Alcohol consumption, cigarette smoking, and subjective health in Korean elderly men

Effects of chronic disease diagnoses on alcohol consumption among elderly individuals: longitudinal evidence from China

OBJECTIVES

This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour.

SUBJECTS AND PARTICIPANTS

Our analysis was applied to a publicly available dataset that covers 5724 individuals aged 50 or above and spans 15 years (2000-2015: six waves) from the China Health and Nutrition Survey.

DESIGN

The outcome variables are elderly individuals' weekly consumption of alcoholic beverages: beer, red wine, Chinese spirits and total alcohol intake. The explanatory variable of primary interest is the number of chronic diseases diagnosed (including hypertension, diabetes, stroke and myocardial infarction). Other covariates concern sample individuals' sociodemographic and health-related characteristics. A Chamberlain-Mundlak correlated random-effect Tobit model is adopted to simultaneously account for the clustering of 'zeros' in the outcome variable and endogeneity issues such as omitted variables and reverse causality.

RESULTS

Our estimation suggests that, on average, an additional chronic disease diagnosed by medical doctors reduced an elderly Chinese individual's weekly consumption of beer, red wine and Chinese spirits, respectively, by 1.49 (95% CI -2.85 to -0.13), 0.93 (95% CI -1.63 to -0.23) and 0.89 (95% CI -1.23 to -0.54) ounces. These effects translate into a reduction of 0.95 (95% CI -1.29 to -0.60) ounces in total weekly alcohol consumption and a reduction of 24% (95% CI -0.35 to -0.14) in the incidence of excessive drinking. Further explorations suggest that elderly Chinese individuals' alcohol consumption is most responsive to diabetes and stroke diagnoses, but the effects vary across different beverages. Moreover, males, rural residents, smokers and those living with non-drinkers respond to CDDs more strongly than their respective counterparts.

CONCLUSION

While CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.

Frey's procedure for chronic pancreatitis: a 10-year single-center experience in Korea

Purpose

Chronic pancreatitis (CP) is progressive inflammatory disease that leads to irreversible destruction of the pancreatic parenchyma. The main indications for surgical intervention in cases involving CP are intractable pain, suspicion of malignancy, and failure of other methods. However, there is no report related to Frey's procedure in Korea; hence, we aimed to investigate and analyze our institution's experience and determine the benefits of surgical treatment for CP.

Methods

This was a retrospective study of 24 patients with CP who underwent Frey's procedure at Gangnam Severance Yonsei University between January 2007 and December 2017. Preoperative exocrine and endocrine pancreatic function, perioperative finding (blood loss, operation time), postoperative complications were evaluated. Statistical analytics were chi-square test, Fisher exact tests, and Wilcoxon signed-rank test and Mann-Whitney U-test.

Results

Surgery was performed due to alcohol-derived CP in 12 of 24 patients (50%) and due to pancreatic stones in 15 of 24 patients (62.5%). Two patients had postoperative complications which were managed conservatively. After surgery, 7 of 24 patients were prescribed with exocrine medication. Comparison of the preoperative and postoperative conditions showed that glycated hemoglobin had no significant differences. After surgery, only 5 patients (21%) complained of intermittent abdominal pain.

Conclusion

In conclusion, Frey's procedure appears to be a less burdensome surgical procedure. Thus, it could be the first option for management of patients with large pancreatic stone.

Domains and Determinants of Well-Being of Older Adults in India

This study proposes a well-being index of older adults which integrates five domains, namely, activities of daily living, health status, psychological strength, life accomplishment and social ties, and examines potential socio-demographic, living arrangement, lifestyle and religiosity determinants of well-being. The present study uses micro data of 1255 older adults from the recent pilot survey for the Longitudinal Aging Study in India (LASI) conducted in 2010. The results suggest that normal activities of daily life, health, and social ties decline with advancing age, while life accomplishment remains stable over age. However, when all domains are integrated, well-being tends to fade out with advancing age. While smoking has a deterrent effect on well-being, better economic status, literacy, living in a joint family with spouse, religiosity, and regular physical exercise have a statistically significant positive effect on the well-being of older adults in India.

