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Bu YL, Wang C, Zhao C, Lu X, Gao W. The association of alcohol consumption with the risk of sarcopenia: a dose-response meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:305-320. [PMID: 38232346 DOI: 10.1080/00952990.2023.2300049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/19/2024]
Abstract
Background: Sarcopenia is defined as a progressive loss of skeletal muscle mass plus a decline in muscle strength and/or reduced physical performance with advancing age. The results of current studies on the relationship between drinking and sarcopenia remain controversial.Objectives: The aim of this meta-analysis was to evaluate the association of alcohol consumption with the risk of sarcopenia.Methods: Systematic searches were conducted without language restrictions from the beginning of each database to September 20, 2023 on PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, Chinese BioMedical Literature, and China national knowledge infrastructure databases. Meta-analysis was conducted to pool the study-specific odds ratios (ORs) with 95% confidence interval (CI).Results: Sixty-two studies with 454,643 participants were enrolled. The meta-analysis of proportions revealed that alcohol consumption was not associated with the presence of sarcopenia, with a pooled OR of 0.964 (95% CI = 0.912-1.019). Further subgroup analysis indicated that alcohol consumption was correlated with lower risk of sarcopenia in men (OR = 0.763; 95% CI = 0.622-0.938; P = .010). The nonlinear dose-response analysis suggested a J-shaped association between alcohol consumption and the risk of sarcopenia, with a nadir at the amounts of alcohol consumption of 6.6 grams/day (OR = 0.765; 95% CI = 0.608-0.957; P < .05).Conclusions: The results of this meta-analysis indicate that alcohol consumption is not a risk factor for the development of sarcopenia. Any suggestion of a putative protective effect of alcohol should be treated with caution, particularly in light of the overall lack of relationship reported in the present comprehensive meta-analysis.
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Affiliation(s)
- Yun-Ling Bu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Cao Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Can Zhao
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Gao
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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2
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Wilds KM, Riddell JR. Cannabis Policy and Consumption: Taking into account Substitution Effects. Subst Use Misuse 2023; 59:97-109. [PMID: 37781770 DOI: 10.1080/10826084.2023.2262012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: Previous studies examining the cannabis-alcohol substitution effect have found that medical cannabis policies may result in substituting the use of cannabis in place of alcohol use. Objectives: This study adds to the literature on cannabis-alcohol substitution by analyzing the effect of decriminalization, medicinal cannabis, and adult-use legalization cannabis policies (2002-2019) on cannabis and alcohol use and substance substitution for all 50 states and the District of Columbia (N=867). Results: Results support the notion that liberalized cannabis policies can increase the prevalence of cannabis use. An adult-use legalization specific analysis yielded findings suggesting a complex and heterogenous effect of such laws on cannabis-alcohol complementation. Conclusion: Given the lack of clarity and heterogenous effects of cannabis laws, policy makers should carefully take into consideration the benefits of medical cannabis laws, along with the risks of decriminalization and adult-use legalization.
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Affiliation(s)
- Katherine M Wilds
- Department of Criminology and Criminal Justice, The University of Texas at Dallas, Richardson, United States
| | - Jordan R Riddell
- School of Criminology and Criminal Justice, Missouri State University, Springfield, United States
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3
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Zeidan RS, McElroy T, Rathor L, Martenson MS, Lin Y, Mankowski RT. Sex differences in frailty among older adults. Exp Gerontol 2023; 184:112333. [PMID: 37993077 DOI: 10.1016/j.exger.2023.112333] [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: 08/21/2023] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
By definition, aging is a natural, gradual and continuous process. On the other hand, frailty reflects the increase in vulnerability to stressors and shortens the time without disease (health span) while longevity refers to the length of life (lifespan). The average life expectancy has significantly increased during the last few decades. A longer lifespan has been accompanied by an increase in frailty and decreased independence in older adults, with major differences existing between men and women. For example, women tend to live longer than men but also experience higher rates of frailty and disability. Sex differences prevent optimization of lifestyle interventions and therapies to effectively prevent frailty. Sex differences in frailty and aging are rooted in a complex interplay between uncontrollable (genetic, epigenetic, physiological), and controllable factors (psychosocial and lifestyle factors). Thus, understanding the underlying causes of sex differences in frailty and aging is essential for developing personalized interventions to promote healthy aging and improve quality of life in older men and women. In this review, we have discussed the key contributors and knowledge gaps related to sex differences in aging and frailty.
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Affiliation(s)
- Rola S Zeidan
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Taylor McElroy
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America; Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Laxmi Rathor
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Matthew S Martenson
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Yi Lin
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Robert T Mankowski
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, United States of America.
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Hu Y, Wang Z, Wu L. Multidimensional health heterogeneity of Chinese older adults and its determinants. SSM Popul Health 2023; 24:101547. [PMID: 38021459 PMCID: PMC10661850 DOI: 10.1016/j.ssmph.2023.101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Nowadays, the "Healthy China" and "Actively Addressing Population Aging" are two important national strategies in China. Promoting high-quality development of demand-driven older adults health services is an important way to achieve these strategies. From the perspective of active ageing, assessing the health status of older adults from multiple dimensions becomes crucial as it helps identify their specific health service needs, intervention measures, and health policies tailored to this population. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 (2018). A total of 4190 older adults (aged ≥60 years) were included as the analysis sample. Latent class analysis was performed to categorize older adults based on 6 health indicators, including Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), doctor diagnosed chronic diseases, depressive symptoms, cognitive function, and social participation. Multinomial logistic model was used to explore determinants associated with the various patterns of multidimensional health of older adults. Results The multidimensional health of older people was classified into three latent classes: Relatively Healthy (Class 1, n = 2806, 66.97%), Highly Depressed and Relatively Health Risk (Class 2, n = 1189, 28.38%), and Functional Impairment (Class 3, n = 195, 4.65%). Gender, age, education, marital status, number of children, alcohol consumption, physical activity, savings, residence, air quality satisfaction, and medical service satisfaction had significant effects on the attribution of all multidimensional health latent classes. Conclusion Heterogeneous and multidimensional health classes exist in China's older population, and these classes are influenced by a variety of factors and to varying degrees. Policymakers and healthcare providers can use these evidence to further address the diverse needs of older adults and improve older-care health services, ultimately achieving the goal of Active Ageing and Healthy China.
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Affiliation(s)
- Yi Hu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
| | - Zhenyu Wang
- School of Government, Sun Yat-sen University, Guangzhou, Guangdong, 510006, China
| | - Liqun Wu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
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5
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Gonçalves PD, Bruzelius E, Levy NS, Segura LE, Livne O, Gutkind S, Boustead AE, Hasin DS, Mauro PM, Silver D, Macinko J, Martins SS. Recreational cannabis legislation and binge drinking in U.S. adolescents and adults. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104085. [PMID: 37329666 PMCID: PMC10527765 DOI: 10.1016/j.drugpo.2023.104085] [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: 02/17/2023] [Revised: 05/12/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Recreational cannabis laws (RCLs) may have spillover effects on binge drinking. Our aims were to investigate binge drinking time trends and the association between RCLs and changes in binge drinking in the United States (U.S.). METHODS We used restricted National Survey on Drug Use and Health data (2008-2019). We examined trends in the prevalence of past-month binge drinking by age groups (12-20, 21-30, 31-40, 41-50, 51+). Then, we compared model-based prevalences of past-month binge drinking before and after RCL by age group, using multi-level logistic regression with state random intercepts, an RCL by age group interaction term, and controlling for state alcohol policies. RESULTS Binge drinking declined overall from 2008 to 2019 among people aged 12-20 (17.54% to 11.08%), and those aged 21-30 (43.66% to 40.22%). However, binge drinking increased among people aged 31+ (ages 31-40: 28.11% to 33.34%, ages 41-50: 25.48% to 28.32%, ages 51+: 13.28% to 16.75%). When investigating model-based prevalences after versus before RCL, binge drinking decreased among people aged 12-20 (prevalence difference=-4.8%; adjusted odds ratio (aOR)=0.77, [95% confidence interval (CI) 0.70-0.85]), and increased among participants aged 31-40 (+1.7%; 1.09[1.01-1.26]), 41-50 (+2.5; 1.15[1.05-1.26]) and 51+ (+1.8%; 1.17[1.06-1.30]). No RCL-related changes were noted in respondents ages 21-30. CONCLUSIONS Implementation of RCLs was associated with increased past-month binge drinking in adults aged 31+ and decreased past-month binge drinking in those aged < 21. As the cannabis legislative landscape continues to change in the U.S., efforts to minimize harms related to binge drinking are critical.
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Affiliation(s)
- Priscila Dib Gonçalves
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Emilie Bruzelius
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Natalie S Levy
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Luis E Segura
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ofir Livne
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Sarah Gutkind
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anne E Boustead
- School of Government & Public Policy, University of Arizona, USA
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Diana Silver
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA
| | - James Macinko
- Departments of Community Health Sciences and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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6
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Abstract
The medical disorders of alcoholism rank among the leading public health problems worldwide and the need for predictive and prognostic risk markers for assessing alcohol use disorders (AUD) has been widely acknowledged. Early-phase detection of problem drinking and associated tissue toxicity are important prerequisites for timely initiations of appropriate treatments and improving patient's committing to the objective of reducing drinking. Recent advances in clinical chemistry have provided novel approaches for a specific detection of heavy drinking through assays of unique ethanol metabolites, phosphatidylethanol (PEth) or ethyl glucuronide (EtG). Carbohydrate-deficient transferrin (CDT) measurements can be used to indicate severe alcohol problems. Hazardous drinking frequently manifests as heavy episodic drinking or in combinations with other unfavorable lifestyle factors, such as smoking, physical inactivity, poor diet or adiposity, which aggravate the metabolic consequences of alcohol intake in a supra-additive manner. Such interactions are also reflected in multiple disease outcomes and distinct abnormalities in biomarkers of liver function, inflammation and oxidative stress. Use of predictive biomarkers either alone or as part of specifically designed biological algorithms helps to predict both hepatic and extrahepatic morbidity in individuals with such risk factors. Novel approaches for assessing progression of fibrosis, a major determinant of prognosis in AUD, have also been made available. Predictive algorithms based on the combined use of biomarkers and clinical observations may prove to have a major impact on clinical decisions to detect AUD in early pre-symptomatic stages, stratify patients according to their substantially different disease risks and predict individual responses to treatment.
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Affiliation(s)
- Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and Tampere University, Seinäjoki, Finland.
