Acute Behavioral and Long-Term Health Effects of Moderate Alcohol Use in Older Adults

Neural and Psychosocial Mechanisms Underlying Alcohol Use and Pain Interactions: Overview of Current Evidence and Future Directions

Purpose of Review

A growing body of research indicates bidirectional associations between alcohol use and pain. In this review, we highlight common neural and psychosocial mechanisms underlying pain and alcohol use and identify current gaps in the literature regarding alcohol/pain interactions. We also suggest future directions for the field moving forward, including more nuanced conceptualization of alcohol's negative reinforcing effects in the context of pain, broader use of clinically-relevant experimental pain induction modalities, and characterization of age, biological sex, gender, race, and ethnicity as moderators of pain/alcohol interactions.

Recent Findings

Acute alcohol intake has analgesic and negative-reinforcing effects in the context of pain, and chronic heavy alcohol use appears to increase risk for development of chronic pain. At the same time, pain, both acute and chronic, acts as a proximal antecedent for alcohol use and is associated with relapse risk for individuals in recovery from alcohol use disorder.

Summary

Although the links between alcohol use and pain are increasingly appreciated, significant gaps in understanding remain and systematic study of alcohol/pain interactions at all levels, including basic, preclinical, translational, and interventional, is needed.

Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality

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.

Functional limitation in later-life: the impact of sips, socialization, and sadness

OBJECTIVES

Findings on the health impact of moderate alcohol use in later-life have been discrepant. Unaddressed mechanisms of action and validity concerns may contribute to contrasting results. Several studies have demonstrated a beneficial relationship between moderate alcohol use and functional ability. Research is needed to identify mechanisms of action that explain this relationship, while employing methods to reduce common validity concerns in alcohol use research. This study examines social interaction and depressive symptoms as serial mediators in the relationship between moderate alcohol use and functional limitation in later-life.

METHOD

HRS data from 2012-2016 were utilized (n = 1,474); heavy drinkers, adults younger than 65, and respondents with inconsistent alcohol use from 2008 to 2016 were excluded. Hypotheses were evaluated using a longitudinal serial mediation model with bias-corrected bootstrapping.

RESULTS

Results indicated that, in the context of demographic variables, medical burden, and previous functional limitation, the relationship between 2012 moderate alcohol use and 2016 reduced functional limitation is only present when considering the mediating effect of 2014 depressive symptoms as a single mediator, and 2012 social interaction and 2014 depressive symptoms as serial mediators, respectively (total effect model R²=.167).

CONCLUSIONS

Data indicate that relationships between moderate drinking and reduced functional limitation are explained through increased social interaction and subsequent reduced depressive symptoms. Results identify social interaction as an accessible treatment target to address depressive symptoms and functional limitation, and support increased assessment of IADLs in adults experiencing depressive symptoms (and vice versa) to facilitate early treatment/prevention of functional and emotional decline.

Effects of low-to-moderate ethanol consumption on colonic growth and gene expression in young adult and middle-aged male rats

Excessive alcohol consumption is a risk factor associated with colorectal cancer; however, some epidemiological studies have reported that moderate alcohol consumption may not contribute additional risk or may provide a protective effect reducing colorectal cancer risk. Prior research highlights the importance of proliferation, differentiation, and apoptosis as parameters to consider when evaluating colonic cell growth and tumorigenesis. The present study investigated whether chronic low-to-moderate ethanol consumption altered these parameters of colonic cell growth and expression of related genes. Twenty-four nondeprived young adult (109 days old) and 24 nondeprived middle-aged (420 days old) Wistar rats were randomly assigned to an ethanol-exposed or a water control group (n = 12/group). The ethanol group was provided voluntary access to a 20% v/v ethanol solution on alternate days for 13 weeks. Colon tissues were collected for quantitative immunohistochemical analyses of cell proliferation, differentiation and apoptosis using Ki-67, goblet cell and TUNEL, respectively. Gene expression of cyclin D1 (Ccnd1), Cdk2, Cdk4, p21waf1/cip1 (Cdkn1a), E-cadherin (Cdh1) and p53 were determined by quantitative real-time polymerase chain reaction in colonic scraped mucosa. Ethanol treatment resulted in a lower cell proliferation index and proliferative zone, and lower Cdk2 expression in both age groups, as well as trends toward lower Ccnd1 and higher Cdkn1a expression. Cell differentiation was modestly but significantly reduced by ethanol treatment only in older animals. Overall, older rats showed decreases in apoptosis and gene expression of Cdk4, Cdh1, and p53 compared to younger rats, but there was no observed effect of ethanol exposure on these measures. These findings suggest that low-to-moderate ethanol consumption improves at least one notable parameter in colonic tumorigenesis (cell proliferation) and associated gene expression regardless of age, however, selectively decreased cell differentiation among older subjects.

Acute Alcohol Intake Produces Widespread Decreases in Cortical Resting Signal Variability in Healthy Social Drinkers

BACKGROUND

Acute alcohol intoxication has wide-ranging neurobehavioral effects on psychomotor, attentional, inhibitory, and memory-related cognitive processes. These effects are mirrored in disruption of neural metabolism, functional activation, and functional network coherence. Metrics of intraregional neural dynamics such as regional signal variability (RSV) and brain entropy (BEN) may capture unique aspects of neural functional capacity in healthy and clinical populations; however, alcohol's influence on these metrics is unclear. The present study aimed to elucidate the influence of acute alcohol intoxication on RSV and to clarify these effects with subsequent BEN analyses.

