementia.
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Affiliation(s)
- Anthony M Downs
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Christina M Catavero
- Graduate Program in Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Michael R Kasten
- Department of Otolaryngology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Zoé A McElligott
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
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6
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Pitkälä KH, Immonen S, Öhman H. "Always on vacation": alcohol has become a geriatric problem. Eur Geriatr Med 2023; 14:5-7. [PMID: 36399254 DOI: 10.1007/s41999-022-00718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kaisu H Pitkälä
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Sirpa Immonen
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Öhman
- Clinics of Internal Medicine and Geriatrics, Helsinki University Hospital, Helsinki, Finland
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7
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Birditt KS, Turkelson A, Polenick CA, Cranford JA, Blow FC. Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality. J Gerontol B Psychol Sci Soc Sci 2022; 77:1592-1602. [PMID: 35219278 PMCID: PMC9434470 DOI: 10.1093/geronb/gbac015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Spouses often have concordant drinking behaviors and important influences on one another's cardiovascular health. However, little is known about the implications of dyadic drinking patterns for blood pressure, and the marital factors that confer risk or resilience. This article examined links between alcohol use and blood pressure within individuals and opposite-sex couples over time, and whether those links vary by negative marital quality among older adults. METHODS Participants were from the nationally representative longitudinal Health and Retirement Study that included 4,619 respondents in 2,682 opposite-sex couples who participated in at least 2 of the waves from 2006 to 2016. Participants reported the number of drinks they typically consume per week, negative marital quality, and had their blood pressure measured via a cuff. RESULTS Analyses revealed that greater drinking was associated with increased systolic blood pressure among both husbands and wives. Furthermore, husbands who drank more had higher blood pressure when wives drank more alcohol, whereas there was no association between husbands' drinking and blood pressure when wives drank less alcohol. Interactions with negative marital quality showed that drinking concordance may be associated with increased blood pressure over time in more negative marriages. DISCUSSION Findings indicated that spousal drinking concordance, although often associated with positive marital quality, may have negative long-term health effects.
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Affiliation(s)
- Kira S Birditt
- Address correspondence to: Kira S. Birditt, PhD, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA. E-mail:
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | | | - James A Cranford
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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8
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Tevik K, Bergh S, Selbæk G, Johannessen A, Helvik AS. A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults. PLoS One 2021; 16:e0261292. [PMID: 34914759 PMCID: PMC8675766 DOI: 10.1371/journal.pone.0261292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. Methods A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. Results Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. Conclusion No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.
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Affiliation(s)
- Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- * E-mail:
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on 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
| | - Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Vestfold, Norway
| | - Anne-S. Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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9
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Bye EK, Moan IS. Trends in older adults’ alcohol use in Norway 1985–2019. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:444-458. [PMID: 35310776 PMCID: PMC8899062 DOI: 10.1177/1455072520954325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
Aims: To examine the prevalence of and trends in older adults’ (60–79 years)
alcohol use in Norway between 1985 and 2019. Methods: Data stem from two repeated cross-sectional surveys in the Norwegian
population: Statistics Norway’s Health and Living Conditions Surveys from
1985 (N = 7799), 1995 (N = 3518) and 2005
(N = 6487), and the Norwegian Institute of Public
Health’s (NIPH) annual surveys on alcohol, tobacco and drug use from
2012/2013 (N = 4047), 2014/2015 (N =
4378), 2016/2017 (N = 4264) and 2018/2019
(N = 4330). The following measures were used to examine
trends in alcohol use among women and men aged 60 and older: drinking
status, drinking frequency, number of drinks per occasion, and frequency of
heavy episodic drinking (HED). Results: Between 1985 and 2019, there has been a substantial increase in the
proportions of older adults in Norway who drink alcohol and who drink
relatively often. The increase was particularly marked between 1985 and
2012/2013, and for elderly women. However, the majority of older adults
drink small amounts of alcohol on typical drinking occasions, illustrating
that the increased frequency of drinking is not accompanied by a
corresponding increase in risky drinking. Conclusions: There has been a marked increase in alcohol use among older adults the past
30 years, particularly among older women, suggesting that the age and gender
gap traditionally found in alcohol use in Norway is diminishing. Due to the
lower alcohol tolerance among elderly, monitoring the changing trends in
alcohol use in this group, as well as the possible consequences of these
changes, is important.
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Affiliation(s)
- Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
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10
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Aging and nutrition. Paving the way to better health. ROMANIAN JOURNAL OF INTERNAL MEDICINE 2020; 58:55-68. [PMID: 32134741 DOI: 10.2478/rjim-2020-0005] [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: 01/22/2020] [Indexed: 01/04/2023] Open
Abstract
Sufficient caloric intake is important to maintain the balanced health status, especially during the period of aging, as aging and sickness share paths. Maintaining adequate nutritional balance is the best preventive measure to counteract the risk of malnutrition. There are several causes for malnutrition in elderly people, and some techniques such as anthropometric measurements, laboratory and clinical parameters could help to diagnose malnutrition in these patients. The use of a simple validated questionnaire called the 'Mini Nutritional Assessment' measures the nutritional status of elderly patients. In this review, we discuss about the malnutrition in elderly people with and without a known cause and we present some of nutritional intervention. There are promising strategies that help overcoming malnutrition.
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Le MH, Yeo YH, Cheung R, Wong VWS, Nguyen MH. Ethnic influence on nonalcoholic fatty liver disease prevalence and lack of disease awareness in the United States, 2011-2016. J Intern Med 2020; 287:711-722. [PMID: 32128904 DOI: 10.1111/joim.13035] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a rising global disease associated with clinical and economic burdens. OBJECTIVES We aimed to quantify NAFLD prevalence and awareness to provide stakeholders necessary information to combat NAFLD burden. METHODS This study utilizes data from the National Health and Nutrition Examination Survey 2011-2016 and included 4538 adult participants who did not have heavy drinking or viral hepatitis history. The US fatty liver index defined NAFLD and NAFLD fibrosis score defined fibrosis. NAFLD awareness was captured by questionnaire. RESULTS Amongst the study population of 4538 persons, NAFLD prevalence was 32.5%, lowest in non-Hispanic Blacks (18.0%) and Asians (18.1%), highest amongst Mexican Americans (48.4%). Within the NAFLD group, advanced fibrosis was highest in non-Hispanic Blacks (28.5%) and lowest amongst non-Hispanic Asians (2.7%). Of the 1473 (97.5%) NAFLD participants who answered NAFLD awareness question, 90% visited a healthcare centre at least once in the past year, but only 5.1% were aware of having NAFLD. On weighted population estimates, 77.33 million persons had NAFLD, 17.63 million had advanced fibrosis, and 73.39 million NAFLD participants were not aware of having NAFLD. CONCLUSIONS Of 77.33 million people in the United States have NAFLD with 17.63 million having advanced fibrosis, with lowest prevalence in non-Hispanic Asians and highest in Mexican Americans. A conundrum exists amongst non-Hispanic Blacks who have low NAFLD prevalence but highest prevalence of advanced fibrosis. Awareness of NAFLD was low across all ethnicities. Effort is needed to improve disease awareness whilst addressing NAFLD clinical burden across ethnicities.
