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Chen Y, Zhong Y, Wang M, Su X, Li Q, Wang J, Sun L. Global trends and differences in the burden of alcohol use disorders attributable to childhood sexual abuse by sex, age, and socio-demographic index: Findings from the Global Burden of Disease Study 2019. CHILD ABUSE & NEGLECT 2024; 153:106818. [PMID: 38696952 DOI: 10.1016/j.chiabu.2024.106818] [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: 05/08/2023] [Revised: 03/13/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is a severe global problem associated with alcohol use disorder (AUD). Previous studies have confirmed this relationship; however, there is a lack of research on the disease burden of AUD attributable to CSA. OBJECTIVE To analyze global spatiotemporal trends and differences in the disease burden of AUD attributable to CSA and its relationship with age, sex, and the sociodemographic index (SDI). PARTICIPANTS AND SETTING Data from the Global Burden of Disease 2019 Public Database. METHODS Summary exposure value (SEV) was used to evaluate CSA. Disability-adjusted life year (DALY), years lived with disability (YLD), years of life lost (YLL), and their annual rates of change were used to evaluate disease burden. Cluster analysis based on Ward's method was used to examine the global burden associated with age, sex, and SDI. A 95 % uncertainty intervals (UI), excluding 0, was considered statistically significant. RESULTS In 2019, 1.63 million (95 % UI 0.23-3.90 million) DALYs of AUD were caused by CSA and the age-standardized rates (ASRs) of DALY was 19.77 (95 % UI 2.78-47.46) globally. Annual rates of change in DALY of people over 65 years of age increased from 1990 to 2019 in all regions except the High-middle SDI regions. The ASRs of DALY of females in High SDI regions, were always at a much higher level than other SDI regions, and showed an upward trend from 1990 to 2019 (DALY 1990: 20.38 [95 % UI 2.87-47.77], 2019: 23.61 [95 % UI 3.55-54.94]). CONCLUSIONS Substantial geographical differences were observed in the burden of AUD attributable to CSA. The level of CSA exposure was inconsistent with the related burden of AUD in different regions according to the sociodemographic index. The burden of disease increased in the elderly population and in females in high sociodemographic index regions.
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Affiliation(s)
- Yifan Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Yunxi Zhong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Xiaoying Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Qixiu Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Jie Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.
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Critchlow N, Moodie C, Gallopel-Morvan K. Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1155-1167. [PMID: 38787498 DOI: 10.1111/acer.15327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Statutory options for restricting alcohol advertising include limiting it to product-orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). METHODS We conducted a 2 × 2 online between-group experiment with adults (18+) (n = 2421) recruited from a non-probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol-related information and support. The "drink responsibly" control reflected the self-regulatory messages commonly used by alcohol companies. Participants rated the advert on 7-point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. RESULTS Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: -1.57 [makes drinking alcohol seem enjoyable] to -0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: -0.55 [advert attractiveness] to -0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. CONCLUSIONS Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups.
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Affiliation(s)
- Nathan Critchlow
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Karine Gallopel-Morvan
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U1309, Rennes, France
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Tevik K, Skråstad RB, Benth JŠ, Selbæk G, Bergh S, Eldholm RS, Krokstad S, Helvik AS. Prevalence and change in alcohol consumption in older adults over time, assessed with self-report and Phosphatidylethanol 16:0/18:1 -The HUNT Study. PLoS One 2024; 19:e0304714. [PMID: 38820445 PMCID: PMC11142565 DOI: 10.1371/journal.pone.0304714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/16/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Changes in alcohol consumption may affect older adults' health. We examined prevalence and changes in the alcohol consumption of older women and men (≥65 years) in Norway over a 24-year period. METHODS Data from three population-based health surveys (The Trøndelag Health Study-HUNT2 1995-97, HUNT3 2006-08, HUNT4 2017-19) were used. Alcohol consumption was measured using self-reported measures and an objective measure of alcohol consumption (Phosphatidylethanol 16:0/18:1, PEth). Self-reported lifetime abstinence, former drinking, current drinking, frequent drinking (≥4 times/week), and risk drinking (≥8 units/week) were measured. The PEth concentrations were stratified: <0.03 μmol/l (abstinence/very low level of alcohol consumption); >0.06 μmol/l (indicating >1 unit/day); >0.10 μmol/l (indicating >3 units/day), and >0.30 μmol/l (heavy alcohol consumption). RESULTS In HUNT4, the prevalence of self-reported lifetime abstinence, frequent drinking, and risk drinking was 5.2%, 4.4%, and 5.6%, respectively, while prevalence of PEth <0.03 μmol/l was 68.1% and PEth >0.06 μmol/l was 21.2%. Over the course of the three surveys, the prevalence of self-reported lifetime abstinence decreased, while the prevalence of frequent drinking and risk drinking increased. Men were less often abstainers and more often frequent and risky drinkers than women in all three surveys. Gender differences for abstinence and current drinking reduced with time. From HUNT3 to HUNT4, the prevalence of PEth <0.03 μmol/l decreased, while the prevalence of PEth >0.06 μmol/l increased. Men compared to women, had less often PEth <0.03 μmol/l and more often PEth >0.06 and >0.10 μmol/l in HUNT3 and HUNT4. Women and men ≥75 years were just as likely to have PEth >0.30 μmol/l in HUNT4. The gender differences in PEth concentrations were reduced in HUNT4 among those aged 70-74 years or ≥75 years. CONCLUSION Alcohol consumption has increased among Norwegian older adults over a 24-year period, but at a slower pace during the last decade.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Geriatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, 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), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-Sofie Helvik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Bolt GL, Piercy H, Bradshaw J, Manning V. Smartphone-delivered approach bias modification for reducing harmful drinking amongst middle-older age adults: Secondary analyses of a single-arm pilot study. Drug Alcohol Rev 2024. [PMID: 38444082 DOI: 10.1111/dar.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Novel, scalable, low-cost interventions are needed to reduce harmful drinking amongst middle-older adults. Approach bias modification (ApBM) is a promising form of cognitive training for preventing/reducing alcohol use that can be delivered via smartphone. This study explored the acceptability and preliminary effectiveness of smartphone delivered and personalised ApBM amongst Australians ≥55 years, an age cohort at risk of alcohol-related harms. METHODS Secondary analyses in a middle-older adult subsample (≥55 years, n = 289) of an open-label pilot study using a retrospective, repeated measures design. We explored acceptability (adherence, user mobile acceptability ratings, free-text responses) and preliminary effectiveness (changes in drinking quantity and frequency, craving, dependence and proportion drinking within government-recommended guidelines) of two sessions/week over 4 weeks of evidence-based ApBM training, adapted to include personalisation and smartphone delivery amongst Australians ≥55 years. RESULTS Although minor adaptations to training were suggested, the intervention was acceptable amongst survey completers, with 72% training adherence. Relative to baseline, there was a significant increase in the proportion of drinking within recommended single-session and weekly guidelines post-training (from 25% to 41% and 6% to 28%, respectively, p < 0.001), with past-week standard drinks significantly decreasing by 18% (p < 0.001) and significant reductions in drinking days, mean craving and dependence scores (p < 0.001). DISCUSSION AND CONCLUSIONS Findings suggest smartphone ApBM is acceptable amongst middle-to-older aged Australians and may support this 'at risk' cohort to remain within government-recommended alcohol consumption guidelines to optimise healthy aging, although, in the context of a single-arm study, preliminary results should be interpreted cautiously.