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7
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Matsumoto E, Oniki K, Ota-Kontani A, Seguchi Y, Sakamoto Y, Kaneko T, Imafuku T, Maeda H, Watanabe H, Maruyama T, Ogata Y, Yoshida M, Harada-Shiba M, Saruwatari J, Ogura M. Additive Effects of Drinking Habits and a Susceptible Genetic Polymorphism on Cholesterol Efflux Capacity. J Atheroscler Thromb 2023; 30:23-38. [PMID: 35249931 PMCID: PMC9899708 DOI: 10.5551/jat.63277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
AIMS High levels of high-density lipoprotein cholesterol (HDL-C) are not necessarily effective in preventing atherosclerotic cardiovascular disease, and cholesterol efflux capacity (CEC) has attracted attention regarding HDL functionality. We aimed to elucidate whether drinking habits are associated with CEC levels, while also paying careful attention to confounding factors including serum HDL-C levels, other life style factors, and rs671 (*2), a genetic polymorphism of the aldehyde dehydrogenase 2 (ALDH2) gene determining alcohol consumption habit. METHODS A cross-sectional study was performed in 505 Japanese male subjects who were recruited from a health screening program. Associations of HDL-C and CEC levels with drinking habits and ALDH2 genotypes were examined. RESULTS The genotype frequencies of ALDH2 *1/*1 (homozygous wild-type genotype), *1/*2 and *2/*2 (homozygous mutant genotype) were 55%, 37% and 8%, respectively. Both HDL-C and CEC levels were higher in ALDH2 *1/*1 genotype carriers than in *2 allele carriers. Although HDL-C levels were higher in subjects who had a drinking habit than in non-drinkers, CEC levels tended to be lower in subjects with ≥ 46 g/day of alcohol consumption than in non-drinkers. Furthermore, CEC levels tended to be lower in ALDH2 *1/*1 genotype carriers with a drinking habit of ≥ 46 g/day than non-drinkers, while for *2 allele carriers, CEC levels tended to be lower with a drinking habit of 23-45.9 g/day compared to no drinking habit. CONCLUSIONS Our results suggest that heavy drinking habits may tend to decrease CEC levels, and in the ALDH2 *2 allele carriers, even moderate drinking habits may tend to decrease CEC levels.
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Affiliation(s)
- Erika Matsumoto
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Ami Ota-Kontani
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Yuri Seguchi
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuki Sakamoto
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tetsuya Kaneko
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tadashi Imafuku
- Department of Molecular Pathophysiology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hitoshi Maeda
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Ogata
- Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan
| | - Minoru Yoshida
- Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan,Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Junji Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masatsune Ogura
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan,Department of General Medical Science, Chiba University Graduate School of Medicine, Chiba, Japan,Department of Metabolism and Endocrinology, Eastern Chiba Medical Center, Togane, Japan
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8
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Hong SH, Bae YJ. Association between Alcohol Consumption and the Risk of Sarcopenia: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14163266. [PMID: 36014771 PMCID: PMC9415919 DOI: 10.3390/nu14163266] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/12/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Sarcopenia is a common disease defined as the loss of skeletal muscle mass, strength, and physical performance. Alcohol consumption is an uncertain risk factor for sarcopenia. Previous observational epidemiological studies have reported inconsistent results regarding the association between alcohol consumption and sarcopenia risk. This study aimed to investigate the association between alcohol consumption and sarcopenia. A literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, EMBASE, and the Cochrane Library through April 2022 using keywords related to alcohol consumption and sarcopenia. The pooled odds ratio (OR) with a 95% confidence interval (CI) was calculated using a random effects model meta-analysis. The risk of bias of the studies was assessed using the Newcastle−Ottawa scale. Nineteen observational studies that reported 3826 sarcopenia patients among 422,870 participants were included in the qualitative analysis. Alcohol consumption was not significantly associated with sarcopenia risk (OR, 1.00; 95% CI, 0.83 to 1.20; I2 = 60.6%). Alcohol consumption resulted in a non-significant decrease in the risk of sarcopenia in men (OR, 0.70; 95% CI, 0.46 to 1.07; I2 = 0.0%) and in women (OR, 1.20; 95% CI, 0.63 to 2.30; I2 = 75.8%). The subgroup analyses by age and alcohol consumption were significantly associated with an increased the risk of sarcopenia in <65 years (OR, 2.62; 95% CI, 1.22 to 5.62; I2 = 100%). This meta-analysis of observational studies indicated that alcohol consumption was not significantly associated with sarcopenia risk. However, there are factors influencing the association between alcohol consumption and sarcopenia, such as smoking and dietary patterns. Additional study of these confounding factors is needed for the systematic analysis of the association of alcohol consumption with sarcopenia in future studies.
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Affiliation(s)
- Seung-Hee Hong
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu 11644, Korea
| | - Yun-Jung Bae
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea
- Correspondence:
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9
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Choi NG, DiNitto DM. Alcohol use disorder and treatment receipt among individuals aged 50 years and older: Other substance use and psychiatric correlates. J Subst Abuse Treat 2021; 131:108445. [PMID: 34098300 PMCID: PMC11143473 DOI: 10.1016/j.jsat.2021.108445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/21/2021] [Accepted: 04/26/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Alcohol use disorder (AUD) is increasing among U.S. individuals aged 50+. We examined associations of past-year AUD with other substance use and any mental illness (AMI) and associations of past-year AUD treatment receipt with other substance use, AMI, and mental health treatment receipt among those with AUD. METHODS Data came from the 2015-2018 National Survey on Drug Use and Health (N = 35,229). We used multivariable logistic regression analysis to examine the research questions. RESULTS In the 50+ age group, 58.7% of women and 66.9% of men reported past-year alcohol use and 2.0% of women and 4.9% of men had AUD. Those with any alcohol use problem (binge drinking, heavy drinking, or AUD) had higher odds of other substance use or use disorders; however, AMI was associated with higher odds of AUD only (AOR = 2.54, 95% CI = 2.15-3.00, AOR = 2.63, 95% CI = 1.98-3.50, and AOR = 3.13, 95% CI = 2.19-4.48, respectively, for mild, moderate, and serious mental illness). Only 7.9% of those with AUD received any alcohol treatment. AMI and mental health treatment were associated with higher odds of alcohol treatment receipt (AOR = 5.18, 95% CI = 2.13-12.55, AOR = 4.14, 95% CI = 1.51-11.30, and AOR = 2.91, 95% CI = 1.41-6.00, respectively, for moderate mental illness, serious mental illness, and mental health treatment receipt). CONCLUSION The findings show that fewer than one in 10 older adults with AUD received any alcohol treatment and suggest that individuals need education on alcohol harms and assistance in accessing alcohol treatment. Combined mental health and alcohol treatment at a single location may improve access and use.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, United States of America.
| | - Diana M DiNitto
- Steve Hicks School of Social Work, University of Texas at Austin, United States of America
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10
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Schuckit MA, Smith TL. Endorsement of specific alcohol use disorder criterion items changes with age in individuals with persistent alcohol use disorders in 2 generations of the San Diego Prospective Study. Alcohol Clin Exp Res 2021; 45:2059-2068. [PMID: 34699073 PMCID: PMC8602760 DOI: 10.1111/acer.14683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diagnostic and Statistical Manual (DSM) alcohol use disorder (AUD) criteria are written in broad enough terms to apply to diverse populations. The current analyses evaluate whether the endorsement of criteria changes with increasing age in individuals with persistent AUDs. METHODS Data regarding AUDs persisting across 3 timepoints between average ages of 31 and 43 were gathered about every 5 years from 318 interviews for 106 San Diego Prospective Study (SDPS) AUD male probands. Similar data regarding persistent AUDs across 2 timepoints were obtained from 136 interviews with 68 SDPS AUD offspring between average ages of 21 and 27. Changes in the endorsement of each AUD criterion were evaluated using Cochran's Q test. RESULTS For AUD probands across time, significant decreases were observed in the proportions endorsing 4 criteria (tolerance, withdrawal, failure to fulfill obligations, and using alcohol in hazardous situations). Increased rates of endorsement were documented for 3 criteria (drinking alcohol in higher amounts or for longer periods of time, spending a great deal of time regarding alcohol, and continued use despite social or interpersonal problems). Significant increases in rates of endorsements for offspring were seen for spending a great deal of time regarding alcohol and giving up or reducing important activities in order to drink. CONCLUSIONS These data indicate that the salience of many DSM AUD criterion items changed significantly with age in both SDPS generations among individuals with persistent AUDs. The current results support the need for additional systematic research to determine whether specific criterion items might need to be weighted differently in evaluating older and younger individuals with persistent AUDs.
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Affiliation(s)
- Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Tom L Smith
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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11
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Older Adult Alcohol Use in Relation to Cognition: An Exploratory Analysis. CANADIAN JOURNAL OF ADDICTION 2020. [DOI: 10.1097/cxa.0000000000000096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Lindström J, Hellström C, Simonsson B, Molarius A. Alcohol consumption and self-rated health among older people: population-based study in Sweden. J Public Health (Oxf) 2020; 42:756-765. [PMID: 31821499 DOI: 10.1093/pubmed/fdz168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyse alcohol consumption and its association with self-rated health among a representative sample of older people in mid-Sweden. BACKGROUND Over the past decades, alcohol consumption has increased in the older population in Sweden, but few studies have investigated the association between alcohol consumption and self-rated health in this group. The aim was therefore to investigate alcohol consumption and self-rated health among older Swedes. METHODS The study is based on a cross-sectional study of 11,716 men and women, 65 years and over, answering a survey questionnaire sent to a random population sample in mid-Sweden in 2012. We assessed alcohol consumption with AUDIT-C and its association with self-rated health using logistic regression analysis, adjusting for age, economic situation, educational level, BMI, physical activity, social support and medication use. RESULTS Men (83%) were more prone to drink alcohol compared to women (71%). The prevalence of risk drinking was about 2% for both genders. Alcohol consumption declined with age. Moderate consumption of alcohol was associated with lower probability of poor self-rated health compared to non-drinking with an adjusted odds ratio 0.64 (95% confidence interval: 0.54-0.76) for men and 0.68 (0.59-0.79) for women. CONCLUSION Since the study was cross-sectional the direction of the association could not be determined, and the results should not be interpreted as an argument for promoting alcohol consumption among older people.