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Affiliation(s)
- M H Le
- From the, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Y H Yeo
- From the, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - R Cheung
- From the, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care, Palo Alto, CA, USA
| | - V W-S Wong
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - M H Nguyen
- From the, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
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12
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Andersen K, Behrendt S, Bilberg R, Bogenschutz MP, Braun B, Buehringer G, Ekstrøm CT, Mejldal A, Petersen AH, Nielsen AS. Evaluation of adding the community reinforcement approach to motivational enhancement therapy for adults aged 60 years and older with DSM-5 alcohol use disorder: a randomized controlled trial. Addiction 2020; 115:69-81. [PMID: 31454444 DOI: 10.1111/add.14795] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/15/2019] [Accepted: 08/09/2019] [Indexed: 11/27/2022]
Abstract
AIM To examine whether adding the Community Reinforcement Approach for Seniors (CRA-S) to Motivational Enhancement Therapy (MET) increases the probability of treatment success in people aged ≥ 60 years with alcohol use disorder (AUD). DESIGN A single blind multi-centre multi-national randomized (1 : 1) controlled trial. SETTING Out-patient settings (municipal alcohol treatment clinics in Denmark, specialized addiction care facilities in Germany and a primary care clinic in the United States). PARTICIPANTS Between January 2014 and May 2016, 693 patients aged 60+ years and fulfilling DSM-5 criteria for AUD participated in comparing MET (n = 351) and MET + CRA-S (n = 342). INTERVENTION AND COMPARATOR MET (comparator) included four manualized sessions aimed at increasing motivation to change and establishing a change plan. CRA-S (intervention) consisted of up to eight further optional, manualized sessions aimed at helping patients to implement their change plan. CRA-S included a specially designed module on coping with age and age-related problems. MEASUREMENTS The primary outcome was either total alcohol abstinence or an expected blood alcohol concentration of ≤ 0.05% during the 30 days preceding the 26 weeks follow-up (defined as success) or blood alcohol concentration of > 0.05% during the follow-up period (defined as failure). This was assessed by self-report using the Form 90 instrument. The main analysis involved complete cases. FINDINGS The follow-up rate at 26 weeks was 76.2% (76.9% in the MET group and 76.0% in the MET + CRA-S group). The success rate in the MET group was 48.9% [95% confidence interval (CI) = 42.9-54.9%] versus 52.3% (95% CI = 46.2-58.3%) in the MET + CRA-S group. The odds of success in the two conditions did not differ (odds ratio = 1.22. 95% CI = 0.86-1.75, P = 0.26, Bayes factor = 0.10). Sensitivity analyses involving alternative approaches to missing values did not change the results. CONCLUSIONS In older adults with an alcohol use disorder diagnosis, adding the 'community reinforcement approach for seniors' intervention to brief out-patient motivational enhancement therapy treatment did not improve drinking outcome.
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Affiliation(s)
- Kjeld Andersen
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Mental Health Odense, Region of Southern Denmark, Odense, Denmark.,OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Silke Behrendt
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Randi Bilberg
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michael P Bogenschutz
- NYU Langone Medical Center, New York, NY, USA.,Health Sciences Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Barbara Braun
- Institut für Therapieforschung (IFT), Munich, Germany
| | - Gerhard Buehringer
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institut für Therapieforschung (IFT), Munich, Germany
| | | | - Anna Mejldal
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
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13
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Alcohol Consumption by Older People in Brazil: A Systematic Review of Population-based Studies. ADDICTIVE DISORDERS & THEIR TREATMENT 2019. [DOI: 10.1097/adt.0000000000000168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Buchmann N, Spira D, König M, Norman K, Demuth I, Steinhagen-Thiessen E. Problematic drinking in the old and its association with muscle mass and muscle function in type II diabetes. Sci Rep 2019; 9:12005. [PMID: 31427589 PMCID: PMC6700201 DOI: 10.1038/s41598-019-47787-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/18/2019] [Indexed: 12/25/2022] Open
Abstract
Problematic drinking behavior is common in the old and negative consequences of hypoglycemic episodes in type 2 diabetes (T2D) as a result of alcohol consumption have been described previously. Although, associations between such hypoglycemic episodes with reduced muscle mass are discussed, it is uncertain if problematic drinking behavior drives decline of muscle mass and/or muscle function. In the current study, we analyzed data of the Berlin Aging Study II (BASE-II) to examine the association of problematic drinking behavior with muscle mass and grip strength in T2D. Cross-sectional data of 1451 old BASE-II participants (51.6% women; 60–84 years old) were analyzed. Problematic drinking behavior was assessed using the Alcohol Use Identification Test (AUDIT). Muscle mass was measured using dual energy X-ray absorptiometry (DXA), grip strength using a Smedley dynamometer. Adjusted regression models were calculated to assess the association of problematic drinking with muscle mass and grip strength. Problematic drinking was evident in 11.2% of BASE-II participants and in 12.5% of BASE-II participants diabetes was evident. In the fully adjusted model (adjusted for age, trunk fat mass, HbA1c, antidiabetic medication, TSH, CRP, testosterone, physical inactivity, depression (GDS-score), morbidities, smoking status and total energy intake/day, we found a statistically significant association between problematic drinking and muscle mass (β-3.7, SE: 1.3, R2 0.481, partial eta square 0.166, observed power 0.816, p-value 0.005) and grip strength (β-8.1, SE: 3.3, R2 0.222, partial eta square 0.134, observed power 0.670, p-value 0.018) in old diabetic men. These associations were not evident in women and subjects without T2D. Problematic drinking behavior was associated with lower muscle mass and grip strength in old men with diabetes. This topic should be addressed in these subjects as they could be at increased risk for early functional decline, sarcopenia or frailty.