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Affiliation(s)
- Georgia L Bolt
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
- Neuropsychology Department, Austin Health, Melbourne, Australia
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
| | - Jennifer Bradshaw
- Neuropsychology Department, Austin Health, Melbourne, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
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Jemberie WB, Snellman F, Eriksson M, Hammarberg A. 'Ageing with an alcohol problem is not what I envision': reclaiming agency in shaping personal ageing trajectory and recovery from alcohol problems. BMC Geriatr 2023; 23:866. [PMID: 38104085 PMCID: PMC10724916 DOI: 10.1186/s12877-023-04573-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Eliciting and understanding older persons' descriptions of their resources for healthy ageing and the interaction of these resources with alcohol use and alcohol problems can facilitate health promotion. It can also inform clinicians when identifying areas of recovery capital that present risks and strength for older people seeking alcohol treatment. The objective of this study was to illuminate the experiences and perspectives of older persons on ageing, alcohol use, treatment, and recovery from alcohol problems, as well as their understanding of healthy ageing. METHODS Eight men and two women, aged 61 to 73 years, with moderate drinking as a treatment goal and treated at an outpatient alcohol clinic in Sweden, participated in semi-structured audio-recorded virtual interviews. A qualitative content analysis examined the transcribed interviews. RESULTS Three themes were identified: "Tipping the balance", "Staying behind a veil" and "Lifting the vail". First, participants understood healthy ageing as a personal and multidimensional process that involved actively expanding, maintaining or adjusting to the resources needed to lead an active and meaningful life while preserving autonomy, dignity and independence for as long as possible. Second, most participants viewed moderate alcohol use as a contributor to healthy ageing. They sought treatment when their drinking became unsustainable and an immediate threat to their healthy ageing resources. Stigma, ambivalence and a lack of treatment options, however, contributed to delayed treatment. Third, the participants responded to treatment approaches that elicited their concern, incorporated their expertise and treatment and life goals, appreciated their autonomy and agency, and considered them partners in goal setting and decision making. Reduced drinking helped participants regain their agency and improved their healthy ageing capital which in turn catalyzed continuing recovery. CONCLUSIONS Older persons in non-abstinent recovery perceive healthy ageing and alcohol recovery as personal and interacting multidimensional processes involving their agency to improve biopsychosocial functioning. Treatment approaches that recognize older persons' desire for healthy ageing, incorporate their treatment goals and respect their autonomy are likely to be acceptable and effective.
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Affiliation(s)
- Wossenseged Birhane Jemberie
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden.
- Centre for Demography and Aging Research (CEDAR), Umeå University, Umeå, Sweden.
- The Swedish National Graduate School for Competitive Science On Aging and Health (SWEAH), Faculty of Medicine, Lund University, Lund, Sweden.
| | - Fredrik Snellman
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden
| | - Malin Eriksson
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden
| | - Anders Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Luo M, Bauman A, Phongsavan P, Ding D. Retirement transition and smoking and drinking behaviors in older Chinese adults: Analysis from the CHARLS study. Prev Med Rep 2023; 36:102408. [PMID: 37744741 PMCID: PMC10511792 DOI: 10.1016/j.pmedr.2023.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Smoking and drinking are important public problems and a substantial part of work culture in mainland China. However, little is known about the effect of retirement on these behaviors. Thus, this study examined the relationships between retirement transition, smoking and excessive drinking among older Chinese adults. Methods Repeated longitudinal data from a nationally representative sample of Chinese adults were collected in 2011, 2013, 2015 and 2018. Respondents completed a structured questionnaire regarding work status and health behaviors. Modified mixed-effects Poisson regression models were used to explore the associations, with additional analyses stratified by gender. Results Of the 10,378 participants included, 62.6% and 20.1% of men reported current smoking and excessive drinking at study entry; compared to 4.4% and 1.5% of women, respectively. There was no significant association between retirement and smoking. We found a dose-response relationship between time in retirement and excessive drinking in the adjusted model where those who retired >= 2 years ago had a 30% lower risk of excessive drinking (risk ratio (RR) = 0.70, 95% confidence interval (CI) = 0.56-0.86), and those who retired < 2 years ago had a 16% lower risk of excessive drinking (RR = 0.84, 95%CI = 0.73-0.97), compared with those who remained working. This pattern remained when analyzed separately for men and women, although not all results reached statistical significance. Discussion Chinese older adults are more likely to reduce drinking following retirement. Such evidence supports the positive framing of retirement in public discourse and the need for workplace interventions to address excessive drinking in China.
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Affiliation(s)
- Mengyun Luo
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, People’s Republic of China
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
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Kostadinov V, Bartram A. 'I'd be willing to take that risk for the enjoyment of the time that I have': a COM-B influenced analysis of older people's perspectives on their alcohol consumption. Psychol Health 2023:1-16. [PMID: 37936405 DOI: 10.1080/08870446.2023.2276748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/21/2023] [Indexed: 11/09/2023]
Abstract
Objectives: To explore how older people understand, perceive, and evaluate the various factors which drive their alcohol consumption behaviours.Methods: Semi-structured interviews were conducted with 33 Australian community-dwelling older adults (aged 65+ years) who drank alcohol at least once a month. Thematic analyses identified common themes which were then mapped onto the COM-B theoretical framework.Results: Drinking behaviours were driven by a lack of capability in the form of poor knowledge regarding safe drinking behaviours and guidelines; high opportunity for consumption due to ease of accessing alcohol and its prominence in social routines; and high motivation to drink due to perceived benefits outweighing perceived risks.Conclusion: Increasing older peoples' knowledge of the risks associated with consumption and safe drinking behaviours represents a key health promotion priority in order to reduce the burden of alcohol-related harms among this group.