METHODS

26 healthy adults between 25 and 45 years of age (65.4% women) participated in 2 counterbalanced sessions. In one, participants consumed a beverage containing alcohol sufficient to produce a breath alcohol concentration of 0.08 g/dl. In the other, they consumed a placebo beverage. Approximately 35 minutes after beverage consumption, participants completed a 9-minute resting-state fMRI scan. Whole-brain, voxel-wise standard deviation was used to assess RSV, which was compared between sessions. Within clusters displaying alterations in RSV, sample entropy was calculated to assess BEN.

RESULTS

Compared to the placebo, alcohol intake resulted in widespread reductions in RSV in the bilateral middle frontal, right inferior frontal, right superior frontal, bilateral posterior cingulate, bilateral middle temporal, right supramarginal gyri, and bilateral inferior parietal lobule. Within these clusters, significant reductions in BEN were found in the bilateral middle frontal and right superior frontal gyri. No effects were noted in subcortical or cerebellar areas.

CONCLUSIONS

Findings indicate that alcohol intake produces diffuse reductions in RSV among structures associated with attentional processes. Within these structures, signal complexity was also reduced in a subset of frontal regions. Neurobehavioral effects of acute alcohol consumption may be partially driven by disruption of intraregional neural dynamics among regions involved in higher-order cognitive and attentional processes.

The Benefit of Moderate Alcohol Use on Mood and Functional Ability in Later Life: Due to Beers or Frequent Cheers?

BACKGROUND AND OBJECTIVES

Evidence relates moderate alcohol consumption in later life to fewer depressive symptoms and greater functional ability. This study evaluated social interaction as a mediator of these outcomes.

RESEARCH DESIGN AND METHODS

Data included older adults in the Health and Retirement Study. In Study 1, cross-sectional mediation analyses evaluated social interaction as a mechanism through which moderate alcohol use was related to decreased depressive symptomatology (Model 1; N = 2,294) and less functional limitation (Model 2; N = 2,357). In Study 2, longitudinal cross-lagged path analyses further evaluated the impact of moderate alcohol use and social interaction on future depressive symptoms and functional limitation.

RESULTS

In Study 1, results from Model 1 indicated that moderate alcohol use was associated with decreased depressive symptomatology indirectly via greater social interaction. In Model 2, moderate alcohol use was associated with less functional limitation indirectly via greater social interaction. In Study 2, significant indirect effects corroborated findings from Study 1. In Model 3, moderate alcohol use in 2012 inversely predicted depressive symptomatology in 2014 via greater levels of social interaction in 2012. In Model 4, moderate alcohol use in 2012 predicted less functional limitation in 2014 via greater social interaction in 2012.

DISCUSSION AND IMPLICATIONS

Social interaction is essential to the seemingly beneficial effect of moderate alcohol use on depressive symptomatology and functional ability. Clinically, this suggests caution in attributing health benefits to consumption of alcohol itself and identifies social interaction as a treatment target for improved health outcomes in later life.

Alcohol Use, Age, and Self-Rated Mental and Physical Health in a Community Sample of Lesbian and Bisexual Women

PURPOSE

Given that self-perceptions of mental and physical health are important predictors of health outcomes and well-being, particularly among older adults, this study focuses on associations among age, alcohol consumption, and indicators of both self-rated mental health and self-rated physical health in a sample of sexual minority women (SMW).

METHODS

This study uses a community sample of SMW to examine the associations among age, drinking, and self-rated mental and physical health.

RESULTS

Heavy drinking among older adult SMW (55+) was less prevalent than among young SMW, ages 18-25 and ages 26-39, but similar to rates reported among SMW ages 40-54. In addition, older SMW reported significantly higher levels of self-rated mental health, compared with SMW in the other age groups, but we found no significant associations between age and self-rated physical health. Across all age groups, moderate drinkers reported better self-rated physical health than alcohol abstainers.

CONCLUSIONS

Overall, these results suggest that, among SMW, drinking does not decline as sharply with age as it does for heterosexual women in the general population. Given the current and projected increases in the aging population and the risks that heavy drinking presents for morbidity and mortality, interventions aimed at older SMW are needed.

Effects of Age and Acute Moderate Alcohol Administration on Electrophysiological Correlates of Working Memory Maintenance

BACKGROUND

Previous studies suggest older adults may be differentially susceptible to the acute neurobehavioral effects of moderate alcohol intake. To our knowledge, no studies have addressed acute moderate alcohol effects on the electrophysiological correlates of working memory in younger and older social drinkers. This study characterized alcohol-related effects on frontal theta (FTP) and posterior alpha power (PAP) associated with maintenance of visual information during a working memory task.

METHODS

Older (55 to 70 years of age; n = 51, 29 women) and younger (25 to 35 years of age; n = 70, 39 women) community-dwelling moderate drinkers were recruited for this study. Participants were given either placebo or an active dose targeting breath alcohol concentrations (BrACs) of 0.04 or 0.065 g/dl. Following absorption, participants completed a visual working memory task assessing cue recognition following a 9-s delay. FTP and PAP were determined via Fourier transformation and subjected to 2 (age group) × 3 (dose) × 2 (repeated: working memory task condition) mixed models analysis.

RESULTS

In addition to expected age-related reductions in PAP, a significant age group × dose interaction was detected for PAP such that 0.04 g/dl dose level was associated with greater PAP in younger adults but lower PAP in their older counterparts. PAP was lower in older versus younger adults at both active doses. Further mixed models revealed a significant negative association between PAP and working memory efficiency for older adults. No effects of age, dose, or their interaction were noted for FTP.

CONCLUSIONS

Results bolster the small but growing body of evidence that older adults exhibit differential sensitivity to the neurobehavioral effects of moderate alcohol use. Given the theoretical role of PAP in attentional and working memory function, these findings shed light on the attentional mechanisms underlying effects of acute moderate alcohol on working memory efficiency in older adults.