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Affiliation(s)
- Nikolaus Buchmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany. .,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
| | - Dominik Spira
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
| | - Maximilian König
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
| | - Kristina Norman
- German Institute of Human Nutrition, Department of Nutrition and Gerontology, Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.,Charite - Universitätsmedizin Berlin, Forschungsgruppe Geriatrie am EGZB, Berlin, Germany
| | - Ilja Demuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany.,Charité - Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Berlin, Germany
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15
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Adeloye D, Olawole-Isaac A, Auta A, Dewan MT, Omoyele C, Ezeigwe N, Jacobs W, Mpazanje RG, Harhay MO, Alemu W, Adewole IF. Epidemiology of harmful use of alcohol in Nigeria: a systematic review and meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:438-450. [DOI: 10.1080/00952990.2019.1628244] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Davies Adeloye
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
- RcDavies Evidence-Based Medicine, Lagos, Nigeria
| | | | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | | | | | - Wura Jacobs
- Department of Kinesiology, California State University, Stanislaus, Turlock, CA, USA
| | | | - Michael O. Harhay
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
- Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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16
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Kitua DW, Kabalimu TK, Muindi RR. Prevalence and Factors Associated With Hazardous Alcohol Consumption Among Motorcycle Taxi Riders in Kinondoni District, Dar-Es-Salaam, Tanzania: A Cross-Sectional Study. East Afr Health Res J 2019; 3:158-165. [PMID: 34308209 PMCID: PMC8279290 DOI: 10.24248/eahrj-d-19-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 08/26/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hazardous alcohol consumption is a significant public health problem contributing to road traffic accidents in nearly all countries. Despite the fact that motorcycles are involved in more than half of all road traffic accidents in Tanzania, little has been reported about hazardous alcohol consumption among motorcyclists. This study investigated the prevalence and factors associated with hazardous alcohol consumption among motorcycle taxi riders in Kinondoni District, Dar es Salaam. METHODS A cross-sectional survey was conducted in Kinondoni District in August 2018 among motorcycle taxi riders. Multistage sampling was applied to select the study participants. Data were collected using structured self-administered questionnaires incorporating the Alcohol Use Disorders Identification Test. Analysis was done using IBM SPSS version 20. RESULTS A total of 210 individuals participated in the study. Within the study sample, the prevalence of hazardous alcohol consumption was 61.5% (n=128). Hazardous alcohol consumption was positively associated with a positive family history of alcohol consumption (odds ratio [OR] 11.74; 95% confidence interval [CI], 5.14 to 26.79; P<.001). Protective factors were younger age (OR 0.09; 95% CI, 0.02 to 0.40; P<.001), having a secondary level of education (OR 0.21; 95% CI, 0.04 to 0.99; P=.034), having a primary level of education (OR 0.06; 95% CI, 0.01 to 0.26; P<.001), and being employed (OR 11.74; 95% CI, 5.14 to 26.79; P<.001). CONCLUSION A high prevalence of hazardous alcohol consumption among motorcycle taxi riders was reported along with several associated factors. Interventions to mitigate hazardous alcohol consumption among commercial motor vehicle drivers must be developed and implemented.
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Affiliation(s)
- Daniel W Kitua
- Department of Community Medicine, Faculty of Medicine, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania,Correspondence to Daniel W Kitua ()
| | - Titus K Kabalimu
- Department of Community Medicine, Faculty of Medicine, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Robert R Muindi
- Department of Community Medicine, Faculty of Medicine, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
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17
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Affiliation(s)
- Susan W Lehmann
- From the Johns Hopkins University School of Medicine, Baltimore
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18
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Parikh NS, Merkler AE, Jesudian A, Kamel H. Association between cirrhosis and aneurysmal subarachnoid hemorrhage. Ann Clin Transl Neurol 2018; 6:27-32. [PMID: 30656181 PMCID: PMC6331206 DOI: 10.1002/acn3.675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/12/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023] Open
Abstract
Objective Cirrhosis has been associated with nontraumatic subarachnoid hemorrhage (SAH). We sought to evaluate the specific association between cirrhosis and aneurysmal SAH. Methods We performed a retrospective cohort study using a sample of Medicare claims data from 2008 to 2015. Cirrhosis was defined using a validated ICD‐9‐CM diagnosis code algorithm. Nontraumatic SAH was identified using a validated approach requiring an inpatient claim for its ICD‐9‐CM diagnosis code. Additionally, we required the presence of an ICD‐9‐CM procedure code reflecting treatment of a cerebral aneurysm during the same hospitalization to ensure ascertainment of aneurysmal SAH specifically. We used survival statistics to calculate incidence rates and Cox proportional hazards models to evaluate the association between cirrhosis and aneurysmal SAH after adjustment for demographics, stroke risk factors, and comorbidities. Results We identified 10,658 (0.6%) patients with cirrhosis from among the 1,778,604 beneficiaries in our sample. The mean age of patients with cirrhosis was 73.5 (±7.8) years, and 48% were female. Over a mean of 4.7 (±2.1) years of follow‐up, 4,272 patients were hospitalized with aneurysmal SAH. The annual incidence of aneurysmal SAH in patients with cirrhosis was 0.12% (95% confidence interval [CI], 0.08–0.17%) compared to 0.05% (95% CI, 0.05–0.05%) in patients without cirrhosis. In the adjusted model, cirrhosis was independently associated with aneurysmal SAH (hazard ratio, 2.2; 95% confidence interval, 1.5–3.4). Interpretation Cirrhosis was independently associated with an increased risk of aneurysmal SAH among older individuals. Confirmation of these findings may yield opportunities for risk stratification and prevention.