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Affiliation(s)
- Victoria Kostadinov
- National Centre for Education and Training on Addiction, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ashlea Bartram
- National Centre for Education and Training on Addiction, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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Müller CP, Schumann G, Rehm J, Kornhuber J, Lenz B. Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment. Mol Psychiatry 2023; 28:2683-2696. [PMID: 37117460 PMCID: PMC10615763 DOI: 10.1038/s41380-023-02074-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.
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Affiliation(s)
- Christian P Müller
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
- Centre for Drug Research, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia.
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Gunter Schumann
- The Centre for Population Neuroscience and Stratified Medicine (PONS), ISTBI, Fudan University, Shanghai, China
- PONS Centre, Charite Mental Health, Department of Psychiatry and Psychotherapie, CCM, Charite Universitaetsmedizin Berlin, Berlin, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Bernd Lenz
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
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Bulanda JR, Curl AL, Roberts AR. Marital Quality and Alcohol Use among Couples in Mid- and Later-Life. J Appl Gerontol 2022; 42:1068-1077. [PMID: 36484423 DOI: 10.1177/07334648221143305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Spouses influence one another’s drinking behavior, but little research has explored how relationship quality may impact older couples’ alcohol use. Using data from the 2014–2018 waves of the Health and Retirement Study (HRS) and actor-partner interdependence models, we examined how marital quality is related to total alcohol consumption and risk of heavy drinking for married couples over age 50. Neither husbands’ nor wives’ perceptions of negative marital quality were related to changes in heavy drinking or number of drinks consumed over the observation period. However, wives’ positive marital quality was associated with increased risk of heavy alcohol use for both wives and husbands, and with an increase in the number of drinks wives consume over time. Couples over age 50 do not appear to use alcohol as a way of coping with negative marital relationships, but rather may increase their drinking in the context of positive relationships.
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Affiliation(s)
| | - Angela L. Curl
- Department of Family Science and Social Work, Miami University, Oxford, OH, USA
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Chai X, Mei J. Investigating food insecurity, health lifestyles, and self-rated health of older Canadians living alone. BMC Public Health 2022; 22:2264. [PMID: 36464679 PMCID: PMC9720941 DOI: 10.1186/s12889-022-14467-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a large number of older of this demographic fact. Although many studies have investigated the association between living arrangements and health, little is known about potential underlying mechanisms regarding how living alone may predict older Canadians' health. In this study, we address this research gap intending to contribute to offering policy suggestions for older Canadians who live alone. RESEARCH DESIGN AND METHODS We applied Cockerham's health lifestyle theory to explore to what degree living alone predicts worse health lifestyles and, further, to what degree these lifestyles can explain the association between living alone and older Canadians' health. We used the 2017-2018 Canadian Community Social Survey (Annual Component) which has a response rate of 58.8%. We focused on respondents aged 60 and above, and the analytical sample size is 39,636. RESULTS Older Canadians living alone are more likely to have food insecurity problems and higher possibilities of smoking cigarettes compared to those living with spouses/partners with or without children. Compared to those living with spouses/partners only, the odds of solo-living older Canadians drinking regularly is significantly lower. There also exists a significant difference between older Canadians living alone and their counterparts living with spouses/partners that the former reported lower self-rated health compared to the latter. Moreover, food insecurity and the three health lifestyle variables are significantly associated with respondents' self-rated health; food insecurity, cigarette smoking, and alcohol drinking can partially explain the difference in self-rated health due to living arrangements. DISCUSSION AND IMPLICATIONS According to our findings, health officials are recommended to pay more attention to food insecurity and heavy smoking problems facing older Canadians who live by themselves. Local communities and other stakeholders are suggested to provide older adults living alone with more opportunities for social engagement and involvement since regular drinking may have played such a role in enhancing social life quality of the aged.
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Affiliation(s)
- Xiangnan Chai
- grid.41156.370000 0001 2314 964XSociology Department, School of Social and Behavioral Sciences, Nanjing University, He’ren Building 359, Xianlin Street, Qixia District, Nanjing, Jiangsu Province People’s Republic of China
| | - Junyi Mei
- grid.41156.370000 0001 2314 964XSociology Department, School of Social and Behavioral Sciences, Nanjing University, He’ren Building 359, Xianlin Street, Qixia District, Nanjing, Jiangsu Province People’s Republic of China
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Destro JSF, Marin MJS, Otani MAP, Selleti JDDN, Higa EDFR. Experiences of alcohol-dependent elderly: grounded theory. Rev Esc Enferm USP 2022; 56:e20220064. [PMID: 36477248 PMCID: PMC10081651 DOI: 10.1590/1980-220x-reeusp-2022-0064en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 10/17/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To interpret the experiences of alcohol-dependent elderly people. METHOD Qualitative research developed through the theoretical and methodological assumptions of the Grounded Theory in the Straussian version. It was carried out in a small town in the mid-western region of the state of São Paulo. The selection was by theoretical sampling, totaling 25 participants from three sample groups. Semistructured interviews were conducted from March 2019 to January 2020. RESULTS The phenomenon "Experiencing alcohol dependence in old age", is conditioned by the category "Initiating Alcohol Consumption", are actions/interactions "Justifying alcohol consumption" and "Coping with alcohol treatment and abstinence" whose consequences are "Experiencing the harms of alcohol dependence" and "Expressing feelings". CONCLUSION It was evidenced that the elderly participants consider alcohol dependence as a way to deal with negative emotions, and, in this trajectory, they experience physical, mental, and social consequences. The elderly in abstinence express feelings of loneliness, regret, and desire for a life with quality, and indicate that behavioral change occurs through treatment and awareness of its harmful effects.