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Affiliation(s)
- Jim Lindström
- Department for Sustainable Development, Region Örebro County, Örebro, Sweden.,Department for Competence Centre for Health, Region Västmanland, Västerås, Sweden
| | - Charlotta Hellström
- Department of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Bo Simonsson
- Department for Competence Centre for Health, Region Västmanland, Västerås, Sweden
| | - Anu Molarius
- Department for Centre for Clinical Research, Region Värmland, Karlstad, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
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Porthé V, García-Subirats I, Ariza C, Villalbí JR, Bartroli M, Júarez O, Díez E. Community-Based Interventions to Reduce Alcohol Consumption and Alcohol-Related Harm in Adults. J Community Health 2020; 46:565-576. [PMID: 32770477 DOI: 10.1007/s10900-020-00898-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Alcohol consumption was associated with 3 million deaths worldwide in 2016. Although community action has proven to be effective and has become a priority area of the global strategy to reduce alcohol consumption, there is a gap in the knowledge of community interventions to reduce alcohol use among adults. This study aims to analyze the evidence on effective community-based interventions to reduce alcohol consumption and harm among adults and to identify their components and underlying theories. Search strategy involved five databases (January 2000-March 2020). We included multicomponent, evaluated, and community interventions addressing to adults in urban settings of high-income countries. Furthermore, two conceptual frameworks were adapted to identify the social determinants of alcohol related harms and modifiable factors through community interventions. The initial search yielded 164 articles. The final sample included eight primary studies. Six of them were effective and shared three components (community mobilization; law enforcement and media campaigns), they combined approaches at individual and environmental levels addressing structural determinants of health and some cultural aspects related to consumption. Health outcomes focused mainly on reducing consumption, modifying patterns and acute effects on health. Few studies addressed social problems arising from harmful consumption. This review has identified several effective community-based interventions to reduce harmful use of alcohol among adults as well as some mechanisms and theories supporting them. It also provides a framework to guide new designs, with potential evidence of factors, as well as possible combinations of methods to improve health at community level across different settings and contexts.
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Affiliation(s)
- Victoria Porthé
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain.
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
| | - Irene García-Subirats
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Carles Ariza
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Joan Ramón Villalbí
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Montse Bartroli
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Olga Júarez
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
| | - Elia Díez
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Institut d'Investigació Biomèdica de Sant Pau, Carrer de Sant Quintí, 77, 08041, Barcelona, Spain
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Wilson TD, Wray LA, Turrisi RJ. Positive alcohol expectancies and injunctive drinking norms in drinking to cope motives and alcohol use among older adults. Addict Behav Rep 2019; 10:100207. [PMID: 31384661 PMCID: PMC6661415 DOI: 10.1016/j.abrep.2019.100207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Studies indicate older adults have increased risk for alcohol-related harms (e.g., risk for falls) that can manifest at lower levels of consumption than younger adults. Specifically, age-related changes in alcohol metabolism, physiology, increased morbidity, and potential interactions with medications to manage chronic conditions increases risk for related harms among older adults. PURPOSE The present study used cross-sectional data to examine the associations between drinking to cope motives and positive alcohol expectancies, and injunctive drinking norms in older adults. We also explored the interaction between drinking to cope, positive expectancies and injunctive drinking norms on alcohol use. METHODS Adults aged 65 and older (N = 98) completed a series of measures assessing drinking to cope motives, positive alcohol expectancies, injunctive drinking norms, and past-month alcohol use. RESULTS Positive alcohol expectancies were positively associated with drinking to cope motives. Drinking norms were not associated with coping motives. Moderating effects of expectancies varied on the link between coping motives and alcohol use. Greater endorsement of coping motives was associated with more alcohol consumption but only for those with low expectancies. CONCLUSIONS Better understanding of the complex interplay between drinking to cope motives, positive expectancies, and injunctive drinking norms of proximal as well as distal referents could foster improvement of clinical assessments to screen for risk factors of alcohol abuse and promote development of more age-salient measures of alcohol expectancies, norms, and motives.
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Affiliation(s)
- Tomorrow D. Wilson
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, United States of America
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Paolillo EW, Inkelis SM, Heaton A, Saloner R, Moore RC, Moore DJ. Age of Last Alcohol Use Disorder Relates to Processing Speed Among Older Adults Living with HIV. Alcohol Alcohol 2019; 54:139-147. [PMID: 30796775 DOI: 10.1093/alcalc/agz008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/25/2019] [Accepted: 02/12/2019] [Indexed: 02/01/2023] Open
Abstract
AIMS Older persons living with HIV (PLWH) and past alcohol use disorder (AUD) are at higher risk for neurocognitive deficits compared to those with either condition alone; however, factors underlying this relationship are unknown. Given that aging potentiates multi-system damage from alcohol misuse, the current study examined whether neurocognitive functioning among older adults relates to the age at which they last met criteria for AUD (i.e. 'age of last AUD'), and whether this relationship differed by HIV serostatus. METHODS All participants (aged between 50 and 75 years) were grouped by HIV/AUD status: 345 HIV+/AUD+, 148 HIV-/AUD+, 273 HIV+/AUD-, and 206 HIV-/AUD-. Neurocognitive functioning was assessed globally and within seven domains. Among only the two AUD+ groups, multivariable linear regressions examined the interaction between age of last AUD and HIV status on neurocognitive functioning, controlling for demographics and clinical characteristics. RESULTS Older age of last AUD related to worse processing speed among PLWH (b = -0.03; P = 0.006); however, this relationship was not significant among persons without HIV (b = 0.01; P = 0.455). The interaction between age of last AUD and HIV status did not predict neurocognitive functioning in other domains. Processing speed appeared clinically important, as slower speed related to worse everyday functioning, including more reported cognitive difficulties (r = -0.26, P < 0.001) and higher rates of functional dependence (OR = 0.87, 95%CI = 0.80-0.95, P = 0.002). CONCLUSIONS Our novel findings, demonstrating slower processing speed when a past AUD occurred at an older age in PLWH, highlight the value in assessing older PLWH for processing speed deficits, even if other cognitive domains appear to be intact.
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Affiliation(s)
- Emily W Paolillo
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Sarah M Inkelis
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Anne Heaton
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, CA, USA
| | - Rowan Saloner
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California, San Diego, HIV Neurobehavioral Research Program, San Diego, CA, USA
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Mortality in older adults with frequent alcohol consumption and use of drugs with addiction potential - The Nord Trøndelag Health Study 2006-2008 (HUNT3), Norway, a population-based study. PLoS One 2019; 14:e0214813. [PMID: 30990815 PMCID: PMC6467384 DOI: 10.1371/journal.pone.0214813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate whether frequent drinking, use of drugs with addiction potential and the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older adults. Methods We used data from the Nord-Trøndelag Health Study (HUNT3 2006–08), a population-based study in Norway. A total of 11,545 (6,084 women) individuals 65 years and older at baseline participated. We assessed frequent drinking (≥ 4 days a week), occasional drinking (i.e. a few times a year), never drinking and non-drinking in the last year. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. This information was drawn from the Norwegian Prescription Database. The main outcome was all-cause mortality with information drawn from the Norwegian Cause of Death Registry. Follow-up continued until death or latest at 31 December 2013. Logistic regression analyses were used to investigate all-cause mortality since date of study entry and exact age at time of death was unknown. Results The adjusted logistic regression analyses showed that frequent drinking was not associated with all-cause mortality compared to occasional drinking. Men who reported to be never drinkers and non-drinkers in the last year had higher odds of mortality compared to those who drank occasionally. Use of prescribed drugs with addiction potential was associated with increased mortality in men, but not in women. No association was found between the possible combination of frequent drinking and use of prescribed drugs with addiction potential and mortality. Conclusion Neither frequent drinking nor the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older women and men. Use of prescribed drugs with addiction potential was associated with higher odds of mortality in men. This finding should lead to more caution in prescribing drugs with addiction potential to this group.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
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von Känel R, Mausbach BT, Dimsdale JE, Ziegler MG, Mills PJ, Allison MA, Patterson TL, Ancoli-Israel S, Grant I. Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers. BMC Geriatr 2019; 19:18. [PMID: 30669980 PMCID: PMC6343283 DOI: 10.1186/s12877-019-1033-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caregivers of a family member with a chronic disability or illness such as dementia are at increased risk for chronic disease. There are many factors that contribute to dementia caregiver vulnerability and these factors can be challenging to assess in clinical settings. Self-rated health (SRH) is an independent measure of survival and physical health in the elderly. As an inclusive measure of health, SRH has been proposed as a reliable way to assess a patient's general health in primary care. Therefore, we sought to identify determinants of poor/fair SRH versus categories of at least good SRH in informal caregivers. METHODS In a cross-sectional study, we examined 134 elderly (≥55 years) providing in-home care for a spouse with dementia who rated their own health with a single-item question: "In general, would you say your health is excellent, very good, good, fair or poor?". In a multivariable model, we compared caregivers with poor/fair SRH to those with good, very good, or excellent SRH on demographics, health characteristics (health behaviors, physical health indicators, psychosocial factors) and caregiving-specific stress (a composite index/total of four caregiving-specific stressors: years of caregiving, dementia severity, care recipient functional impairment and perceived caregiver burden). RESULTS Compared with caregivers who rated their own health as either good (31.3%), very good (38.8%) or excellent (14.2%), caregivers with poor/fair SRH (15.7%) were more likely to have lower physical function and total greater caregiving-specific stress. More years of caregiving, severe dementia and care recipient functional impairment, but not perceived caregiver burden, were also more likely among caregivers with poor/fair SRH. Additionally, high negative affect and low positive affect were more likely in caregivers with poor/fair vs. good or excellent and very good or excellent SRH, respectively. CONCLUSIONS Caregivers with poor/fair SRH were characterized by higher levels of medical comorbidity, low physical function, high negative, but low positive affect and longer duration of caregiving, as well as more severe dementia and greater functional impairment of the care recipient. These findings suggest that caregivers need to be more closely evaluated and targeted for preventive interventions in clinical practice. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT02317523 .
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091 Zurich, Switzerland
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
| | - Brent T. Mausbach
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
| | - Joel E. Dimsdale
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
| | - Michael G. Ziegler
- Department of Medicine, University of California San Diego, La Jolla, California USA
| | - Paul J. Mills
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California USA
| | - Matthew A. Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California USA
| | - Thomas L. Patterson
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
- Department of Medicine, University of California San Diego, La Jolla, California USA
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, La Jolla, California USA
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18
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Gill PA, van Zelm MC, Muir JG, Gibson PR. Review article: short chain fatty acids as potential therapeutic agents in human gastrointestinal and inflammatory disorders. Aliment Pharmacol Ther 2018; 48:15-34. [PMID: 29722430 DOI: 10.1111/apt.14689] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/09/2018] [Accepted: 04/06/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Butyrate, propionate and acetate are short chain fatty acids (SCFA), important for maintaining a healthy colon and are considered as protective in colorectal carcinogenesis. However, they may also regulate immune responses and the composition of the intestinal microbiota. Consequently, their importance in a variety of chronic inflammatory diseases is emerging. AIMS To review the physiology and metabolism of SCFA in humans, cellular and molecular mechanisms by which SCFA may act in health and disease, and approaches for therapeutic delivery of SCFA. METHODS A PubMed literature search was conducted for clinical and pre-clinical studies using search terms: 'dietary fibre', short-chain fatty acids', 'acetate', 'propionate', 'butyrate', 'inflammation', 'immune', 'gastrointestinal', 'metabolism'. RESULTS A wide range of pre-clinical evidence supports roles for SCFA as modulators of not only colonic function, but also multiple inflammatory and metabolic processes. SCFA are implicated in many autoimmune, allergic and metabolic diseases. However, translating effects of SCFA from animal studies to human disease is limited by physiological and dietary differences and by the challenge of delivering sufficient amounts of SCFA to the target sites that include the colon and the systemic circulation. Development of novel targeted approaches for colonic delivery, combined with postbiotic supplementation, may represent desirable strategies to achieve adequate targeted SCFA delivery. CONCLUSIONS There is a large array of potential disease-modulating effects of SCFA. Adequate targeted delivery to the sites of action is the main limitation of such application. The ongoing development and evaluation of novel delivery techniques offer potential for translating promise to therapeutic benefit.