Relações hipotéticas entre os determinantes sociais da saúde que influenciam na obesidade em idosos

Os elevados índices de prevalência de obesidade em idosos suscitam a necessidade de compreender os fatores envolvidos nesta desordem nutricional, por meio de métodos quantitativos que permitam uma análise relacional desses determinantes. O objetivo deste estudo foi propor um modelo hipotético que estabeleça as relações entre os determinantes sociais da saúde associados à obesidade em idosos. Para a construção do modelo hipotético, foram delineadas as variáveis latentes e observadas de acordo com a análise de 45 artigos nacionais e internacionais e em concordância com o referencial da Modelagem de Equações Estruturais. Foi construído um diagrama representativo para evidenciar as correlações entre os 11 determinantes sociais da saúde relacionados à obesidade no idoso: atividade física, tabagismo, etilismo, consumo alimentar, contato social, ocupação, renda, escolaridade, idade, sexo e estado civil. Espera-se que as relações hipotéticas estabelecidas no estudo contribuam para a compreensão das relações dos fatores que estão envolvidos nesse contexto visando ao desenvolvimento de estratégias para a saúde da pessoa idosa.

Gender differences in alcohol consumption among middle-aged and older adults in Australia, the United States and Korea

OBJECTIVES

To compare gender differences in alcohol use and the socioeconomic correlates of at-risk drinking among middle-aged and older adults in Australia, the United States (US) and South Korea.

METHOD

Data were drawn from large nationally representative surveys of people aged 45 years and older, collected in 2006.

RESULTS

Rates of any drinking and at-risk drinking (>14 US standard drinks/week) were higher for males than females in all countries and these gender differences were largest in Korea. Socioeconomic differentials for at-risk drinking varied by country and gender. In the US, at-risk drinking was associated with lower educational levels among men, but higher educational levels among women; in Korea, it was associated with being unpartnered, particularly for women; and in Australia, at-risk drinking was associated with higher income.

CONCLUSIONS

Gender-role expectations differ between countries and may influence both the levels at which older adults consume alcohol and the ways in which at-risk drinking is associated with socioeconomic factors.

IMPLICATIONS

Heavy alcohol use in middle-aged and older adults is a cause for concern. Health promotion strategies should target older age groups and consider the ways in which gender, marital status and education influence norms and opportunities for risky alcohol use.

Alcohol and the older adult: a comprehensive review

Alcohol consumption in the older adult is of major concern with the advent of baby boomers coming into the over 65-age bracket. Alcohol consumption has been touted as beneficial for health, and while that may be accurate for moderate consumption in younger persons, there is considerable risk associated with increased alcohol intake in older adults. This increase is partially due to age-related physiological changes, existing diagnoses, number of comorbid conditions, and increased use of prescribed and/or over-the-counter medications, coupled with other concerns. This review addresses the current research regarding ethanol consumption in older adults and all-cause mortality as well as several conditions more frequently seen in the geriatric population. These conditions include vascular diseases, hypertension, type 2 diabetes, gastrointestinal disorders, hepatic disorders, dental and oro-facial problems, bone density decline, and falls and fractures. In addition, drug interactions and recent research into select vitamin and mineral considerations with increased alcohol intake in older persons are addressed. While recommendations for alcohol intake have not been specifically established for age ranges within the 65-year-and-older bracket, and practitioners do not routinely assess alcohol intake or ethanol related adverse events in this population, common sense approaches to monitoring will become increasingly important as the generation of "boomers" who believe that alcohol intake improves health comes of age.

Alcoolismo e tabagismo em idosos: relação com ingestão alimentar e aspectos socioeconômicos

OBJETIVOS: Verificar a prevalência do alcoolismo e tabagismo em idosos residentes na cidade de Porto Alegre, RS, e estabelecer sua relação entre a ingestão alimentar diária e o nível socioeconômico, de acordo com o sexo, grupo etário, escolaridade, renda, situação e composição familiar. MÉTODOS: Esta pesquisa fez parte do Projeto Estudo Multidimensional dos Idosos de Porto Alegre (EMIPOA), que foi desenvolvida pelo IGG/PUCRS. As entrevistas foram realizadas no ambulatório do Instituto de Geriatria e Gerontologia do Hospital São Lucas da PUCRS. Foi aplicado um questionário com dados socioeconômicos e de saúde por profissionais treinados. RESULTADOS: Dos 832 entrevistados, 71,2% eram mulheres e 28,8% homens. A faixa etária mais prevalente foi de 60 a 69 anos (44,8%). Com prevalência na faixa etária acima citada de 7,5% para alcoolistas e 23,9% para tabagistas. O alcoolismo e o tabagismo prevaleceram entre os homens, 11,7% e 20,8%, respectivamente. Em relação à escolaridade, a maior prevalência foi entre alcoolistas e tabagistas que possuíam apenas o 1º grau, 4,7% e 16,1%, respectivamente. Observou-se que dentre os idosos alcoolistas ou fumantes, a maioria não tem relação familiar (P<0,001). Já em relação à ingestão alimentar, houve um maior número de fumantes ou alcoolistas que fazem de 1 a 2 refeições diárias. CONCLUSÕES: Existem poucos estudos que investigam as tendências e consequências do tabagismo e alcoolismo entre a população idosa. Ações de saúde devem ser planejadas, visando a diminuir o consumo abusivo de álcool e tabagismo, bem como prevenir seus malefícios a saúde.