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Affiliation(s)
- José Stéfano Faia Destro
- Faculdade de Medicina de Marília, Programa de Mestrado Acadêmico em "Saúde e Envelhecimento", Marília, SP, Brazil
| | - Maria José Sanches Marin
- Faculdade de Medicina de Marília, Programa de Mestrado Acadêmico em "Saúde e Envelhecimento", Marília, SP, Brazil
| | | | - Jaqueline Dias do Nascimento Selleti
- Universidade Federal do Paraná, Complexo Hospital de Clínicas, Núcleo de Estudos, Pesquisa e Extensão em Cuidado Humano de Enfermagem, Curitiba, PR, Brazil
| | - Elza de Fátima Ribeiro Higa
- Faculdade de Medicina de Marília, Programa de Mestrado Acadêmico em "Saúde e Envelhecimento", Marília, SP, Brazil
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12
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Nielsen DG, Andersen K, Nielsen AS, Nielsen F, Behrendt S, Bilberg R, Bogenschutz M, Bühringer G, Mellentin AI. Comparison of self-reported alcohol consumption and ethyl glucuronide in hair in a sample of 60+ year -olds treated for DSM-5 alcohol use disorder. Addict Biol 2022; 27:e13231. [PMID: 36301220 PMCID: PMC9786874 DOI: 10.1111/adb.13231] [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: 11/16/2021] [Revised: 07/17/2022] [Accepted: 08/26/2022] [Indexed: 01/24/2023]
Abstract
There is a lack of evidence for the consistency between self-reported alcohol consumption (SRAC) and concentrations of ethyl glucuronide in hair (hEtG) among elderly patients treated exclusively for alcohol use disorder (AUD). Hence, this study assessed the consistency between these two measures in these patients. A total of 190 patients with AUD were assessed for SRAC using Form 90 and hEtG, 14 or 22 weeks after treatment conclusion. Patients were grouped according to SRAC (g/day) and corresponding hEtG concentrations (pg/mg): 0 and <5 (abstinence), 0.1-14.3 and 5.0-9.9 (low consumption), 14.4-21.4 and 10.0-15.9 (moderate consumption), 21.5-59.9 and 16.0-30 (high consumption) and ≥60 and >30 (excessive consumption). The extent of underreporting and overreporting was examined by crosstabulations, and inter-rater reliability was reported by kappa correlations. Associations and effect modification were examined by conditional logistic regression. Due to multitesting, p-values ≤0.01 were considered significant. Underreporting was found in 96 patients (50.5%) and overreporting in 41 patients (21.6%). The kappa coefficients varied between 0.19 and 0.34. HEtG was more likely to detect low, moderate and high alcohol consumption compared with SRAC (ORs between 5.1 and 12.6, all p-values <0.01), but SRAC and hEtG did not differ significantly with respect to identification of abstinence (OR = 1.9, p = 0.05). Inconsistency between the outcome measures was found in a considerable number of the patients. More studies examining the consistency between SRAC and specific direct biomarkers of alcohol in this population seem warranted.
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Affiliation(s)
- Dorthe Grüner Nielsen
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Kjeld Andersen
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,BRIDGE, Brain Research, Inter‐Disciplinary Guided Excellence, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,Open, Odense Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - Anette Søgaard Nielsen
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,BRIDGE, Brain Research, Inter‐Disciplinary Guided Excellence, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Flemming Nielsen
- Environmental Medicine, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Silke Behrendt
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,Institute for PsychologyUniversity of Southern DenmarkOdenseDenmark
| | - Randi Bilberg
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Michael Bogenschutz
- NYU Grossman School of MedicineNew York CityNew YorkUSA,Health Sciences CenterUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Gerhard Bühringer
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany,IFT Institut für TherapieforschungMunichGermany
| | - Angelina Isabella Mellentin
- Unit for Clinical Alcohol Research, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,BRIDGE, Brain Research, Inter‐Disciplinary Guided Excellence, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark,Tele‐Psychiatric Center, Region of Southern DenmarkOdenseDenmark
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13
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Freni F, Moretti M, Scardo S, Carelli C, Vignali C, Monti MC, Morini L. Ethyl glucuronide in hair: a 5-years retrospective cohort study in subjects sanctioned for driving under the influence of alcohol and psychoactive substances. Drug Test Anal 2022; 14:1417-1428. [PMID: 35355418 PMCID: PMC9543301 DOI: 10.1002/dta.3265] [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: 02/06/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The evaluation of drinking behaviours can help in limiting high-risk situation, such as driving under the influence (DUI). We investigate ethyl glucuronide in hair (hEtG) levels to evaluate alcohol consumption behaviour in subjects followed up after having been charged for DUI of psychoactive substances and/or alcohol. METHODS We performed a retrospective observational cohort study on 4328 subjects over 18 years old who underwent hEtG analysis in the period 2015-2019 in the Italian Province of Pavia. hEtG level was used as a proxy for the alcohol consumption behaviour. Effects of age, sex and district on alcohol drinking behaviour were investigated with an ordinal logit model. A state sequence analysis was used to study people's alcohol consumption behaviour over time. RESULTS hEtG was found ≥7.0 pg/mg in 22.2% of the drivers (of which 7% has an hEtG ≥30.0 pg/mg). Among positive cases, a prevalence of males (96.3%) aged 35-44 (32.6%), coming from main city and hinterland (38.2%) was observed. The propensity to drink was higher for males (OR≈2.28, p<0.001) and for subject coming from the district devoted to the cultivation of vineyards. Young age classes have a reduced drinking risk if compared to the drivers over 55 years old (p<0.001). A general decreasing trend over time in hEtG values was observed. CONCLUSION Being male, age ≥ 55 years, and coming from rural areas are potential risk factors related to alcohol drinking habits among drivers. Ethyl glucuronide in hair test in the driving license reissuing protocol contributed to decrease alcohol misuse behaviours.