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Affiliation(s)
- P A Gill
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia.,Department of Immunology and Pathology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic, Australia
| | - M C van Zelm
- Department of Immunology and Pathology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic, Australia
| | - J G Muir
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia
| | - P R Gibson
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Vic., Australia
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Shah M, Paulson D, Nguyen V. Alcohol Use and Frailty Risk among Older Adults over 12 Years: The Health and Retirement Study. Clin Gerontol 2018; 41:315-325. [PMID: 28990855 DOI: 10.1080/07317115.2017.1364681] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The primary goal was to examine the relationship between alcohol use and frailty, a variable characterizing late-life decline, in a national, longitudinal survey of older adults living in the United States. METHODS The sample drawn from the Health and Retirement Study included 9,499 stroke-free participants over age 65 in 2000. The sample was 59.1% female, and had a mean age of 74.25 years (SD = 6.99). Follow-up data was from 2004, 2008, and 2012. Frailty was defined phenotypically using the Paulson-Lichtenberg Frailty Index (PLFI). Alcohol use was measured via self-report. Control variables included age, race, education, socio-economic status (SES), depressive symptomatology, medical burden score, body mass index (BMI), and partner status. With abstinent participants as the reference group, logistic regressions were conducted to determine prevalent frailty at 2000, and Cox's proportional hazard models were utilized to determine time to incident frailty over a 12-year period. RESULTS Results revealed that age, depressive symptomatology, and medical burden score were significant positive correlates of prevalent and incident frailty (p < .05) for both males and females. Logistic regressions revealed that consumption of 1-7 alcoholic drinks per week was associated with reduced prevalent frailty (OR = .49, p < .001) for females. Survival analysis results reveal that compared with nondrinkers, males and females who reportedly consumed 1-7 drinks per week had a decreased probability of incident frailty (HR = .78-081, p < .05). CONCLUSIONS Findings suggest that moderate alcohol use confers reduced frailty risk for both older men and women. Future research should examine the mechanism(s) relating alcohol consumption and frailty. CLINICAL IMPLICATIONS Findings support extant literature suggesting some healthcare benefits may be associated with moderate drinking.
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Affiliation(s)
- Mona Shah
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
| | - Daniel Paulson
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
| | - Vu Nguyen
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
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20
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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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21
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Cunningham SA, Mosher A, Judd SE, Matz LM, Kabagambe EK, Moy CS, Howard VJ. Alcohol Consumption and Incident Stroke Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2018; 73:636-648. [PMID: 28184880 PMCID: PMC6018946 DOI: 10.1093/geronb/gbw153] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 11/13/2016] [Indexed: 02/07/2023] Open
Abstract
Objectives This study examines the relationship between alcohol consumption and incident stroke among older adults and tests whether alcohol consumption contributes to observed race and sex differences in stroke. Method Data are from a U.S. national cohort of black and white adults aged 45 and older, the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Current and past drinking levels were reported at baseline (2003-2007). Participants who had never had a stroke were followed for adjudicated stroke events through September 2015 (n = 27,265). We calculated Cox proportional hazard models for stroke, adjusting for demographic, socioeconomic, behavioral, and health characteristics. Results Participants, mean age 64.7 years, consumed on average 2.2 drinks/week and experienced 1,140 first-time stroke events over median 9.1 years follow-up. Nondrinkers had a 12% higher risk of stroke than current drinkers; the risk of stroke among nondrinkers largely reflected high risks among past drinkers; these differences were explained by socioeconomic characteristics. Among current drinkers, light drinkers had significantly lower stroke risks than moderate drinkers after accounting for demographic, socioeconomic, behavioral, and health characteristics. Implications of alcohol did not differ between blacks and whites but did differ by sex: Especially among women, nondrinkers, and specifically past drinkers, had higher risks; these differences were largely explained by health characteristics and behaviors. Alcohol did not explain race and sex differences in stroke incidence. Discussion Among older adults, those who used to, but no longer, drink had higher risks of stroke, especially among women; current light drinkers had the lowest risk of stroke.
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Affiliation(s)
- Solveig A Cunningham
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Aleena Mosher
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Suzanne E Judd
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Lisa M Matz
- London School of Hygiene and Tropical Medicine, UK
| | - Edmond K Kabagambe
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Claudia S Moy
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
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22
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Poole L, Jackowska M. The Epidemiology of Depressive Symptoms and Poor Sleep: Findings from the English Longitudinal Study of Ageing (ELSA). Int J Behav Med 2018; 25:151-161. [PMID: 29204805 PMCID: PMC5852187 DOI: 10.1007/s12529-017-9703-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The reasons for the comorbidity between depressed mood and poor sleep are not well understood. METHOD Participants were 5172 adults aged 50 years and older from the English Longitudinal Study of Ageing. Sleep was measured via self-report and depressive symptoms using the Centre for Epidemiological Studies Depression scale. RESULTS Greater depressive symptoms and sleep complaints were associated with female sex, non-cohabitation, relative poverty, smoking, infrequent physical activity, infrequent alcohol consumption, higher body mass index (BMI), diagnosis of hypertension, coronary heart disease, diabetes/high blood glucose, pulmonary disease, arthritis, and higher levels of fibrinogen and C-reactive protein (all p < 0.05). At a 4-year follow-up, depressive symptoms and sleep complaints were both predicted by baseline depressive symptoms and sleep complaints, relative poverty, smoking, physical inactivity, BMI, and arthritis (all p < 0.05). CONCLUSION Depressive symptoms and sleep complaints share a range of correlates cross-sectionally and prospectively. These findings highlight the common comorbidity between depressive symptoms and sleep complaints underscoring the need for further research to understand their combined detrimental effect on long-term health and wellbeing.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Marta Jackowska
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD UK
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23
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Gonçalves PD, Schuckit MA, Smith TL. Drinking Status Between Ages 50 and 55 for Men From the San Diego Prospective Study Who Developed DSM-IV Alcohol Abuse or Dependence in Prior Follow-Ups. J Stud Alcohol Drugs 2018; 78:512-520. [PMID: 28728633 DOI: 10.15288/jsad.2017.78.512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Although alcohol use disorders (AUDs) are prevalent among older individuals, few studies have examined the course and predictors of AUDs from their onset into the person's 50s. This study describes the AUD course from ages 50 to 55 in participants who developed AUDs according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), during the San Diego Prospective Study (SDPS). METHOD Among the 397 university students in the SDPS who were followed about every 5 years from age 20 (before AUD onset), 165 developed AUDs, 156 of whom were interviewed at age 55. Age 50-55 outcomes were compared regarding age 20-50 characteristics. Variables that differed significantly across outcome groups were evaluated using binary logistic regression analyses predicting each outcome type. RESULTS Between ages 50 and 55, 16% had low-risk drinking, 36% had high-risk drinking, 38% met DSM-5 AUD criteria, and 10% were abstinent. Baseline predictors of outcome at ages 50-55 included earlier low levels of response to alcohol predicting DSM-5 AUDs and abstinence, higher drinking frequency predicting DSM-5 diagnoses and lower predicting low-risk drinking, higher participation in treatment and/or self-help groups predicting abstinence and lower predicting DSM-5 AUDs, later ages of AUD onset predicting high-risk drinking, and cannabis use disorders predicting abstinent outcomes. CONCLUSIONS Despite the high functioning of these men, few were abstinent or maintained low-risk drinking during the recent 5 years, and 38% met DSM-5 AUD criteria. The data may be helpful to both clinicians and researchers predicting the future course of AUDs in their older patients and research participants.
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Affiliation(s)
- Priscila Dib Gonçalves
- Department of Psychiatry, University of California, San Diego, La Jolla, California.,Institute of Psychiatry, Psychology and Neuropsychology Service and Institute of Psychiatry, Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), University of São Paulo, São Paulo, Brazil
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Tom L Smith
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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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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25
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Vafeas C, Graham R, de Jong G, Sharp J, Ngune I, Maes S. Alcohol consumption patterns of older adults: a study in a regional town in Western Australia. Contemp Nurse 2017; 53:647-657. [PMID: 29279033 DOI: 10.1080/10376178.2017.1421051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM This study aimed to demonstrate that opportunistic health screening at health expos can provide an overall impression of alcohol consumption patterns. DESIGN A repeated cross-sectional survey design, completed over a four-year period (2011-2014), was used to assess the risk of harmful alcohol consumption, within a community setting of older adults, in the South West region of Western Australia. METHODS An alcohol screening survey (AUDIT) was used to collect data on alcohol consumption patterns on those aged 65 years and over. A total of 411 surveys were completed. RESULTS There was a statistically significant difference in mean risk scores across the four years (p < .001). 6.3-22.2% of survey completers presented as 'risky', and a further 3.8-12.3% as 'high risk' in terms of alcohol consumption. CONCLUSIONS Opportunistic screening for alcohol consumption during health expos can aid the identification of at-risk individuals who may require further education or treatment.