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Affiliation(s)
- Neal S Parikh
- Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute Weill Cornell Medical College New York New York.,Department of Neurology Columbia University Medical Center New York New York
| | - Alexander E Merkler
- Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute Weill Cornell Medical College New York New York.,Department of Neurology Weill Cornell Medical College New York New York
| | - Arun Jesudian
- Division of Gastroenterology and Hepatology Weill Cornell Medical College New York New York
| | - Hooman Kamel
- Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute Weill Cornell Medical College New York New York.,Department of Neurology Weill Cornell Medical College New York New York
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19
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Dullius AADS, Fava SMCL, Ribeiro PM, Terra FDS. Alcohol consumption/dependence and resilience in older adults with high blood pressure. Rev Lat Am Enfermagem 2018; 26:e3024. [PMID: 30110100 PMCID: PMC6091391 DOI: 10.1590/1518-8345.2466.3024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/06/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate alcohol consumption/dependence and resilience in older adults with high blood pressure and to analyze the factors associated with these variables. METHOD a descriptive, cross-sectional, quantitative study developed with 300 older adult patients with high blood pressure from Family Health Strategy units in a municipality of Minas Gerais, Brazil. A semi-structured questionnaire called the Alcohol Use Disorder Identification Test and the Resilience Scale were used. Data were analyzed using the Pearson's chi-square test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. RESULTS 89.3% of the interviewees were low-risk for consuming alcoholic beverages. The variables gender, age, smoking and disease duration were significantly associated with alcohol consumption/dependence. 36.7% of the people presented a low resilience. The variables family and individual monthly income, education level, physical activity and leisure had an association with resilience. No statistically significant association was observed between alcohol consumption/dependence and resilience. CONCLUSION alcohol consumption and resilience can interfere with the physical and mental health of older adults with high blood pressure.
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Affiliation(s)
| | | | - Patrícia Mônica Ribeiro
- PhD, Adjunct Professor, Escola de Enfermagem, Universidade Federal
de Alfenas, Alfenas, MG, Brazil
| | - Fábio de Souza Terra
- PhD, Adjunct Professor, Escola de Enfermagem, Universidade Federal
de Alfenas, Alfenas, MG, Brazil
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20
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21
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Searby A, Maude P, McGrath I. The Experiences of Older Adults with Dual Diagnosis in an Inner Melbourne Community Mental Health Service. Issues Ment Health Nurs 2018; 39:420-426. [PMID: 29370568 DOI: 10.1080/01612840.2017.1413458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Less is known about the experiences of older adults (65+ years of age) with co-occurring mental health and alcohol and other drug use disorders (dual diagnosis) than is known about the experiences of their younger counterparts. This exploratory qualitative study sought to interview individuals receiving case management from an inner Melbourne community mental health service to determine their experiences of living with dual diagnosis and explore their interactions with mental health and addiction treatment, and general medical services alike. Six older adults with a dual mental health and substance disorder agreed to participate in a semi-structured interview process and provided their perspectives about living with complex mental illness and alcohol and other drug use. Several key themes emerged throughout the interview process, mirroring the notion of dual diagnosis being a complex phenomenon involving a number of interrelated factors: these include medical complexity, poor service engagement and long-term use of alcohol and other drugs. Interviews also demonstrate the challenges inherent in providing care to this cohort, with the participants frequently describing their experiences with services as being fraught with difficulty. The increased understanding of the perspectives of older adults with dual diagnosis provides the foundation for further research into this population in addition to influencing future nursing care provided to this cohort.
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Affiliation(s)
- Adam Searby
- a RMIT University (School of Health and Biomedical Sciences - Nursing) , Bundoora , Australia
| | - Phillip Maude
- b RMIT University (School of Health and Biomedical Sciences - Nursing), Bundoora, Australia/University of Tasmania, School of Health Sciences (Nursing) , Hobart , Australia
| | - Ian McGrath
- c RMIT University (School of Health and Biomedical Sciences - Nursing) , Bundoora , Australia
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22
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Birditt KS, Cranford JA, Manalel JA, Antonucci TC. Drinking Patterns Among Older Couples: Longitudinal Associations With Negative Marital Quality. J Gerontol B Psychol Sci Soc Sci 2018; 73:655-665. [PMID: 27353031 DOI: 10.1093/geronb/gbw073] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/06/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives Research with younger couples indicates that alcohol use has powerful effects on marital quality, but less work has examined the effects of drinking among older couples. This study examined whether dyadic patterns of drinking status among older couples are associated with negative marital quality over time. Method Married participants (N = 4864) from the Health and Retirement Study reported on alcohol consumption (whether they drink alcohol and average amount consumed per week) and negative marital quality (e.g., criticism and demands) across two waves (Wave 1 2006/2008 and Wave 2 2010/2012). Results Concordant drinking couples reported decreased negative marital quality over time, and these links were significantly greater among wives. Wives who reported drinking alcohol reported decreased negative marital quality over time when husbands also reported drinking and increased negative marital quality over time when husbands reported not drinking. Discussion The present findings stress the importance of considering the drinking status rather than the amount of alcohol consumed of both members of the couple when attempting to understand drinking and marital quality among older couples. These findings are particularly salient given the increased drinking among baby boomers and the importance of marital quality for health among older couples.
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Affiliation(s)
- Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor
| | | | | | - Toni C Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor
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23
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Polenick CA, Birditt KS, Blow FC. Couples' Alcohol Use in Middle and Later Life: Stability and Mutual Influence. J Stud Alcohol Drugs 2018; 79:111-118. [PMID: 29227239 PMCID: PMC5894855 DOI: 10.15288/jsad.2018.79.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Wives and husbands may influence one another's alcohol use, but little is known about within-couple patterns of alcohol consumption over time during midlife and later life. Drawing from a nationally representative U.S. sample of middle-aged and older married couples, we examined individual stability and partner influence in alcohol use across a 16-year period. METHOD The analytic sample comprised 1,257 married couples age 40 and older who completed nine waves of the Health and Retirement Study (1996-2012). Dyadic multilevel models were estimated to simultaneously examine the stability of one's own alcohol use (number of drinks per occasion and per week) over time as well as whether partner drinking predicted subsequent alcohol use within couples. Models controlled for marital duration. RESULTS Wives' and husbands' own prior alcohol use positively predicted alcohol use across waves, demonstrating individual stability in drinking patterns. Partners' alcohol use also positively predicted wives' and husbands' subsequent alcohol use, revealing partner influence in drinking patterns. Both stability and influence effects were stronger for husbands than for wives. CONCLUSIONS This study provides evidence of stability and mutual influence in long-term patterns of alcohol use within mid- and late-life married couples. Findings highlight the interdependence between spouses and indicate that partners' drinking should be considered when examining men's and women's alcohol use over time.