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Affiliation(s)
- Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Sara Scardo
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
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14
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Sex differences in at-risk drinking and associated factors-a cross-sectional study of 8,616 community-dwelling adults 60 years and older: the Tromsø study, 2015-16. BMC Geriatr 2022; 22:170. [PMID: 35232388 PMCID: PMC8886794 DOI: 10.1186/s12877-022-02842-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Alcohol consumption among older adults is on the rise, which may be an increasing public health concern. The proportion of older adults who drink above defined low-risk drinking limits, associated characteristics and the sex distribution of at-risk drinking vary across countries. The aims of this study were to (i) estimate the prevalence of at-risk drinking among older adults in Norway, (ii) investigate factors associated with at-risk drinking, and (iii) examine sex differences in alcohol consumption in the context of sociodemographic and selected health characteristics. Method A cross-sectional study based on Tromsø 7 (2015–16), an ongoing population-based cohort survey. Data were retrieved from participants aged 60 and older (60-99 years) who answered questions about alcohol consumption (n = 8,616). Sex-stratified logistic regressions were used to assess the association between three at-risk drinking outcome variables, and sociodemographic and selected health characteristics. The outcome variables were operationalized using the Alcohol Use Disorders Identification Test (AUDIT), and Alcohol Consumption Questions (AUDIT-C), i.e. – cut off for at risk drinking, drinking any 6+ in the past year, and any alcohol problems. Results The overall prevalence of at-risk drinking among those aged 60-99 years was equal in women and men; 44% and 46%, respectively. At-risk drinking was strongly associated with a higher level of education, with OR 2.65 (CI 2.28-3.10) in women and OR 1.73 (CI 1.48-2.04) in men. Conclusions Almost half of older adults in Norway exceeded sex- and older adult-specific at-risk drinking thresholds. Our findings suggest some differences in factors associated with at-risk drinking between women and men. Explicitly, at-risk drinking was associated with very good health, living with a spouse or partner, and having adequate social support in women, while it was associated with the use of sleeping pills in men. Our findings suggest that women exceed at-risk drinking thresholds with better health, while men exceed at-risk drinking thresholds regardless of good or poor health. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02842-w.
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15
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Chartier KG, Karriker‐Jaffe KJ. Commentary on Nordeck et al.: Disruption of social roles and daily routines in the initial phase of the COVID-19 pandemic may explain changes in alcohol use frequency. Addiction 2022; 117:341-342. [PMID: 34676603 PMCID: PMC8652924 DOI: 10.1111/add.15707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Karen G. Chartier
- School of Social Work and Department of PsychiatryVirginia Commonwealth UniversityRichmondVAUSA
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16
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Paula TCS, Chagas C, Henrique AEG, Castro-Costa E, Lima-Costa MF, Ferri CP. Alcohol consumption among older adults: Findings from the ELSI-Brazil study. Int J Geriatr Psychiatry 2022; 37. [PMID: 34762348 DOI: 10.1002/gps.5655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/07/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study estimates the national prevalence of drinking patterns (current, heavy, and binge) and the associated factors, among older Brazilians. DESIGN Cross-sectional study using survey data from ELSI-Brazil (2015-2016). SETTING/PARTICIPANTS A total of 7839 adults aged 50 years or older. MEASUREMENTS Respondents were asked about alcohol drinking. Alcohol consumption status was categorized as current drinkers (last month), heavy drinkers (≥7 drinks/week for females and ≥14 drinks/week for males), and binge drinkers (≥4 drinks on one occasion for females and ≥5 drinks on one occasion for males). Covariates included sociodemographic characteristics, tobacco smoking, depression, and number of chronic diseases. RESULTS Of the 7839 participants, 29.4% were current drinkers, 5.1% were heavy drinkers, and 10.3% reported binge drinking. In the ≥60 years old age group, the prevalence of current drinking was 23.8%, 3.9% were heavy drinkers, and 6.7% reported binge drinking. All drinking patterns had similar associated factors: being male, being younger, having higher education, tobacco smoking, and falls. In addition, the greater the number of chronic conditions, the lower the prevalence of current drinking and binge drinking. CONCLUSION Heavy drinking and binge drinking are often reported by older Brazilians, particularly among males, those with higher education and in the younger age groups. These behaviors can negatively affect the health of older adults. It is, therefore, important to identify the problems related to alcohol consumption among older adults to minimize the risks and harms.
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Affiliation(s)
- Tassiane C S Paula
- Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Camila Chagas
- Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Amanda E G Henrique
- Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.,Faculdade de Educação e Artes, Curso de Psicologia, Universidade do Vale do Paraíba - UNIVAP, São José dos, Brazil
| | - Erico Castro-Costa
- Fundação Oswaldo Cruz, Núcleo de Estudos em Saúde Pública e Envelhecimento (NESPE), Instituto René Rachou, Belo Horizonte, Brazil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz, Núcleo de Estudos em Saúde Pública e Envelhecimento (NESPE), Instituto René Rachou, Belo Horizonte, Brazil.,Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cleusa P Ferri
- Health Technology Assessment Unit, International Research Institute, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
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17
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Destro JSF, Marin MJS, Otani MAP, Selleti JDDN, Higa EDFR. Vivências de idosos dependentes de álcool: teoria fundamentada nos dados. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0064pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
RESUMO Objetivo: Interpretar as vivências dos idosos dependentes de álcool. Método: Pesquisa qualitativa desenvolvida por meio dos pressupostos teórico-metodológicos da Teoria Fundamentada dos Dados na versão straussiana. Foi realizada em um município de pequeno porte da região centro-oeste paulista. A seleção foi por amostragem teórica, totalizando 25 participantes a partir de três grupos amostrais. Foram conduzidas entrevistas semiestruturadas entre março de 2019 a janeiro de 2020. Resultados: O fenômeno “Vivenciando a dependência de álcool na velhice”, está condicionado pela categoria “Iniciando o consumo de Álcool”, são ações/interações “Justificando o consumo de álcool” e “Enfrentando o tratamento e a abstinência do álcool” cujas consequências são “Experienciando os danos da dependência de álcool” e “Expressando sentimentos”. Conclusão: Evidenciou-se que os idosos participantes consideram a dependência de álcool como forma de lidar com emoções negativas, e, nessa trajetória, experienciam consequências físicas, mentais e sociais. Os idosos em abstinência expressam sentimentos de solidão, arrependimento e desejo de uma vida com qualidade, e indicam que a mudança comportamental ocorre por meio do tratamento e conscientização de seus malefícios.