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Affiliation(s)
- Caroline Vafeas
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Renee Graham
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Gideon de Jong
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Jennie Sharp
- b School of Nursing & Midwifery , Edith Cowan University , Bunbury , Australia
| | - Irene Ngune
- c School of Nursing, Midwifery & Paramedicine , Curtin University , Bentley , Australia
| | - Saskia Maes
- d Edith Cowan College, Edith Cowan University , Joondalup , Australia
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Choi NG, DiNitto DM, Marti CN. Older Adults Driving Under the Influence: Associations With Marijuana Use, Marijuana Use Disorder, and Risk Perceptions. J Appl Gerontol 2017; 38:1687-1707. [DOI: 10.1177/0733464817745379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite increasing marijuana use among the 50+ age group, little research has been done on marijuana’s impact on older adults’ driving under the influence (DUI). Using the 2013 to 2014 National Survey on Drug Use and Health data, this study examined the association of older adults’ self-reported DUI with marijuana use, marijuana abuse/dependence, and marijuana risk perception. The findings show that one third of past-year marijuana users aged 50+ reported past-year DUI, two thirds of which involved drugs. Those with marijuana abuse/dependence were 2.6 times more likely than those without the disorder to report DUI, controlling for alcohol abuse/dependence, other illicit drug use, and sociodemographic and health/mental health statuses. As safe driving is key to prolonging independence in late life, clinicians need to educate older adults about the risk of marijuana use, alone and with other substances, on their driving capacity and provide age-appropriate treatment for marijuana use disorder.
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Alcohol and other drug use in older adults: results from a community needs assessment. Aging Clin Exp Res 2017; 29:1149-1155. [PMID: 28181205 DOI: 10.1007/s40520-016-0718-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND With the "Baby Boomer" generation reaching older adulthood, substance abuse treatment providers find themselves needing to address the unique needs of this population. Heavy drinking in adults ages 65 and over is strongly correlated with depression, anxiety, decreased social support, and poor health. However, while alcohol misuse has been shown to be predictive of a lower quality of life in older adults, the generalizability of these findings to urban dwelling, lower socioeconomic status individuals remains unclear. AIMS To identify potential treatment needs of this population, a city-funded needs assessment was conducted. METHODS Subjects were 249 individuals (44% male) who voluntarily completed measures of quality of life (QOL), depression, and substance abuse. Measures used included the Psychological General Well-Being Schedule, the Geriatric Depression Scale-15, and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS Alcohol or substance abuse was reported by over 20% of respondents, with 3.4% of respondents engaged in maladaptive alcohol use. Scores on the AUDIT were predictive of increased depression (r = - .209, p = .01), anxiety (r = - .201, p = .002), lower general well-being (r = - .154, p = .019), and decreased self-control (r = - .157, p = .017). DISCUSSION A substantial percentage of the sample reported alcohol and substance misuse. Alcohol use was predictive of depression, global psychological distress, and decreased quality of life. CONCLUSIONS This needs assessment reinforces findings from previous studies and addresses the added dimension of examining this in an urban, lower socioeconomic population.
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Grant BF, Chou SP, Saha TD, Pickering RP, Kerridge BT, Ruan WJ, Huang B, Jung J, Zhang H, Fan A, Hasin DS. Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry 2017; 74:911-923. [PMID: 28793133 PMCID: PMC5710229 DOI: 10.1001/jamapsychiatry.2017.2161] [Citation(s) in RCA: 905] [Impact Index Per Article: 129.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information. OBJECTIVE To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013. DESIGN, SETTING, AND PARTICIPANTS The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016. MAIN OUTCOMES AND MEASURES Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD. RESULTS The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also seen for the total sample and most sociodemographic subgroups for the prevalences of 12-month DSM-IV AUD among 12-month alcohol users from 12.9% (95% CI, 12.3%-17.5%) to 17.5% (95% CI, 16.7%-18.3%) and 12-month DSM-IV AUD among 12-month high-risk drinkers from 46.5% (95% CI, 44.3%-48.7%) to 54.5% (95% CI, 52.7%-56.4%). CONCLUSIONS AND RELEVANCE Increases in alcohol use, high-risk drinking, and DSM-IV AUD in the US population and among subgroups, especially women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged, constitute a public health crisis. Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role.
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Affiliation(s)
- Bridget F. Grant
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - S. Patricia Chou
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Tulshi D. Saha
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Roger P. Pickering
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | | | - W. June Ruan
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Boji Huang
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Jeesun Jung
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Haitao Zhang
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Amy Fan
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Deborah S. Hasin
- New York State Psychiatric Institute, New York,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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Dreher-Weber M, Laireiter AR, Kühberger A, Kunz I, Yegles M, Binz T, Rumpf HJ, Hoffmann R, Praxenthaler V, Lang S, Wurst FM. Screening for Hazardous Drinking in Nursing Home Residents: Evaluating the Validity of the Current Cutoffs of the Alcohol Use Disorder Identification Test-Consumption Questions by Using Ethyl Glucuronide in Hair. Alcohol Clin Exp Res 2017; 41:1593-1601. [DOI: 10.1111/acer.13449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 07/10/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Monika Dreher-Weber
- Department of Psychosomatic Medicine and Psychotherapy; Medical Park Chiemseeblick; Bernau-Felden Germany
| | | | - Anton Kühberger
- Department of Psychology; University of Salzburg; Salzburg Austria
| | - Isabella Kunz
- Department of Psychiatry and Psychotherapy; Christian-Doppler-Hospital; Paracelsus Medical University; Salzburg Austria
| | - Michel Yegles
- Laboratoire National de Santé - Toxicology; Dudelange Luxembourg
| | - Tina Binz
- Institute for Forensic Medicine; University of Zürich; Zürich Switzerland
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy; Medical University of Lübeck; Lübeck Germany
| | | | | | | | - Friedrich M. Wurst
- Paracelsus Medical University; Salzburg Austria
- Psychiatric University Hospital Basel; Basel Switzerland
- Center for Interdisciplinary Addiction Research; Hamburg Germany
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Bosque-Prous M, Brugal MT, Lima KC, Villalbí JR, Bartroli M, Espelt A. Hazardous drinking in people aged 50 years or older: a cross-sectional picture of Europe, 2011-2013. Int J Geriatr Psychiatry 2017; 32:817-828. [PMID: 27388047 DOI: 10.1002/gps.4528] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/12/2016] [Accepted: 05/27/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess gender and age differences in hazardous drinking and to analyse and compare the factors associated with it in men versus women, and in 50 to 64-year-old versus ≥65-year-old people in Europe. METHODS Cross-sectional study with data from 65,955 people aged ≥50 years from 18 countries (SHARE project, 2011-2013). The outcome variable, hazardous drinking, was calculated using an adaptation of the AUDIT-C test. Several individual (sociodemographic, life-style and health factors) and contextual variables (country socioeconomic indicators and alcohol policies) were analysed. The prevalence of hazardous drinking was estimated by each exposure variable. To estimate associations, multilevel Poisson regression models with robust variance were fit, yielding prevalence ratios and their 95% confidence intervals (95%CI). RESULTS Overall, the prevalence of hazardous drinking was 21.5% (95%CI = 21.1-22.0), with substantial differences between countries. The proportion of hazardous drinking was higher in men than in women [26.3%(95%CI = 25.6-27.1); 17.5%(95%CI = 17.0-18.0), respectively], as well as in middle-aged people than in older people [23.6%(95%CI = 23.0-24.3); 19.2%(95%CI = 18.6-19.8), respectively]. At the individual level, associations were found for migrant background, marital status, educational level, tobacco smoking, depression and self-perceived health. At the contextual level, hazardous drinking was associated with gender inequalities in society (only in women) and alcohol advertising regulations (both genders). CONCLUSIONS One in five people aged ≥50 years in the countries studied is a hazardous drinker, with large differences by countries, gender and age group. Interventions and policies aimed at preventing or reducing alcohol use in this population should account for country, gender and age differences, as well as individual characteristics. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marina Bosque-Prous
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M Teresa Brugal
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Kenio C Lima
- Department of Dentistry, Postgraduate Public Health Program (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Joan R Villalbí
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Montse Bartroli
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Albert Espelt
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Psicobiologia i Metodologia en Ciències de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
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Wu HZ, Barry LC, Duan Y, Bohannon RW, Covault JM, Grady JJ. Acute Effects of Moderate Alcohol Consumption on Postural Stability in Older Adults. Percept Mot Skills 2017; 124:912-931. [DOI: 10.1177/0031512517721069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study involved healthy community-living older adults in an investigation of the association between moderate alcohol consumption (AC) and acute changes in postural stability and whether the association differed according to pre-AC balance skills. Thirty-nine moderate drinkers aged ≥ 65 years (62% women; mean age: 73.9 ± 6.1 years) consumed a moderate dose of alcohol (0.4 g/kg; administered as two drinks). Breath alcohol concentration and postural stability were measured at five time points (pre-AC and 40, 80, 120, and 160 minutes post-AC) using unipedal stance time (UPST) and center of pressure (CoP) displacement. Pre-AC UPST was used to categorize participants into good-balance (≥30 seconds) and poor-balance (<30 seconds) groups. Peak breath alcohol concentration was 30 mg/dL at 40 minutes post-AC. For all participants, postural stability declined significantly at 80 minutes post-AC (UPST, p = .005; anterior–posterior CoP displacement, p = .029). While the poor-balance group did not show a significant decrease in UPST duration over the course of the study, the good-balance group experienced significant decline at 80 minutes compared with baseline ( p < .001) and remained above the 30-second UPST cutoff. Both groups experienced similar worsening in anterior–posterior CoP displacement at 80 minutes post-AC. Thus, moderate AC was associated with acute decline in postural stability in older adults. The worsened anterior–posterior CoP displacement post-AC in the poor-balance group was of particular concern because these participants were already at lower balance functioning pre-AC. Larger, more representative studies of varying groups of participants are needed to further explore how this change relates to fall incidents and fall risk.
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Affiliation(s)
- Helen Z. Wu
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
- Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA
| | - Lisa C. Barry
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
- Center on Aging, University of Connecticut Heath Center, Farmington, CT, USA
| | - Yinghui Duan
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA
- Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA
| | - Richard W. Bohannon
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Lillington, NC, USA
| | - Jonathan M. Covault
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - James J. Grady
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA
- Connecticut Institute for Clinical and Translational Science (CICATS), Farmington, CT, USA
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Rafferty E, Bonner WIA, Code J, McBride K, Andkhoie M, Tikoo R, McClean S, Dell C, Szafron M, Farag M. Factors influencing risky single occasion drinking in Canada and policy implications. Arch Public Health 2017; 75:22. [PMID: 28515907 PMCID: PMC5430596 DOI: 10.1186/s13690-017-0190-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/26/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Misuse of alcohol, including single risky occasion drinking (RSOD) is associated with a number of health, social and economic consequences. While research demonstrates that many factors contribute to individuals' drinking practices, little is known about risk factors that contribute to RSOD in the Canadian population. The objectives of this study are to examine the patterns of RSOD in Canada, to identify factors associated with RSOD, and to explore policy implications. METHODS The Canadian Community Health Survey (CCHS) 2009-2010 annual component was used to conduct all the analyses in this paper. We used two models: (1) a binary logistic regression model, and (2) a multinomial logistic regression model, to identify factors that were significantly associated with our dependent variables, RSOD engagement and frequency of RSOD, respectively. RESULTS Daily smokers were 6.20 times more likely to engage in frequent RSOD than those who never smoke. Males were 4.69 times more likely to engage in risky RSOD. We also found significant associations between the frequency of RSOD and Province/Territory of residence, income and education, marital status and perceived health status. Finally, stress was associated with engaging in infrequent RSOD. CONCLUSIONS Our finding associating daily smoking with risk alcohol intake specifically suggests the possibility of combining public health interventions for both. The study findings also indicate that education is a protective factor, further supporting the role of education as a major determinant of health. The significant provincial variation we found also point to the need to study this issue further and understand the links between provincial level policies and RSOD.
