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Mejldal A, Andersen K, Behrendt S, Bilberg R, Christensen AI, Lau CJ, Möller S, Nielsen AS. History of healthcare use and disease burden in older adults with different levels of alcohol use. A register-based cohort study. Alcohol Clin Exp Res 2021; 45:1237-1248. [PMID: 33860951 DOI: 10.1111/acer.14615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Only a minority of individuals with problematic alcohol use ever seek alcohol treatment. Knowledge of general help-seeking behavior in the healthcare system can identify possibilities for prevention and intervention. METHOD The current study describes healthcare use, burden of disease, and prior morbidities over a 15-year period by current alcohol use behavior among Danish adults aged 60-70. The Danish National Health Survey 2013 and the baseline assessment of the Elderly Study (2014-2016) were linked to Danish national registers to collect annual information on healthcare use and morbidity for the 15 years prior to inclusion. Participants from the 3 largest Danish municipalities were divided into 4 groups with varying drinking patterns and no recent treatment [12-month abstinent (n = 691), low-risk drinkers (n = 1978), moderate-risk drinkers (n = 602), and high-risk drinkers (n = 467)], and a group of treatment-seeking individuals with a 12-month DSM-5 alcohol use disorder (AUD; n=262). Negative binomial regression models were utilized to compare rates of healthcare use and logistic regressions were used to compare odds of diagnoses. RESULTS Low-, moderate-, and high-risk drinkers had similar rates of past healthcare utilization (low-risk mean yearly number of contacts for primary care 7.50 (yearly range 6.25-8.45), outpatient care 0.80 (0.41-1.32) and inpatient care 0.13 (0.10-0.21)). Higher rates were observed for both the 12-month abstinent group (adjusted RR = 1.16-1.26) and the group with AUD (ARR = 1.40-1.60) compared to the group with low-risk alcohol consumption. Individuals with AUD had higher odds of previous liver disease (adjusted OR = 6.30), ulcer disease (AOR = 2.83), and peripheral vascular disease (AOR 2.71). Twelve-month abstinence was associated with higher odds of diabetes (AOR = 1.97) and ulcer disease (AOR = 2.10). CONCLUSIONS Looking back in time, we found that older adults had regular healthcare contacts, with those who received treatment for AUD having had the highest contact frequency and prevalence of alcohol-related diseases. Thus, healthcare settings are suitable locations for efforts at AUD prevention and intervention.
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Affiliation(s)
- Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Kjeld Andersen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, University of Southern Denmark, Odense C, Denmark.,Department of Mental Health Odense, Region of Southern Denmark, Vejle, Denmark
| | - Silke Behrendt
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Institute for Psychology, University of Southern Denmark, Odense C, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | | | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg Hospital, København, Denmark.,Frederiksberg Hospital, Frederiksberg, Denmark
| | - Sören Möller
- OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, University of Southern Denmark, Odense C, Denmark
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Pardo-Garcia I, Amo-Saus E, Moya-Martinez P. Socioeconomic and Lifestyle Factors Related to Cost and Frequency of Hospitalization in European Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2833. [PMID: 33802180 PMCID: PMC7998278 DOI: 10.3390/ijerph18062833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Individuals' lifestyles play an important role in healthcare costs. A large part of these costs is derived from hospitalizations. With the aim of determine the relationship between lifestyle and the likelihood of hospitalization and associate costs in older adults, this study used the Survey of Health, Aging, and Retirement in Europe. Generalized regression models for panel data were developed and adjusted hospitalization costs derived from the length of hospital stay were also estimated. The average adjusted cost of hospitalization was I$ 9901.50 and the analyses showed that performing weekly physical activity significantly reduces the probability of hospitalization (OR: 0.624) and its costs (I$ 2594.5 less per person per year than subjects who never performed physical activity). Muscle strength plays an important role in this relationship and eating habits are not of great significance. Furthermore, we found interesting differences in the frequency and costs of hospitalization between subjects by country.
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Affiliation(s)
- Isabel Pardo-Garcia
- School of Economics and Business Administration, Castilla-La Mancha University (UCLM), 02071 Albacete, Spain;
- Sociosanitary Research Center, 16071 Cuenca, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
| | - Elisa Amo-Saus
- School of Economics and Business Administration, Castilla-La Mancha University (UCLM), 02071 Albacete, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
| | - Pablo Moya-Martinez
- Sociosanitary Research Center, 16071 Cuenca, Spain;
- Research Group of Economy, Food and Society, Castilla La Mancha University, 02071 Albacete, Spain
- School of Social Sciences, Castilla- La Mancha University (UCLM), 16071 Cuenca, Spain
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Sarala M, Miettunen J, Koskela J, Mustonen A, Rose RJ, Hurtig T, Veijola J, Niemelä S. Frequent intoxication and alcohol tolerance in adolescence: associations with psychiatric disorders in young adulthood. Addiction 2020; 115:888-900. [PMID: 31756009 DOI: 10.1111/add.14889] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 11/04/2019] [Indexed: 12/17/2022]
Abstract
AIMS To assess the associations of intoxication frequency and number of drinks needed to become intoxicated in mid-adolescence with onset of psychiatric disorders in early adulthood. DESIGN, SETTING AND PARTICIPANTS Prospective cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986 who self-reported adolescent alcohol use: 6548 subjects (69.4% of the original sample). Data on alcohol use were collected using questionnaires at ages 15-16 years. MEASUREMENTS Outcomes were any non-organic psychosis, mood disorder, anxiety disorder, any substance use disorder (SUD) and all the studied psychiatric disorders in early adulthood gathered from nation-wide health care, pension and insurance registers. Number of drinks needed to become intoxicated was categorized into three classes: (1) no alcohol use or intoxication, and (2) low and (3) high alcohol tolerance (more than seven/nine drinks for females/males) groups. Similarly, intoxication frequency was divided into three classes: (1) never, (2) one to two times and (3) three or more times during the past 30 days. Information regarding gender, family type, other drug use, psychopathology using Youth Self-Report (YSR) total score and parental psychiatric disorders were used as covariates. FINDINGS In the multivariable analyses, both low [odds ratio (OR) = 3.0, 95% confidence interval (CI) = 1.3-6.7, P-value = 0.009] and high (OR = 4.4, 95% CI = 1.8-11.1, P-value = 0.001) alcohol tolerance were associated with increased risk of SUD. More frequent intoxication was associated with increased frequency of SUD (OR = 3.9, 95% CI = 2.0-7.3, P-value < 0.001) and mood disorder (OR = 1.6, 95% CI = 1.1-2.3, P-value = 0.008). The latter was attenuated after adjusting with concurrent psychopathology (YSR) and other drug use. CONCLUSIONS Both higher alcohol tolerance and frequent intoxication in adolescence appear to be associated with increased risk of future substance use disorder.
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Affiliation(s)
- Marian Sarala
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jari Koskela
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Antti Mustonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Richard J Rose
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Tuula Hurtig
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,PEDEGO Research Unit, Child Psychiatry, University of Oulu, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Hospital District of Southwest Finland, Turku, Finland
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