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Affiliation(s)
- Courtney A. Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Correspondence may be sent to: Courtney A. Polenick at the Department of Psychiatry, University of Michigan, 2800 Plymouth Rd, Building 16, Room 200S, Ann Arbor, MI 48109, or via email at:
| | - Kira S. Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, Michigan
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24
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Holahan CJ, Brennan PL, Schutte KK, Holahan CK, Hixon JG, Moos RH. Late-Life Drinking Problems: The Predictive Roles of Drinking Level vs. Drinking Pattern. J Stud Alcohol Drugs 2017; 78:435-441. [PMID: 28499111 DOI: 10.15288/jsad.2017.78.435] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Research on late-middle-aged and older adults has focused primarily on average level of alcohol consumption, overlooking variability in underlying drinking patterns. The purpose of the present study was to examine the independent contributions of an episodic heavy pattern of drinking versus a high average level of drinking as prospective predictors of drinking problems. METHOD The sample comprised 1,107 adults ages 55-65 years at baseline. Alcohol consumption was assessed at baseline, and drinking problems were indexed across 20 years. We used prospective negative binomial regression analyses controlling for baseline drinking problems, as well as for demographic and health factors, to predict the number of drinking problems at each of four follow-up waves (1, 4, 10, and 20 years). RESULTS Across waves where the effects were significant, a high average level of drinking (coefficients of 1.56, 95% CI [1.24, 1.95]; 1.48, 95% CI [1.11, 1.98]; and 1.85, 95% CI [1.23, 2.79] at 1, 10, and 20 years) and an episodic heavy pattern of drinking (coefficients of 1.61, 95% CI [1.30, 1.99]; 1.61, 95% CI [1.28, 2.03]; and 1.43, 95% CI [1.08, 1.90] at 1, 4, and 10 years) each independently increased the number of drinking problems by more than 50%. CONCLUSIONS Information based only on average consumption underestimates the risk of drinking problems among older adults. Both a high average level of drinking and an episodic heavy pattern of drinking pose prospective risks of later drinking problems among older adults.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, Texas
| | - Penny L Brennan
- Institute for Health and Aging, University of California, San Francisco, San Francisco, California
| | - Kathleen K Schutte
- Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California
| | - Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas
| | - J Gregory Hixon
- Department of Psychology, University of Texas at Austin, Austin, Texas
| | - Rudolf H Moos
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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25
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Baumeister SE, Finger JD, Gläser S, Dörr M, Markus MR, Ewert R, Felix SB, Grabe HJ, Bahls M, Mensink GB, Völzke H, Piontek K, Leitzmann MF. Alcohol consumption and cardiorespiratory fitness in five population-based studies. Eur J Prev Cardiol 2017; 25:164-172. [PMID: 29056079 DOI: 10.1177/2047487317738594] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Poor cardiorespiratory fitness is a risk factor for cardiovascular morbidity. Alcohol consumption contributes substantially to the burden of disease, but its association with cardiorespiratory fitness is not well described. We examined associations between average alcohol consumption, heavy episodic drinking and cardiorespiratory fitness. Design The design of this study was as a cross-sectional population-based random sample. Methods We analysed data from five independent population-based studies (Study of Health in Pomerania (2008-2012); German Health Interview and Examination Survey (2008-2011); US National Health and Nutrition Examination Survey (NHANES) 1999-2000; NHANES 2001-2002; NHANES 2003-2004) including 7358 men and women aged 20-85 years, free of lung disease or asthma. Cardiorespiratory fitness, quantified by peak oxygen uptake, was assessed using exercise testing. Information regarding average alcohol consumption (ethanol in grams per day (g/d)) and heavy episodic drinking (5+ or 6+ drinks/occasion) was obtained from self-reports. Fractional polynomial regression models were used to determine the best-fitting dose-response relationship. Results Average alcohol consumption displayed an inverted U-type relation with peak oxygen uptake ( p-value<0.0001), after adjustment for age, sex, education, smoking and physical activity. Compared to individuals consuming 10 g/d (moderate consumption), current abstainers and individuals consuming 50 and 60 g/d had significantly lower peak oxygen uptake values (ml/kg/min) (β coefficients = -1.90, β = -0.06, β = -0.31, respectively). Heavy episodic drinking was not associated with peak oxygen uptake. Conclusions Across multiple adult population-based samples, moderate drinkers displayed better fitness than current abstainers and individuals with higher average alcohol consumption.
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Affiliation(s)
- Sebastian E Baumeister
- 1 Division of Epidemiology, Technical University of Munich, Germany.,2 Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany.,3 Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Jonas D Finger
- 4 Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Germany
| | - Sven Gläser
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany
| | - Marcus Dörr
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany.,6 German Center for Cardiovascular Research (DZHK), Germany
| | - Marcello Rp Markus
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany.,6 German Center for Cardiovascular Research (DZHK), Germany
| | - Ralf Ewert
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany
| | - Stephan B Felix
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany.,6 German Center for Cardiovascular Research (DZHK), Germany
| | - Hans-Jörgen Grabe
- 7 Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Martin Bahls
- 5 Department of Internal Medicine B, University Medicine Greifswald, Germany.,6 German Center for Cardiovascular Research (DZHK), Germany
| | - Gert Bm Mensink
- 4 Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Germany
| | - Henry Völzke
- 3 Institute for Community Medicine, University Medicine Greifswald, Germany.,6 German Center for Cardiovascular Research (DZHK), Germany
| | - Katharina Piontek
- 8 Institute for Medical Psychology, University Medicine Greifswald, Germany
| | - Michael F Leitzmann
- 2 Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
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26
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Gano A, Doremus-Fitzwater TL, Deak T. A cross-sectional comparison of ethanol-related cytokine expression in the hippocampus of young and aged Fischer 344 rats. Neurobiol Aging 2017; 54:40-53. [PMID: 28319836 PMCID: PMC5401774 DOI: 10.1016/j.neurobiolaging.2017.01.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 01/02/2017] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Abstract
Our work in Sprague Dawley rats has shown rapid alterations in neuroimmune gene expression (RANGE) in the hippocampus and paraventricular nucleus of the hypothalamus (PVN). These manifest as increased interleukin (IL)-6 and IκBα, and suppressed IL-1β and tumor necrosis factor alpha during acute ethanol intoxication. The present studies tested these effects across the lifespan (young adulthood at 2-3 months; senescence at 18 and 24 months), as well as across strain (Fischer 344) and sex. The hippocampus revealed age-dependent shifts in cytokine expression (IL-6, IL-1β, and monocyte chemoattractant protein 1), but no changes were observed in the PVN at baseline or following ethanol. RANGE in adults was similar across sex and comparable with effects seen in Sprague Dawley rats. Plasma corticosterone levels increased with age, whereas the blood ethanol concentrations and loss of righting reflex were similar in all groups older than 2 months. These findings indicate that the RANGE effect is largely conserved across strain and is durable across age, even in the face of a shifting neuroimmune profile that emerges during immunosenescence.