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Affiliation(s)
- Ellen Rafferty
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | | | - Jillian Code
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Keely McBride
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Mustafa Andkhoie
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Richa Tikoo
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Stephanie McClean
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Colleen Dell
- Department of Sociology, University of Saskatchewan, 1019 - 9 Campus Drive, Saskatoon, SK S7N 5A5 Canada
| | - Michael Szafron
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
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Abstract
Taylor et al. (2014) raise an important issue concerning the detection of alcohol problems in older adults. The authors identify a number of age-related factors playing a role in the detection of alcohol problems, such as stigma, the concept of alcohol use disorder diagnoses and their standardized assessment, and drinking levels. They list a comprehensive review of tools for assessing alcohol problems among older adults, including laboratory tests, questionnaires, and interviews.
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Bryan AEB, Kim HJ, Fredriksen-Goldsen KI. Factors Associated With High-Risk Alcohol Consumption Among LGB Older Adults: The Roles of Gender, Social Support, Perceived Stress, Discrimination, and Stigma. THE GERONTOLOGIST 2017; 57:S95-S104. [PMID: 28087799 PMCID: PMC5241750 DOI: 10.1093/geront/gnw100] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 10/31/2016] [Indexed: 01/09/2023] Open
Abstract
PURPOSE OF THE STUDY Lesbian, gay, and bisexual (LGB) adults have elevated rates of high-risk alcohol consumption compared with heterosexual adults. Although drinking tends to decline with age in the general population, we know little about LGB older adults' drinking. Using 2014 data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), we aimed to identify factors associated with high-risk drinking in LGB older adults. DESIGN AND METHODS A U.S. sample of 2,351 LGB adults aged 50-98 years completed a survey about personal and social experiences, substance use, and health. Multinomial logistic regression was conducted to identify predictors of past-month high-risk alcohol consumption. RESULTS Approximately one fifth (20.6%) of LGB older adults reported high-risk drinking, with nonsignificantly different rates between men (22.4%) and women (18.4%). For women, current smoking and greater social support were associated with greater likelihood of high-risk drinking; older age, higher income, recovery from addiction, and greater perceived stress were associated with lower likelihood. For men, higher income, current smoking, and greater day-to-day discrimination were associated with greater likelihood of high-risk drinking; transgender identity and recovery from addiction were associated with lower likelihood. IMPLICATIONS Social contexts and perceived drinking norms may encourage higher levels of alcohol consumption in LGB older women, whereas men's drinking may be linked with discrimination-related stress. Prevention and intervention with this population should take into account gender differences and sexual minority-specific risk factors. With future waves of data, we will be able to examine LGB older adults' drinking trajectories over time.
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Affiliation(s)
| | - Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle
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35
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Wang Y, Shan G, Shen J, Zhou Q, Tan B, Liu Y, Luo R, Zhao S, Bi W, Yao F, Li G. Assessment of left ventricular function in chronic alcoholics by real-time three-dimensional echocardiography. Medicine (Baltimore) 2017; 96:e6033. [PMID: 28151910 PMCID: PMC5293473 DOI: 10.1097/md.0000000000006033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Chronic alcohol consumption may lead to progressive cardiac dysfunction. The aim of this study was to evaluate the feasibility of using real-time 3-dimensional echocardiography (3DE) on assessing left ventricular (LV) function in chronic alcoholics.We classified 92 male alcoholics into mild, moderate, and severe groups; 30 age-matched controls were also recruited. LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV ejection fraction (LVEF), LV mass (LVM), LV mass index (LVMI), and systolic dyssynchrony index (SDI) were measured by 3DE and 2-dimensional echocardiography (2DE).Compared to the control group, LV volume and mass were higher in the moderate and severe alcoholic groups (P < 0.05). The severe alcoholic (symptomatic) group demonstrated decreased LVEF and increased SDI (detected by 3DE) (P < 0.05).Real-time 3DE can detect the increases of LV volumes and mass in asymptomatic alcoholics, and the changes of LVEF and systolic synchrony index in symptomatic alcoholics.
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Affiliation(s)
- Yuanzheng Wang
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guoxin Shan
- Department of Ultrasound, the Weifang Traditional Chinese Hospital, Kuiwen District, Weifang, Shandong, China
| | - Jiaqi Shen
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Qiao Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Bijun Tan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Yue Liu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Runlan Luo
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
| | - Shifen Zhao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Wenjun Bi
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Fangyi Yao
- Department of Ultrasound, The Xinhua Affiliated Hospital of Dalian University, Shahekou District, Dalian, Liaoning
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University
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Tucker JA, Cheong J, Chandler SD, Lambert BH, Pietrzak B, Kwok H, Davies SL. Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery. Alcohol Clin Exp Res 2016; 40:2676-2684. [PMID: 27775161 DOI: 10.1111/acer.13245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/23/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND As interventions have expanded beyond clinical treatment to include brief interventions for persons with less severe alcohol problems, predicting who can achieve stable moderation drinking has gained importance. Recent behavioral economic (BE) research on natural recovery has shown that active problem drinkers who allocate their monetary expenditures on alcohol and saving for the future over longer time horizons tend to have better subsequent recovery outcomes, including maintenance of stable moderation drinking. This study compared the predictive utility of this money-based "Alcohol-Savings Discretionary Expenditure" (ASDE) index with multiple BE analogue measures of behavioral impulsivity and self-control, which have seldom been investigated together, to predict outcomes of natural recovery attempts. METHODS Community-dwelling problem drinkers, enrolled shortly after stopping abusive drinking without treatment, were followed prospectively for up to a year (N = 175 [75.4% male], M age = 50.65 years). They completed baseline assessments of preresolution drinking practices and problems, analogue behavioral choice tasks (Delay Discounting, Melioration-Maximization, and Alcohol Purchase Tasks), and a Timeline Followback interview including expenditures on alcohol compared to voluntary savings (ASDE index) during the preresolution year. RESULTS Multinomial logistic regression models showed that, among the BE measures, only the ASDE index predicted stable moderation drinking compared to stable abstinence or unstable resolutions involving relapse. As hypothesized, stable moderation was associated with more balanced preresolution allocations to drinking and savings (odds ratio = 1.77, 95% confidence interval = 1.02 to 3.08, p < 0.05), suggesting it is associated with longer-term behavior regulation processes than abstinence. CONCLUSIONS The ASDE's unique predictive utility may rest on its comprehensive representation of contextual elements to support this patterning of behavioral allocation. Stable low-risk drinking, but not abstinence, requires such regulatory processes.
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Affiliation(s)
- Jalie A Tucker
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - JeeWon Cheong
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Susan D Chandler
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Brice H Lambert
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brittney Pietrzak
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Heather Kwok
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Susan L Davies
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
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Choi NG, DiNitto DM, Marti CN, Choi BY. Association of Traffic Injuries, Substance Use Disorders, and ED Visit Outcomes among Individuals Aged 50+ Years. J Psychoactive Drugs 2016; 48:369-376. [DOI: 10.1080/02791072.2016.1240838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Villiers-Tuthill A, Copley A, McGee H, Morgan K. The relationship of tobacco and alcohol use with ageing self-perceptions in older people in Ireland. BMC Public Health 2016; 16:627. [PMID: 27448397 PMCID: PMC4957865 DOI: 10.1186/s12889-016-3158-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/27/2016] [Indexed: 01/25/2023] Open
Abstract
Background Health behaviour patterns in older groups, including tobacco and alcohol use, are key factors in chronic disease prevention. We explore ageing self-perceptions as motivating factors behind smoking and drinking alcohol in older adults, and the complex reasons why individuals engage harmfully in these behaviours. Methods Cigarette and alcohol use was assessed in a large cross-sectional national sample aged 50 years and above from the Irish Longitudinal Study on Ageing (TILDA) (n = 6,576). The Brief Ageing Perceptions Questionnaire (BAPQ) assessed individual’s views of their own ageing across five domains. Study hypothesis that stronger beliefs on each of the BAPQ domains would be related to drinking and smoking was examined using multinomial logit models (MNLM). Regression parameter estimates for all variables were estimated relative risk ratios (RRR). Results More women were non-drinkers (30 % vs. 20 %) and men displayed significantly higher alcohol use patterns. One in five older Irish adults was a current smoker (16.8 % of women, 17 % of men), and smoking and harmful drinking were strongly associated (P < .001). Some domains of ageing perceptions were significantly associated with harmful drinking and smoking. While the risk of being be harmful drinker decreased with stronger beliefs about the positive consequences of ageing (RRR 0.89), it increased with higher scores on both emotional representation and control positive domains. Greater awareness of ageing and stronger emotional reaction to ageing increased likelihood of smoking. A greater sense of control over the outcomes of ageing was associated with increased risk of both harmful drinking (RRR control positive 1.16) and smoking (RRR control and consequences negative 1.25). This suggests optimistic bias in relation to perceived health risk from smoking and harmful drinking as a potential adverse effect of perceptions of control. Risks of concurrent smoking and harmful drinking increased with chronic awareness of ageing (RRR 1.24), and negative emotional responses to it (RRR 1.21), and decreased with stronger perceptions of the positive consequences of ageing (RRR 0.85). Conclusions The relationship between ageing perceptions, smoking and drinking is complex. Altering perceptions of ageing may be a useful intervention target aimed at facilitating engagement in preventative health behaviours in older people.