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18
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Kersey K, Lyons AC, Hutton F. Alcohol and drinking within the lives of midlife women: A meta-study systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103453. [PMID: 34653766 DOI: 10.1016/j.drugpo.2021.103453] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND A range of societal changes have created positive and encouraging environments for women's alcohol use. Within this context, in Western countries there is evidence of rising rates of alcohol consumption and related harms among midlife and older women. It is timely and important to explore the role of alcohol in the lives of midlife women to better understand observed data trends and to develop cohort specific policy responses. Focussing on Western countries and those with similar mixed market systems for alcohol regulation, this review aimed to identify 1) how women at midlife make sense of and account for their consumption of alcohol; 2) factors that play a role; and 3) the trends in theoretical underpinnings of qualitative research that explores women's drinking at midlife. METHODS A meta-study approach was undertaken. The review process involved extracting and analysing the data findings of eligible research, as well as reviewing the contextual factors and theoretical framing that actively shape research and findings. RESULTS Social meanings of alcohol were interwoven with alcohol's psycho-active qualities to create strong localised embodied experiences of pleasure, sociability, and respite from complicated lives and stressful circumstances in midlife women. Drinking was shaped by multiple and diverse aspects of social identity, such as sexuality, family status, membership of social and cultural groups, and associated responsibilities, underpinned by the social and material realities of their lives, societal and policy discourses around drinking, and how they physically experienced alcohol in the short and longer term. CONCLUSION For harm reduction strategies to be successful, further research effort should be undertaken to understand alcohol's diverse meanings and functions in women's lives and the individual, material, and socio-cultural factors that feed into these understandings. As well as broad policies that reduce overall consumption and "de-normalise" drinking in society, policy-makers could usefully work with cohorts of women to develop interventions that address the functional role of alcohol in their lives, as well as policies that address permissive regulatory environments and the overall social and economic position of women.
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Affiliation(s)
- Kate Kersey
- School of Health, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand.
| | - Antonia C Lyons
- School of Health, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
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19
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Clarke N, Blackwell AKM, De-Loyde K, Pechey E, Hobson A, Pilling M, Morris RW, Marteau TM, Hollands GJ. Health warning labels and alcohol selection: a randomised controlled experiment in a naturalistic shopping laboratory. Addiction 2021; 116:3333-3345. [PMID: 33861881 DOI: 10.1111/add.15519] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/15/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial-standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption. DESIGN A between-subjects randomised experiment with three groups was conducted: group 1: image-and-text HWL; group 2: text-only HWL; group 3: no HWL. SETTING A commercial-standard naturalistic shopping laboratory in the United Kingdom. PARTICIPANTS Adults (n = 399, 55% female) over the age of 18 years, who purchased beer or wine weekly to drink at home. INTERVENTIONS Participants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: (i) image-and-text HWL (n = 135); (ii) text-only HWL (n = 129); (iii) no HWL (n = 135). Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks. MEASUREMENT The primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability. FINDINGS There was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image-and-text HWL: 46% (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 0.82, 1.42); text-only HWL: 41% (OR = 0.87, 95% CI = 0.67, 1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (P < 0.001) and acceptability lower (P < 0.001) in the image-and-text HWL group, compared to the text-only HWL group. CONCLUSIONS In a naturalistic shopping laboratory, there was no evidence that health warning labels describing the adverse health consequences of excessive alcohol consumption changed selection behaviour.
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Affiliation(s)
- Natasha Clarke
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anna K M Blackwell
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Katie De-Loyde
- Tobacco and Alcohol Research Group, School of Psychological Science, University of Bristol, Bristol, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Alice Hobson
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Theresa M Marteau
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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20
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Bareham BK, Stewart J, Kaner E, Hanratty B. Factors affecting primary care practitioners' alcohol-related discussions with older adults: a qualitative study. Br J Gen Pract 2021; 71:e762-e771. [PMID: 33950854 PMCID: PMC8407858 DOI: 10.3399/bjgp.2020.1118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/20/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Risk of harm from drinking is heightened in later life, owing to age-related sensitivities to alcohol. Primary care services have a key role in supporting older people (aged ≥50 years) to make healthier decisions about alcohol. AIM To examine primary care practitioners' perceptions of factors that promote and challenge their work to support older people in alcohol risk-reduction. DESIGN AND SETTING Qualitative study consisting of semi-structured interviews and focus groups with primary care practitioners in Northern England. METHOD Thirty-five practitioners (GPs, practice/district nurses, pharmacists, dentists, social care practitioners, and domiciliary carers) participated in eight interviews and five focus groups. Data were analysed thematically, applying principles of constant comparison. RESULTS Practitioners highlighted particular sensitivities to discussing alcohol among older people, and reservations about older people's resistance to making changes in old age; given that drinking practices could be established, and promote socialisation and emotional wellbeing in later life. Age-related health issues increased older people's contact with practitioners, but management of older people's long-term conditions was prioritised over discussion of alcohol. Dedicated time to address alcohol in routine consultations with older people and training in alcohol intervention facilitated practitioners, particularly pharmacists and practice nurses. CONCLUSION There are clear opportunities to support older people in primary care to make healthier decisions about alcohol. Dedicated time to address alcohol, training in identification of alcohol-related risks (particularly those associated with old age), and tailored interventions for older people, feasible to implement in practice settings, would help primary care practitioners to address older people's alcohol use.
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Affiliation(s)
- Bethany Kate Bareham
- Newcastle University Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Jemma Stewart
- Newcastle University Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne
| | - Eileen Kaner
- Newcastle University Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Barbara Hanratty
- Newcastle University Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
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21
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Johannessen A, Tevik K, Engedal K, Gade Haanes G, Helvik AS. Health Professionals' Experiences Regarding Alcohol Consumption and Its Relation to Older Care Recipient's Health and Well-Being. J Multidiscip Healthc 2021; 14:1829-1842. [PMID: 34285501 PMCID: PMC8286065 DOI: 10.2147/jmdh.s310620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Alcohol consumption among older people is expected to increase in the years ahead. Health professionals' experiences of, and reflections on, alcohol consumption and its relation to well-being are thus important to the provision of adequate and high-quality treatment and care. AIM To investigate health professionals' experiences and reflections about alcohol consumption among older people and how it is related to their health and well-being. METHODS A case study design approach was adopted, incorporating three qualitative studies involving Norwegian health professionals. The health professionals interviewed included workers in nursing homes, home care professionals and general practitioners. RESULTS The study revealed a diversity of views and reflections on alcohol consumption, its facilitation, and the impact on the health and well-being of older patients and care recipients. Six themes were revealed by the three studies: (i) the facilitation of alcohol consumption to promote and normalize life in nursing homes, (ii) the restriction of unhealthy alcohol consumption, (iii) attempts to discuss alcohol consumption with care recipients, (iv) the initiation of collaboration with informal caregivers in restricting alcohol consumption, (v) minimalizing the dialogue regarding alcohol consumption to guard patient privacy and (vi) a desire for joint action and a national political strategy. CONCLUSION Health professionals working in NHs, in-home and GPs find it difficult to discuss the use and elevated use of alcohol with older people for whom they have care and treatment responsibilities. In general, they are concerned that such conversations infringe on the principles governing an individual's autonomy. However, because they are aware that elevated alcohol intake may have a negative impact on health and well-being, they also express a need for guidelines how they in a better and open minded way can discuss the use and elevated use of alcohol with the patients they care for.