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Affiliation(s)
- Anny Gano
- Behavioral Neuroscience Program, Department of Psychology, Binghamton University, Binghamton, NY, USA
| | | | - Terrence Deak
- Behavioral Neuroscience Program, Department of Psychology, Binghamton University, Binghamton, NY, USA.
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27
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Zapolski TCB, Baldwin P, Banks DE, Stump TE. Does a Crossover Age Effect Exist for African American and Hispanic Binge Drinkers? Findings from the 2010 to 2013 National Study on Drug Use and Health. Alcohol Clin Exp Res 2017; 41:1129-1136. [PMID: 28423479 PMCID: PMC5490378 DOI: 10.1111/acer.13380] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among general population studies, lower rates of binge drinking tend to be found among African Americans and Hispanics compared to Whites. However, among older adult populations, minority groups have been shown to be at higher risk for binge drinking, suggesting the presence of a crossover effect from low to high risk as a function of age. To date, limited research has examined the crossover effect among African American and Hispanic populations compared to non-Hispanic Whites across large developmental time frames or explored variation in risk based on income or gender. This study aimed to fill these gaps in the literature. METHODS Data were compiled from the 2010 to 2013 National Survey on Drug Use and Health surveys, which provide annual, nationally representative data on substance use behaviors among individuals aged 12 and older. Hispanic, non-Hispanic African American, and non-Hispanic White respondents were included (N = 205,198) in the analyses. RESULTS A crossover effect was found for African American males and females among the lowest income level (i.e., incomes less than $20,000). Specifically, after controlling for education and marital status, compared to Whites, risk for binge drinking was lower for African American males at ages 18 to 24 and for females at ages 18 to 34, but higher for both African American males and females at ages 50 to 64. No crossover effect was found for Hispanic respondents. CONCLUSIONS Although African Americans are generally at lower risk for binge drinking, risk appears to increase disproportionately with age among those who are impoverished. Explanatory factors, such as social determinants of health prevalent within low-income African American communities (e.g., lower education, violence exposure, housing insecurity) and potential areas for intervention programming are discussed.
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Affiliation(s)
- Tamika C B Zapolski
- Department of Psychology, Indiana University Purdue University - Indianapolis, Indianapolis, Indiana
| | - Patrick Baldwin
- Department of Psychology, Chestnut Hill College, Philadelphia, Pennsylvania
| | - Devin E Banks
- Department of Psychology, Indiana University Purdue University - Indianapolis, Indianapolis, Indiana
| | - Timothy E Stump
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
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Boule LA, Kovacs EJ. Alcohol, aging, and innate immunity. J Leukoc Biol 2017; 102:41-55. [PMID: 28522597 DOI: 10.1189/jlb.4ru1016-450r] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/24/2017] [Accepted: 04/13/2017] [Indexed: 12/15/2022] Open
Abstract
The global population is aging: in 2010, 8% of the population was older than 65 y, and that is expected to double to 16% by 2050. With advanced age comes a heightened prevalence of chronic diseases. Moreover, elderly humans fair worse after acute diseases, namely infection, leading to higher rates of infection-mediated mortality. Advanced age alters many aspects of both the innate and adaptive immune systems, leading to impaired responses to primary infection and poor development of immunologic memory. An often overlooked, yet increasingly common, behavior in older individuals is alcohol consumption. In fact, it has been estimated that >40% of older adults consume alcohol, and evidence reveals that >10% of this group is drinking more than the recommended limit by the National Institute on Alcohol Abuse and Alcoholism. Alcohol consumption, at any level, alters host immune responses, including changes in the number, phenotype, and function of innate and adaptive immune cells. Thus, understanding the effect of alcohol ingestion on the immune system of older individuals, who are already less capable of combating infection, merits further study. However, there is currently almost nothing known about how drinking alters innate immunity in older subjects, despite innate immune cells being critical for host defense, resolution of inflammation, and maintenance of immune homeostasis. Here, we review the effects of aging and alcohol consumption on innate immune cells independently and highlight the few studies that have examined the effects of alcohol ingestion in aged individuals.
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Affiliation(s)
- Lisbeth A Boule
- Department of Surgery, Division of GI, Trauma, and Endocrine Surgery (GITES), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; .,The Mucosal Inflammation Program (MIP), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.,The Investigations in Metabolism, Aging, Gender and Exercise (IMAGE) Research Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; and
| | - Elizabeth J Kovacs
- Department of Surgery, Division of GI, Trauma, and Endocrine Surgery (GITES), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; .,The Mucosal Inflammation Program (MIP), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.,The Investigations in Metabolism, Aging, Gender and Exercise (IMAGE) Research Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; and.,The Immunology Graduate Program, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA
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Han BH, Moore AA, Sherman S, Keyes KM, Palamar JJ. Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005-2014. Drug Alcohol Depend 2017; 170:198-207. [PMID: 27979428 PMCID: PMC5241162 DOI: 10.1016/j.drugalcdep.2016.11.003] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol use is common among older adults, and this population has unique risks with alcohol consumption in even lower amounts than younger persons. No recent studies have estimated trends in alcohol use including binge alcohol use and alcohol use disorders (AUD) among older adults. METHODS We examined alcohol use among adults age ≥50 in the National Survey on Drug Use and Health (NSDUH) from 2005 to 2014. Trends of self-reported past-month binge alcohol use and AUD were estimated. Logistic regression models were used to examine correlates of binge alcohol use and AUD. RESULTS The prevalence of both past-month binge alcohol use and AUD increased significantly among adults age ≥50 from 2005/2006 to 2013/2014, with a relative increase of 19.2% for binge drinking (linear trend p<0.001) and a 23.3% relative increase for AUD (linear trend p=0.035). While males had a higher prevalence of binge alcohol use and AUD compared to females, there were significant increases in both among females. In adjusted models of aggregated data, being Hispanic, male, and a smoker or illicit drug user were associated with binge alcohol use, while being male, a smoker, an illicit drug user, or reporting past-year depression or mental health treatment were associated with AUD. CONCLUSIONS Alcohol use among older adults is increasing in the US, including past-month binge alcohol use and AUD with increasing trends among females. Providers and policymakers need to be aware of these changes to address the increase of older adults with unhealthy drinking.