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Affiliation(s)
- Amanda Villiers-Tuthill
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland. .,PU-RCSI School of Medicine, Perdana University, Kuala Lumpur, Malaysia.
| | - Antoinette Copley
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hannah McGee
- Faculty of Medicine & Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Karen Morgan
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland.,PU-RCSI School of Medicine, Perdana University, Kuala Lumpur, Malaysia
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Hewitt J, Walters M, Padmanabhan S, Dawson J. Cohort profile of the UK Biobank: diagnosis and characteristics of cerebrovascular disease. BMJ Open 2016; 6:e009161. [PMID: 27006341 PMCID: PMC4809076 DOI: 10.1136/bmjopen-2015-009161] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The UK Biobank is a large-scale biomedical resource, containing sociodemographic and medical information, including data on a previous diagnosis of stroke or transient ischaemic attack (TIA). We described these participants and their medication usage. PARTICIPANTS We identified participants who either self-reported or were identified from a nurse-led interview, having suffered a stroke or a TIA and compared them against participants without stroke ort TIA. We assessed their risk factor burden (sex, age, deprivation, waist to hip ratio (WHR), hypertension, smoking, alcohol intake, diabetes, physical exercise and oral contraception use (oral contraceptive pill, OCP)) and medication usage. FINDINGS TO DATE We studied 502,650 people (54.41% women), 6669 (1.23%) participants self-reported a stroke. The nurse-led interview identified 7669 (1.53%) people with stroke and 1781 (0.35%) with TIA. Hypertension, smoking, higher WHR, lower alcohol consumption and diabetes were all more common in people with cerebrovascular disease (p<0.0001 for each). Women with cerebrovascular disease were less likely to have taken the OCP (p=0.0002). People with cerebrovascular disease did more exercise (p=0.03). Antithrombotic medication was taken by 81% of people with stroke (both self-report and nurse-led responders) and 89% with TIA. For self-reported stroke, 63% were taking antithrombotic and cholesterol medications, 54% taking antithrombotic and antihypertensive medications and 46% taking all 3. For the nurse-led interview and TIA, these figures were 65%, 54% and 46%, and 70%, 53% and 45%, respectively. FUTURE PLANS The UK Biobank provides a large, generalisable and contemporary data source in a young population. The characterisation of the UK Biobank cohort with cerebrovascular disease will form the basis for ongoing research using this data source.
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Affiliation(s)
- J Hewitt
- Department of Geriatric Medicine, Division of Population Medicine, Cardiff University, Cardiff, UK
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - M Walters
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - J Dawson
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Wilkinson C, Dare J, French M, McDermott ML, Lo J, Allsop S. Prescribing or dispensing medication represents the best opportunity for GPs and pharmacists to engage older people in alcohol-related clinical conversations. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2016; 24:319-25. [PMID: 26871545 DOI: 10.1111/ijpp.12255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This research aimed to identify older Australian drinkers' knowledge about Australian Alcohol Guidelines and their beliefs about the risks and benefits of alcohol; their recall of alcohol-related issues being raised with them by their community pharmacist and General Practitioner (GP); and their receptiveness to alcohol-related information being provided by either health professional. METHODS This research was conducted in Perth, Western Australia. Flyers calling for participants were placed in local health and service centres, and advertisements were placed in local media. Participants who met eligibility requirements were posted a survey pack (n = 190) including an information letter, consent form, quantitative survey, and return addressed, postage paid envelope. 188 people aged over 60 years returned completed questionnaires. KEY FINDINGS Women were more familiar with national alcohol guidelines, and were more conservative about the potential health benefits of alcohol. While 90% of participants were receptive to their GP asking about their alcohol use, only 30% of men and 20% of women recalled their GP raising this issue with them in the prior 12 months. Of these, high-risk drinkers were six times more likely than low-risk drinkers to have been asked by their GP. Likewise, 50% of men and 65% of women were receptive to having alcohol-related health conversations with their community pharmacist, but less than 4% recalled their pharmacist raising this issue. Participants were most receptive to receiving information about alcohol-medication interactions. CONCLUSIONS This research highlights that prescribing and dispensing medication represents the ideal opportunity for health professionals to deliver alcohol-related information to older people.
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Affiliation(s)
- Celia Wilkinson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia. .,National Drug Research Institute, Curtin University of Technology, Perth, Western Australia, Australia.
| | - Julie Dare
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Michelle French
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | | | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
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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, Choi BY. Associations of Mental Health and Substance Use Disorders With Presenting Problems and Outcomes in Older Adults' Emergency Department Visits. Acad Emerg Med 2015; 22:1316-26. [PMID: 26473592 DOI: 10.1111/acem.12803] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/24/2015] [Accepted: 06/28/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The increasing prevalence of mental health and/or substance use disorders in older adults is a significant public health issue affecting their health, health care use, and health care outcomes. These disorders are especially prevalent in emergency department (ED) visits. This study examined the effect of mental health and substance use disorders on older adults' ED presenting problems and outcomes. METHODS Data were from the publicly available 2012 Nationwide Emergency Department Sample data set (unweighted n = 5,344,743 visits by the 65+ years age group). We used binary logistic regression analysis to test relationships between mental health and substance use disorders and suicide attempts, falls, and other injuries and multinomial logistic regression analysis to test relationships between the disorders and ED outcomes of death, hospital admission, transfer to institutional care, home health care, leaving against medical advice (AMA), or other or unknown destinations, as opposed to routine care. RESULTS Of ED visits by older adults, 5.1% involved anxiety disorders, 7.1% involved mood disorders, 10.45% involved delirium/dementia, 1.4% involved alcohol use disorders, and 0.6% involved drug use disorders; 0.2% were suicide-related, 12.0% involved falls, and 10.2% involved other injuries. Mental health and substance use disorders had large-to-medium effects on suicide attempts. Both dementia and delirium and alcohol use disorders had a small effect on falls. Drug use disorders had a small effect on other injuries. Anxiety disorder had a small effect on the risk of death in the ED or in the hospital, relative to routine care. Suicide attempts and drug use disorders had a medium effect on hospital admission. Suicide attempts had a large effect, delirium and dementia and other mental disorders had medium effects, and mood disorder had a small effect on the risk of transfer to another facility. Delirium and dementia, suicide attempts, and drug use disorders had small effects on the risk of discharge with home health care. Alcohol use disorders and drug use disorders had a small effect on the risk of leaving AMA. Finally, suicide attempts had a medium effect on the risk of other outcomes and unknown destinations. CONCLUSIONS Late-life mental health and substance use disorders are significant risk factors for both intentional self-harm and unintentional injuries that bring older adults to the ED and contribute to ED dispositions and outcomes that involve more intensive and longer-term health care services. The findings underscore the importance of detection and treatment of these disorders among older adults before they end up in the ED.
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Affiliation(s)
- Namkee G. Choi
- University of Texas at Austin School of Social Work; Austin TX
| | | | - C. Nathan Marti
- University of Texas at Austin School of Social Work; Austin TX
| | - Bryan Y. Choi
- Department of Emergency Medicine; Warren Alpert Medical School; Brown University; Providence RI
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Jones SB, Loehr L, Avery CL, Gottesman RF, Wruck L, Shahar E, Rosamond WD. Midlife Alcohol Consumption and the Risk of Stroke in the Atherosclerosis Risk in Communities Study. Stroke 2015; 46:3124-30. [PMID: 26405203 PMCID: PMC4725192 DOI: 10.1161/strokeaha.115.010601] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/31/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Alcohol consumption is common in the United States and may confer beneficial cardiovascular effects at light-to-moderate doses. The alcohol-stroke relationship remains debated. We estimated the relationship between midlife, self-reported alcohol consumption and ischemic stroke and intracerebral hemorrhage (ICH) in a biracial cohort. METHODS We examined 12,433 never and current drinkers in the Atherosclerosis Risk in Communities study, aged 45 to 64 years at baseline. Participants self-reported usual drinks per week of beer, wine, and liquor at baseline. We used multivariate Cox proportional hazards regression to assess the association of current alcohol consumption relative to lifetime abstention with incident ischemic stroke and ICH and modification by sex-race group. We modeled alcohol intake with quadratic splines to further assess dose-response relationships. RESULTS One third of participants self-reported abstention, 39% and 24%, respectively, consumed ≤3 and 4 to 17 drinks/wk, and only 5% reported heavier drinking. There were 773 ischemic strokes and 81 ICH over follow-up (median≈22.6 years). For ischemic stroke, light and moderate alcohol consumption were not associated with incidence (hazard ratios, 0.98; 95% CI, 0.79-1.21; 1.06, 0.84-1.34), whereas heavier drinking was associated with a 31% increased rate relative to abstention (hazard ratios, 1.31; 95% CI, 0.92-1.86). For ICH, moderate-to-heavy (hazard ratios, 1.99; 95% CI, 1.07-3.70), but not light, consumption increased incidence. CONCLUSIONS Self-reported light-to-moderate alcohol consumption at midlife was not associated with reduced stroke risk compared with abstention over 20 years of follow-up in the Atherosclerosis Risk in Communities study. Heavier consumption increased the risk for both outcomes as did moderate intake for ICH.
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Affiliation(s)
- Sara B Jones
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.).
| | - Laura Loehr
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Christy L Avery
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Rebecca F Gottesman
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Lisa Wruck
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Eyal Shahar
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
| | - Wayne D Rosamond
- From the Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill (S.B.J., L.L., C.L.A., W.D.R.); Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (R.F.G.); Department of Biostatistics, Gillings School of Global Public Health, UNC-Chapel Hill, NC (L.W.); and Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (E.S.)
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Johnson-Davis KL, Slawson MH. Ethyl Glucuronide Positivity Rate in a Pain Management Population. J Anal Toxicol 2015; 39:686-90. [PMID: 26324207 DOI: 10.1093/jat/bkv096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ethanol may be consumed by some patients as a means to manage their pain or psychiatric disorder. Consequently, there is the potential to consider ethanol a co-therapeutic in pain management. The purpose of this study was to perform a retrospective analysis to evaluate the rate of ethanol use in a population of patients in pain management programs that were evaluated by our in-house pain management drug panel test. Results from this retrospective study showed that 12.6% of patients in a pain management population were positive for the direct ethanol metabolite, ethyl glucuronide (EtG), by immunoassay. Furthermore, 86% of the individuals positive for EtG were also positive for prescription pain medication and illicit drugs. Results presented here suggest that ethanol use should be routinely monitored in pain management populations in an effort to determine any potential adverse effects of ethanol-drug interactions and as a way to further evaluate the effect of ethanol on pain management outcomes. Testing this population of patients suggests that ethanol use is prevalent and the risk of drug-ethanol adverse effects should be monitored in a pain management population.