How Gender and Religion Influence Alcohol Use in Elderly Korean Immigrants

This study examined the effects of religion and gender on drinking behaviors among a sample of 148 older Korean immigrants living in a metropolitan area in Canada. Face-to-face interviews were conducted using standardized questions. The mean age of the participants was 74 years (range: 60-97 years). Logistic regression models were used to assess the effects of religion on drinking and heavier drinking and gender differences in correlates of current drinking and heavier drinking. Results revealed that being married and having lower religiosity were significant correlates that increased the odds of being a current drinker. Older Korean men tend to engage in heavier drinking behavior. Higher religiosity, not mere affiliation to Protestant churches, decreased the odds of heavier drinking for both men and women. The odds of heavier drinking increased for depressed men. Study limitations and implications are presented in a cultural context.

Prevalence and neuropsychiatric comorbidities of alcohol use disorders in an elderly Korean population

OBJECTIVES

We investigated the prevalence and comorbidities of problem drinking in community-dwelling elders living in Korea.

METHODS

Structured face-to-face diagnostic interviews were administered to the 714 Korean elders randomly sampled from Seongnam, Korea. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and the Alcohol Use Disorders Identification Test (AUDIT) scores, the participants were categorized into one of six diagnostic groups: lifetime abstainer, ex-drinker, social drinking, at-risk drinking, alcohol abuse, and alcohol dependence.

RESULTS

Prevalence rates of social drinking, at-risk drinking, alcohol abuse, and alcohol dependence were estimated to be 13.60%, 5.42%, 2.28%, and 2.92%, respectively. Problem drinking was associated with increased risks of smoking (OR = 3.52), whereas social drinking was associated with decreased risks of stroke (OR = 0.27) and depression (OR = 0.49).

CONCLUSIONS

Problem drinking was common particularly in men and associated with smoking. Social drinking was associated with the lower risks of stroke and depression.

Smoking patterns within a primary care sample of resettled Bosnian refugees

The interconnections among smoking status, severity of nicotine related physical dependence (NRPD), posttraumatic stress disorder (PTSD)-related physiological arousal and subjective health were explored within a sample of 66 resettled Bosnian refugees seeking primary healthcare services. Fifty-nine percent (n = 39/66) of the participants reported that they were current smokers and 44% (n = 29/66) indicated that they had smoked prior to the war. Both pre-war smoking and PTSD arousal independently predicted current smoking. In addition, total PTSD arousal and individual symptoms of sleep difficulties, irritability, concentration, and hypervigilance were significantly and positively associated with NRPD. Severity of PTSD arousal and age uniquely predicted NRPD. While poorer subjective health was significantly associated with positive current smoking status, neither poorer subjective health nor severity of PTSD arousal was significantly associated with interest in quitting/reducing smoking. Findings were discussed within the context of culture and stressor-related issues.

DIFFERENCES BETWEEN SMOKERS AND NONSMOKERS IN MORNINGNESS-EVENINGNESS

Some factors influencing smoking habits have been identified, but chronotype or the misalignment of social and biological time has rarely been examined. In this study, chronotype was examined and it was found that on average, smokers consumed more coffee, more alcohol, and had less developed breakfast habits compared with nonsmokers. Smokers tended towards eveningness and had a greater difference in wake-up times between week days and free days. Using a canonical discriminant function it was found that breakfast habits, coffee and alcohol consumption, total Composite Scale of Morningness (CSM) score, and weekend sleep-in separated smokers from nonsmokers, while age and gender were excluded. As late chronotypes do not fit well into conventional social and working schedules, this relationship can be interpreted as a behavioral symptom of the inability to cope with social demands.