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Affiliation(s)
- Benjamin H Han
- New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, United States; Center for Drug Use and HIV Research, New York University Rory College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, United States.
| | - Alison A Moore
- University of California, San Diego, Department of Medicine, Division of Geriatrics, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Scott Sherman
- New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, United States; New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, United States
| | - Katherine M Keyes
- Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States
| | - Joseph J Palamar
- Center for Drug Use and HIV Research, New York University Rory College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, United States; New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, United States
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DiBartolo MC, Jarosinski JM. Alcohol Use Disorder in Older Adults: Challenges in Assessment and Treatment. Issues Ment Health Nurs 2017; 38:25-32. [PMID: 27936333 DOI: 10.1080/01612840.2016.1257076] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Alcohol use disorder (AUD) is a common, under-recognized, and under-treated health concern in older adults. Its prevalence is expected to reach unprecedented levels as the U.S. population ages; consequently, it is poised to place a significant burden on the healthcare system. Given the growing body of evidence regarding the patterns of use in this age group and the serious consequences of its misuse, it is critical that nurses and other healthcare providers assess for AUD in order to identify older adults in need of treatment. Yet, differences in symptom presentation, problems in isolating the symptoms of AUD from other healthcare complaints associated with aging, as well as the denial and fear of stigma that is especially pervasive in this age group, are major barriers to its identification and subsequent treatment. Furthermore, the lack of consistent use of evidence-based, age-specific screening instruments to identify those at risk is another significant obstacle to successful treatment. Healthcare providers in primary care are especially well-positioned to perform a systematic assessment utilizing appropriate instruments to identify AUD and initiate age-specific interventions, including the use of alcohol screening and brief interventions (ASBIs). The use of ASBIs, along with other targeted interventions such as mutual help groups (MHGs), such as Alcoholics Anonymous, can be key in encouraging insight, dismantling denial, and supporting treatment success, lifelong recovery, and overall quality of life in this vulnerable group.
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Affiliation(s)
- Mary C DiBartolo
- a Salisbury University , Department of Nursing , Salisbury , Maryland , USA
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Du Y, Wolf IK, Knopf H. Psychotropic drug use and alcohol consumption among older adults in Germany: results of the German Health Interview and Examination Survey for Adults 2008-2011. BMJ Open 2016; 6:e012182. [PMID: 27855095 PMCID: PMC5073532 DOI: 10.1136/bmjopen-2016-012182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The use and combined use of psychotropic drugs and alcohol among older adults is a growing public health concern and should be constantly monitored. Relevant studies are scarce in Germany. Using data of the most recent national health survey, we analyse prevalence and correlates of psychotropic drug and alcohol use among this population. METHODS Study participants were people aged 60-79 years (N=2508) of the German Health Interview and Examination Survey for Adults 2008-2011. Medicines used during the last 7 days were documented. Psychotropic drugs were defined as medicines acting on the nervous system (ATC code N00) excluding anaesthetics (N01), analgesics/antipyretics (N02B), but including opiate codeines used as antitussives (R05D). Alcohol consumption in the preceding 12 months was measured by frequency (drinking any alcohol-containing beverages at least once a week/a day) and quantity (alcohol consumed in grams/day; cut-offs: 10/20 g/day for women/men defining moderate and risky drinking). SPSS complex sample module was used for analysis. RESULTS 21.4% of study participants use psychotropic medications, 66.9% consume alcohol moderately and 17.0% riskily, 51.0% drink alcohol at least once a week and 18.4% daily, 2.8% use psychotropic drugs combined with daily alcohol drinking. Among psychotropic drug users, 62.7% consume alcohol moderately, 14.2% riskily. The most frequently used psychotropic medications are antidepressants (7.9%) and antidementia (4.2%). Factors associated with a higher rate of psychotropic drug use are female sex, worse health status, certified disability and polypharmacy. Risky alcohol consumption is positively associated with male sex, smoking, upper social class, better health status, having no disability and not living alone. CONCLUSIONS Despite the high risk of synergetic effects of psychotropic drugs and alcohol, a substantial part of older psychotropic drug users consume alcohol riskily and daily. Health professionals should talk about the additional health risks of alcohol consumption when prescribing psychotropic drugs to older adults.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Ingrid-Katharina Wolf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
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Reczek C, Pudrovska T, Carr D, Thomeer MB, Umberson D. Marital Histories and Heavy Alcohol Use among Older Adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:77-96. [PMID: 26957135 PMCID: PMC4785832 DOI: 10.1177/0022146515628028] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We develop a gendered marital biography approach-which emphasizes the accumulating gendered experiences of singlehood, marriage, marital dissolution, and remarriage-to examine the relationship between marital statuses and transitions and heavy alcohol use. We test this approach using individual-level (n = 10,457) and couple-level (n = 2,170) longitudinal data from the Health and Retirement Study, and individual-level (n = 46) and couple-level (n = 42) in-depth interview data. Quantitative results show that marriage, including remarriage, reduces men's but increases women's drinking relative to being never married and previously married, whereas divorce increases men's but decrease women's drinking, with some variation by age. Our qualitative findings reveal that social control and convergence processes underlie quantitative results. We call attention to how men's and women's heavy drinking trajectories stop, start, and change direction as individuals move through their distinctive marital biography.