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Affiliation(s)
- Kamisha L Johnson-Davis
- University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA
| | - Matthew H Slawson
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA ARUP Laboratories, Salt Lake City, UT 84108, USA
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Alcohol and Exercise Affect Declining Kidney Function in Healthy Males Regardless of Obesity: A Prospective Cohort Study. PLoS One 2015; 10:e0134937. [PMID: 26237314 PMCID: PMC4523200 DOI: 10.1371/journal.pone.0134937] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 07/15/2015] [Indexed: 11/19/2022] Open
Abstract
Background Although lifestyle is associated with metabolic syndrome and cardiovascular diseases, there has been no sufficient evidence of lifestyles on incident chronic kidney disease (CKD). The purpose of this prospective cohort study is to investigate the effects of lifestyles on kidney function in healthy people. Methods A total of 7473 healthy people were enrolled in this Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Data on alcohol consumption, exercise frequency, and sleep duration were collected. The outcome event was incident CKD or decrease in estimated glomerular filtration rate (eGFR) by >25% in 3 years. Results Subjects were classified into four groups according to body mass index and gender. Mean ± standard deviation of age was 38.8±10.5 years; eGFR, 78.1±15.2 ml/min/1.73m2. In the male groups, multivariate logistic regression models showed that the outcome events were associated with a small amount of alcohol consumed (20 to 140g of alcohol/week) (ref. more than 140g of alcohol/week); non-obese male, adjusted odds ratio 1.366 (95% confidence interval, 1.086, 1.718); obese male (body mass index ≥25), 1.634 (1.160, 2.302); and with frequent exercise (twice a week or more) (ref. no exercise); non-obese male, 1.417 (1.144, 1.754); obese male, 1.842 (1.317, 2.577). Sleep duration was not associated with the outcome events. Conclusion These findings suggest that, regardless of obesity, a small amount of alcohol consumed and high exercise frequency were associated with the increased risk of loss of kidney function in the male groups.
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Abstract
OBJECTIVES This paper looks into the socioeconomic determinants of risk of harmful alcohol drinking and of the transitions between risk categories over time among the population aged 50 or over in England. SETTING Community-dwellers across England. PARTICIPANTS Respondents to the English Longitudinal Survey of Ageing, waves 4 and 5. RESULTS (Confidence level at 95% or higher, except when stated): ▸ Higher risk drinking falls with age and there is a non-linear association between age and risk for men, peaking in their mid-60s. ▸ Retirement and income are positively associated with a higher risk for women but not for men. ▸ Education and smoking are positively associated for both sexes. ▸ Loneliness and depression are not associated. ▸ Caring responsibilities reduce risk among women. ▸ Single, separated or divorced men show a greater risk of harmful drinking (at 10% confidence level). ▸ For women, being younger and having a higher income at baseline increase the probability of becoming a higher risk alcohol drinker over time. ▸ For men, not eating healthily, being younger and having a higher income increase the probability of becoming a higher risk alcohol drinker. Furthermore, the presence of children living in the household, being lonely, being older and having a lower income are associated with ceasing to be a higher risk alcohol drinker over time. CONCLUSIONS Several socioeconomic factors found to be associated with high-risk alcohol consumption behaviour among older people would align with those promoted by the 'successful ageing' policy framework.
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Lynch BM, Mihala G, Beesley VL, Wiseman AJ, Gordon LG. Associations of health behaviours with return to work outcomes after colorectal cancer. Support Care Cancer 2015. [PMID: 26198457 DOI: 10.1007/s00520-015-2855-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE Engaging in positive health behaviours can improve quality of life amongst cancer survivors, whether this facilitates return to work is unknown. We examined associations of health behaviours with return to work outcomes following a diagnosis of colorectal cancer in middle-aged men and women (45-64 years). METHODS We recruited 239 participants through the Queensland Cancer Registry between January 2010 and September 2011. Data were collected through telephone-administered interviews and postal questionnaires at 6 and 12 months post-diagnosis. Logistic regression examined likelihood of ceasing or reducing work, and Cox regression examined factors associated with time to return to work. RESULTS No significant associations were observed between health behaviours (fruit and vegetables consumption, alcohol consumption, smoking status, physical activity or sitting time) at 6 months and ceasing or reducing work at 12 months post-diagnosis. Participants who reported excessive sleep (≥9 h/day) were 2.69 times more likely to reduce work time or retire (relative to those sleeping the recommended 7 to <9 h/day; 95 % CI 1.06, 6.87, adjusted for cancer treatment). In Cox regression analysis, excessive sleep was associated with a longer work re-entry time (relative to sleeping 7 to <9 h/day; HR = 0.47; 95 % CI 0.22, 1.00, adjusted for education and cancer treatment). CONCLUSIONS Further research into how excessive sleep might be related to return to work amongst colorectal cancer survivors is warranted. Interventions focused on achieving optimal sleep patterns may assist colorectal cancer survivors to return to work and should be tested in future studies.
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Affiliation(s)
- Brigid M Lynch
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia. .,Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia. .,Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Gabor Mihala
- Griffith Health Institute, Centre for Applied Health Economics, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia
| | - Vanessa L Beesley
- QIMR Berghofer Medical Research Institute, Locked Bag 2000, Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.,Queensland University of Technology, School of Public Health and Social Work, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4006, Australia
| | - Allan J Wiseman
- Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Louisa G Gordon
- Griffith Health Institute, Centre for Applied Health Economics, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia
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Chan LN, Anderson GD. Pharmacokinetic and pharmacodynamic drug interactions with ethanol (alcohol). Clin Pharmacokinet 2015; 53:1115-36. [PMID: 25267448 DOI: 10.1007/s40262-014-0190-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ethanol (alcohol) is one of the most widely used legal drugs in the world. Ethanol is metabolized by alcohol dehydrogenase (ADH) and the cytochrome P450 (CYP) 2E1 drug-metabolizing enzyme that is also responsible for the biotransformation of xenobiotics and fatty acids. Drugs that inhibit ADH or CYP2E1 are the most likely theoretical compounds that would lead to a clinically significant pharmacokinetic interaction with ethanol, which include only a limited number of drugs. Acute ethanol primarily alters the pharmacokinetics of other drugs by changing the rate and extent of absorption, with more limited effects on clearance. Both acute and chronic ethanol use can cause transient changes to many physiologic responses in different organ systems such as hypotension and impairment of motor and cognitive functions, resulting in both pharmacokinetic and pharmacodynamic interactions. Evaluating drug interactions with long-term use of ethanol is uniquely challenging. Specifically, it is difficult to distinguish between the effects of long-term ethanol use on liver pathology and chronic malnutrition. Ethanol-induced liver disease results in decreased activity of hepatic metabolic enzymes and changes in protein binding. Clinical studies that include patients with chronic alcohol use may be evaluating the effects of mild cirrhosis on liver metabolism, and not just ethanol itself. The definition of chronic alcohol use is very inconsistent, which greatly affects the quality of the data and clinical application of the results. Our study of the literature has shown that a significantly higher volume of clinical studies have focused on the pharmacokinetic interactions of ethanol and other drugs. The data on pharmacodynamic interactions are more limited and future research addressing pharmacodynamic interactions with ethanol, especially regarding the non-central nervous system effects, is much needed.
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Affiliation(s)
- Lingtak-Neander Chan
- Department of Pharmacy, University of Washington, Box 357630, Seattle, WA, 98195, USA
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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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50
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Marshall BD, Operario D, Bryant KJ, Cook RL, Edelman EJ, Gaither JR, Gordon AJ, Kahler CW, Maisto SA, McGinnis KA, van den Berg JJ, Zaller ND, Justice AC, Fiellin DA. Drinking trajectories among HIV-infected men who have sex with men: a cohort study of United States veterans. Drug Alcohol Depend 2015; 148:69-76. [PMID: 25596785 PMCID: PMC4330114 DOI: 10.1016/j.drugalcdep.2014.12.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/12/2014] [Accepted: 12/15/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although high rates of alcohol consumption and related problems have been observed among HIV-infected men who have sex with men (MSM), little is known about the long-term patterns of and factors associated with hazardous alcohol use in this population. We sought to identify alcohol use trajectories and correlates of hazardous alcohol use among HIV-infected MSM. METHODS Sexually active, HIV-infected MSM participating in the Veterans Aging Cohort Study were eligible for inclusion. Participants were recruited from VA infectious disease clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh, and Washington, DC. Data from annual self-reported assessments and group-based trajectory models were used to identify distinct alcohol use trajectories over an eight-year study period (2002-2010). We then used generalized estimate equations (GEE) to examine longitudinal correlates of hazardous alcohol use (defined as an AUDIT-C score ≥4). RESULTS Among 1065 participants, the mean age was 45.5 (SD=9.2) and 606 (58.2%) were African American. Baseline hazardous alcohol use was reported by 309 (29.3%). Group-based trajectory modeling revealed a distinct group (12.5% of the sample) with consistently hazardous alcohol use, characterized by a mean AUDIT-C score of >5 at every time point. In a GEE-based multivariable model, hazardous alcohol use was associated with earning <$6000 annually, having an alcohol-related diagnosis, using cannabis, and using cocaine. CONCLUSIONS More than 1 in 10 HIV-infected MSM US veterans reported consistent, long-term hazardous alcohol use. Financial insecurity and concurrent substance use were predictors of consistently hazardous alcohol use, and may be modifiable targets for intervention.
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Affiliation(s)
- Brandon D.L. Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI, 02912, USA,Send correspondence to: Brandon D.L. Marshall, Assistant Professor, Department of Epidemiology Brown University School of Public Health, 121 South Main Street (Box G-S-121-2), Providence, RI, 02912, T: 401-863-6427, F: 401-863-3713
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA
| | - Kendall J. Bryant
- National Institute on Alcohol Abuse and Alcoholism, 6000 Executive Blvd, Rockville, MD, 20852, USA
| | - Robert L. Cook
- Department of Epidemiology, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610, USA
| | - E. Jennifer Edelman
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, PO Box 20802, New Haven, CT, 06520-8025, USA,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT, 06510-2483
| | - Julie R. Gaither
- Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT, 06510-2483,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, PO Box 208034, New Haven, CT, 06520-8034
| | - Adam J. Gordon
- University of Pittsburgh School of Medicine (Mailcode 151-C-H), 7180 Highland Drive, Pittsburgh, PA, 15206,VA Pittsburgh Healthcare System, University Drive (151-C), Pittsburgh, PA, 15240
| | - Christopher W. Kahler
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA,Center for Alcohol and Addiction Studies and the Alcohol Research Center of HIV (ARCH), Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA
| | - Stephen A. Maisto
- Department of Psychology, Syracuse University, 430 University Avenue, Syracuse, NY, 13244,VA Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY, 13210
| | - Kathleen A. McGinnis
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Jacob J. van den Berg
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA,Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA
| | - Nickolas D. Zaller
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham #820, Little Rock, AR, 72205, USA
| | - Amy C. Justice
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, PO Box 20802, New Haven, CT, 06520-8025, USA,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT, 06510-2483,VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - David A. Fiellin
- Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, PO Box 20802, New Haven, CT, 06520-8025, USA,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT, 06510-2483
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