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Affiliation(s)
- Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- University of South-Eastern Norway (USN), Department of Nursing and Health Sciences, Kongsberg, Norway
| | - Kjerstin Tevik
- 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
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Gro Gade Haanes
- University of South-Eastern Norway (USN), Department of Nursing and Health Sciences, Kongsberg, Norway
| | - Anne-Sofie 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
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Stelander LT, Høye A, Bramness JG, Selbæk G, Lunde LH, Wynn R, Grønli OK. The changing alcohol drinking patterns among older adults show that women are closing the gender gap in more frequent drinking: the Tromsø study, 1994-2016. Subst Abuse Treat Prev Policy 2021; 16:45. [PMID: 34039389 PMCID: PMC8152329 DOI: 10.1186/s13011-021-00376-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As the population of older adults continues to grow, changes in alcohol consumption are important to monitor because an increase may have public health consequences. Rates of alcohol use vary with geographical location. The aim of this study was to examine trends in alcohol consumption among older adults in a geographically defined area in Norway, especially changing sex differences in drinking patterns over a 22-year period. METHODS Repeated cross-sectional survey (in 1994-95, 2007-08, and 2015-16) of a general population of older adults. Eligible for this study were 20,939 participants (aged 60-99 years). The data were analysed using generalized estimating equations, stratified by age and sex. Alcohol consumption and drinking patterns were assessed, using an adaptation of the AUDIT-C. RESULTS Between 1994 and 2016, there has been a significant increase in the proportion of current drinkers among older adults. Furthermore, the probability of frequent drinking (alcohol consumption at least twice weekly) increased significantly between 1994 and 2016, particularly among older women; OR 8.02 (CI 5.97-10.79) and OR 5.87 (CI 4.00-8.63) in the age groups 60-69 and 70+ respectively for women, and OR 4.13 (CI 3.42-4.99) and OR 3.10 (CI 2.41-3.99), in the age groups 60-69 and 70+ respectively for men. The majority of older adults drank small amounts of alcohol on typical drinking days, but there was an increasing probability of drinking three drinks or more on each occasion over the study period, except among women aged 70+ years. CONCLUSIONS Among older adults in Norway, alcohol consumption in terms of frequency and quantity on typical drinking days has increased considerably from 1996 to 2016. This change is in the opposite direction of what has been reported among younger adults. The gap between women and men in frequent drinking has been markedly narrowed, which indicate that women's drinking patterns are approaching those of men. This may involve a need to change alcohol policy in Norway to more targeted interventions aimed at older people.
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Affiliation(s)
- Line Tegner Stelander
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway.
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Anne Høye
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G Bramness
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Rolf Wynn
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Kristian Grønli
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Stewart D, Hewitt C, McCambridge J. Exploratory Validation Study of the Individual AUDIT-C Items among Older People. Alcohol Alcohol 2021; 56:258-265. [PMID: 32860051 DOI: 10.1093/alcalc/agaa080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/19/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS The AUDIT-C is a brief and commonly used alcohol screening tool, with few data available on the relative validity of the three individual items in older adult populations. The aim of this study was to explore the validity of the AUDIT-C items in identifying unhealthy drinking among older people, with a view to developing a single-item screener. METHODS A sample of 143 older adults (mean age = 71) were recruited from non-clinical settings in the UK. AUDIT-C scores were compared to an unhealthy drinking reference category of consuming more than the UK recommended weekly units of alcohol. Standard analyses were conducted for men and women, and for those prescribed medications for long term conditions. RESULTS The AUDIT-C items performed well in identifying unhealthy drinking in this sample of older people, with generally high sensitivity, specificity and area under the ROC curve. No significant differences were found in the validity of the three items, though the combined sensitivity and specificity scores and ROC values for item 3 were consistently slightly lower than for items 1 and 2. The findings were similar for men and women, and for participants prescribed medications for long-term conditions. CONCLUSIONS AUDIT-C items 1 and 2 performed as well as item 3 in identifying unhealthy drinking among older people in this study. Both are reasonable single-item screener candidates, especially given relative ease of administration, with further validation study needed to examine psychometrics and how alcohol screening for older people can best be implemented in clinical settings.
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Affiliation(s)
- Duncan Stewart
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Catherine Hewitt
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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Your friends, my friends, and our family: Informal social participation and mental health through the lens of linked lives. Soc Sci Med 2021; 276:113848. [PMID: 33770570 DOI: 10.1016/j.socscimed.2021.113848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/05/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022]
Abstract
RATIONALE Social participation is an important predictor of individual health outcomes, but few studies have examined it in the context of marriage relationships, even though the social lives of spouses are inextricably linked. OBJECTIVE To examine whether individuals' mental health is associated with their spouse's contact with friends and family. METHODS Using dyadic data from adults aged 50 and above in the Health and Retirement Study (N = 5030 couples), I examine whether individuals' mental health is associated with their spouse's contact with friends and family (i.e., partner effects) through a longitudinal actor-partner interdependence model. In addition, I test for the presence of gender differences in these effects. Both depressive symptoms and binge drinking are used as measures of mental health to account for the different ways in which men and women may express psychological distress. RESULTS Results show partial evidence that spousal contact with friends and family are associated with one's own mental health outcomes, and that within-dyad discrepancies in informal social participation may be detrimental to mental well-being. CONCLUSIONS These findings highlight the importance of understanding the dynamics between social participation and health through the lens of "linked lives", especially for married couples.