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Fink A, Kwan L, Osterweil D, Van Draanen J, Cooke A, Beck JC. Assessing the Usability of Web-Based Alcohol Education for Older Adults: A Feasibility Study. JMIR Res Protoc 2016; 5:e11. [PMID: 26832213 PMCID: PMC4754533 DOI: 10.2196/resprot.4545] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/21/2015] [Accepted: 11/02/2015] [Indexed: 11/13/2022] Open
Abstract
Background Older adults can experience unfavorable health effects from drinking at relatively low consumption levels because of age-related physiological changes and alcohol’s potentially adverse interactions with declining health, increased medication-use and diminishing functional status. At the same time, alcohol use in older adults may be protective against heart disease, stroke, and other disorders associated with aging. We developed “A Toast to Health in Later Life! Wise Drinking as We Age,” a web-based educational intervention to teach older adults to balance drinking risks and benefits. Objective To examine the intervention’s feasibility in a sample of community-dwelling current drinkers ≥55 years of age and examine its effects on their quantity and frequency of alcohol use, adherence to standard drinking guidelines, and alcohol-related risks. Methods Participants were recruited in person, by mail and by telephone between September and October 2014 from a community-based social services organization serving Los Angeles County. Once enrolled, participants were randomly assigned to the intervention or to a control group. The conceptual frameworks for the intervention were the Health Belief Model, models of adult learning, and the US Department of Health and Human Services guidelines for designing easy-to-use websites. The intervention’s content focuses on the relationship between drinking and its effects on older adults’ medical conditions, use of medications, and ability to perform daily activities. It also addresses quantity and frequency of alcohol use, drinking and driving and binge drinking. The control group did not receive any special intervention. Data on alcohol use and risks for both groups came from the online version of the Alcohol-Related Problems Survey and were collected at baseline and four weeks later. Data on usability were collected online from the intervention group immediately after it completed its review of the website. Results The 49 intervention and 47 control participants did not differ at baseline in age, ethnicity, medication use, medical conditions, or alcohol use and both groups were mostly female, college-educated, and in good health. Of the intervention participants, 94% (46/49) had little or no difficulty using the website, with 67% (33/49) reporting that they will change the way they think about drinking because of their exposure to the education. At the 4-week follow-up, the intervention group reported drinking less (P=.02). No changes between groups were found in quantity and frequency, adherence to recommended guidelines, or risk status. Conclusions Community-dwelling older adults are receptive to online alcohol education. To be most effective, the education should be included as a component of a larger effort consisting of screening and counseling preferably in a health care setting.
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Affiliation(s)
- Arlene Fink
- Arlene Fink Associates, Pacific Palisades, CA, United States.
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Choi NG, Marti CNN, DiNitto DM, Choi BY. Alcohol Use as Risk Factors for Older Adults' Emergency Department Visits: A Latent Class Analysis. West J Emerg Med 2015; 16:1146-58. [PMID: 26759670 PMCID: PMC4703192 DOI: 10.5811/westjem.2015.9.27704] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Late middle-aged and older adults' share of emergency department (ED) visits is increasing more than other age groups. ED visits by individuals with substance-related problems are also increasing. This paper was intended to identify subgroups of individuals aged 50+ by their risk for ED visits by examining their health/mental health status and alcohol use patterns. METHODS Data came from the 2013 National Health Interview Survey's Sample Adult file (n=15,713). Following descriptive analysis of sample characteristics by alcohol use patterns, latent class analysis (LCA) modeling was fit using alcohol use pattern (lifetime abstainers, ex-drinkers, current infrequent/light/moderate drinkers, and current heavy drinkers), chronic health and mental health status, and past-year ED visits as indicators. RESULTS LCA identified a four-class model. All members of Class 1 (35% of the sample; lowest-risk group) were infrequent/light/moderate drinkers and exhibited the lowest probabilities of chronic health/mental health problems; Class 2 (21%; low-risk group) consisted entirely of lifetime abstainers and, despite being the oldest group, exhibited low probabilities of health/mental health problems; Class 3 (37%; moderate-risk group) was evenly divided between ex-drinkers and heavy drinkers; and Class 4 (7%; high-risk group) included all four groups of drinkers but more ex-drinkers. In addition, Class 4 had the highest probabilities of chronic health/mental problems, unhealthy behaviors, and repeat ED visits, with the highest proportion of Blacks and the lowest proportions of college graduates and employed persons, indicating significant roles of these risk factors. CONCLUSION Alcohol nonuse/use (and quantity of use) and chronic health conditions are significant contributors to varying levels of ED visit risk. Clinicians need to help heavy-drinking older adults reduce unhealthy alcohol consumption and help both heavy drinkers and ex-drinkers improve chronic illnesses self-management.
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Affiliation(s)
- Namkee G. Choi
- The University of Texas at Austin, School of Social Work, Austin, Texas
| | | | - Diana M. DiNitto
- The University of Texas at Austin, School of Social Work, Austin, Texas
| | - Bryan Y. Choi
- Brown University, Department of Emergency Medicine, Providence, Rhode Island
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Choi NG, DiNitto DM, Marti CN. Alcohol and other substance use, mental health treatment use, and perceived unmet treatment need: Comparison between baby boomers and older adults. Am J Addict 2015; 24:299-307. [DOI: 10.1111/ajad.12225] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/21/2015] [Accepted: 03/23/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Namkee G. Choi
- University of Texas at Austin School of Social Work; 1925 San Jacinto Blvd, D3500 Austin Texas 78712
| | - Diana M. DiNitto
- University of Texas at Austin School of Social Work; 1925 San Jacinto Blvd, D3500 Austin Texas 78712
| | - C. Nathan Marti
- University of Texas at Austin School of Social Work; 1925 San Jacinto Blvd, D3500 Austin Texas 78712
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Choi NG, DiNitto DM, Marti CN. Risk Factors for Self-reported Driving Under the Influence of Alcohol and/or Illicit Drugs Among Older Adults. THE GERONTOLOGIST 2014; 56:282-91. [DOI: 10.1093/geront/gnu070] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/29/2014] [Indexed: 11/14/2022] Open
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Jackson JL. Capsule commentary on Wilson et al., the prevalence of harmful and hazardous alcohol consumption in U.S. older adults. J Gen Intern Med 2014; 29:357. [PMID: 24146348 PMCID: PMC3912287 DOI: 10.1007/s11606-013-2611-1] [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: 11/29/2022]
Affiliation(s)
- Jeffrey L Jackson
- Division of General Internal Medicine, Zablocki VA Medical Center, Milwaukee, WI, 53295, USA,
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