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van Gils Y, Franck E, Dierckx E, van Alphen SPJ, Dom G. The Role of Psychological Distress in the Relationship between Drinking Motives and Hazardous Drinking in Older Adults. Eur Addict Res 2021; 27:33-41. [PMID: 32434195 DOI: 10.1159/000507664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/02/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Drinking motives seem to be the most proximal predictors of alcohol outcomes. Consequently, these are an essential factor to consider as they may influence the extent to which alcohol is used in a risky way, even in older adults. OBJECTIVE We studied the moderating effect of distress on the relationship between drinking motives and drinking behaviour in a community-dwelling older adult sample. METHOD In a retrospective cross-sectional research study, participants were community-dwelling older adults aged 65 years and older. All respondents completed a questionnaire covering the Drinking Motives Questionnaire (DMQ), the Alcohol Use Disorders Identification Test (AUDIT), and the General Severity Index (GSI) of the Brief Symptom Inventory (BSI). RESULTS In this sample of 1,148 older adults, drinking motives and hazardous alcohol use were associated (enhancement motives r = 0.478, p < 0.001; coping motives r = 0.367, p < 0.001; and social motives r = 0.235, p < 0.001). Furthermore, moderation analysis showed that older adults drinking predominantly for enhancement or coping motives (respectively, β = 0.433, CI [95%] = 2.557-3.222 and β = 0.327, CI [95%] = 1.077-1.491, p < 0.001), and older adults who had higher levels of psychological distress (β = 2.518, CI [95%] = 2.017-3.019, p < 0.001) were more likely to report higher degree of hazardous alcohol use. CONCLUSION The relations between coping drinking motives and enhancement drinking motives on hazardous drinking depended on the level of distress. The associations between drinking for coping and drinking for enhancement were stronger in high levels of distress. Although causality cannot be interpreted from cross-sectional data, tackling psychological distress and drinking to cope with negative affect or to enhance positive affect might have strong effects on reducing hazardous drinking behaviour among older adults.
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Affiliation(s)
- Yannic van Gils
- Faculty of Medicine and Social Science, University of Antwerp, Wilrijk, Belgium, .,Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium,
| | - Erik Franck
- Faculty of Medicine and Social Science, University of Antwerp, Wilrijk, Belgium
| | - Eva Dierckx
- Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium.,Alexianen Zorggroep Tienen, Psychiatric Hospital, Tienen, Belgium
| | - Sebastiaan P J van Alphen
- Faculty of Psychology and Educational Science, Free University Brussel, Elsene, Belgium.,Clinical Centre of Excellence for Personality Disorders in Older Adults, Mondriaan Hospital, Heerlen-Maastricht, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Geert Dom
- Alexianen Zorggroep Multiversum, Psychiatric Hospital, Boechout, Belgium.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
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Bareham BK, Kaner E, Hanratty B. Managing older people's perceptions of alcohol-related risk: a qualitative exploration in Northern English primary care. Br J Gen Pract 2020; 70:e916-e926. [PMID: 33077511 PMCID: PMC7575405 DOI: 10.3399/bjgp20x713405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Risk of harm from drinking increases with age as alcohol affects health conditions and medications that are common in later life. Different types of information and experiences affect older people's perceptions of alcohol's effects, which must be navigated when supporting healthier decisions on alcohol consumption. AIM To explore how older people understand the effects of alcohol on their health; and how these perspectives are navigated in supportive discussions in primary care to promote healthier alcohol use. DESIGN AND SETTING A qualitative study consisting of semi-structured interviews and focus groups with older, non-dependent drinkers and primary care practitioners in Northern England. METHOD A total of 24 older adults aged ≥65 years and 35 primary care practitioners participated in interviews and focus groups. Data were analysed thematically, applying principles of constant comparison. RESULTS Older adults were motivated to make changes to their alcohol use when they experienced symptoms, and if they felt that limiting consumption would enable them to maintain their quality of life. The results of alcohol-related screening were useful in providing insights into potential effects for individuals. Primary care practitioners motivated older people to make healthier decisions by highlighting individual risks of drinking, and potential gains of limiting intake. CONCLUSION Later life is a time when older people may be open to making changes to their alcohol use, particularly when suggested by practitioners. Older people can struggle to recognise potential risks or perceive little gain in acting on perceived risks. Such perceptions may be challenging to navigate in supportive discussions.
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Affiliation(s)
- Bethany Kate Bareham
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne
| | - Eileen Kaner
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne
| | - Barbara Hanratty
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne
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Ng Fat L, Bell S, Britton A. A life-time of hazardous drinking and harm to health among older adults: findings from the Whitehall II prospective cohort study. Addiction 2020; 115:1855-1866. [PMID: 32233123 PMCID: PMC7487058 DOI: 10.1111/add.15013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/19/2019] [Accepted: 02/12/2020] [Indexed: 01/20/2023]
Abstract
AIMS To investigate associations of life-time hazardous and binge drinking with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality. DESIGN Prospective cohort study with median follow-up time to CVD incidence of 4.5 years. SETTING London, UK: civil servants within the Whitehall II Study. PARTICIPANTS A total of 4820 drinkers aged 59-83 years with biological measurements during the 2011-12 survey. MEASUREMENTS Hazardous drinking was defined as having an AUDIT-C score ≥ 5 calculated at each decade of life, forming the following groups: never hazardous drinker, former early (stopping before age 50), former later (stopping after age 50), current hazardous drinker and consistent hazardous drinker (hazardous drinker at each decade of life). FINDINGS More than half the sample had been hazardous drinkers at some point during their life-time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent hazardous drinker (AUDIT-C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent hazardous drinking (e.g. compared with never hazardous drinkers, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25-2.08]; former later by 1.88 cm (CI = 0.77-2.98); current by 2.44 cm (CI = 1.50-3.34) and consistent hazardous drinker by 3.85 cm (CI = 2.23-5.47). Current hazardous drinkers had higher systolic blood pressure (2.44 mmHg, CI = 1.19-3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92-5.18) than never hazardous drinkers. Current hazardous drinkers [hazard ratio (HR) = 2.75, CI = 1.44-5.22) had an elevated risk of stroke, and former later hazardous drinkers had an elevated risk of non-CVD mortality (HR = 1.93, CI = 1.19-3.14) than never hazardous drinkers. Life-time binge drinking was associated with larger waist circumferences and poorer liver function compared with never binge drinkers. CONCLUSION Hazardous drinking may increase cardiometabolic risk factors; this is made worse by persistent hazardous drinking throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.
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Affiliation(s)
- Linda Ng Fat
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Steven Bell
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK,National Institute for Health Research Blood and Transplant Unit in Donor Health and Genomics at the University of Cambridge, Strangeways Research LaboratoryCambridgeUK,Stroke Research Group, Department of Clinical NeurosciencesCambridge Biomedical CampusCambridgeUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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Grossi A, Holmes A, Ibrahim JE. Use of Alcohol in Long Term Care Settings: A Comparative Analysis of Personal Choice, Public Health Advice and the Law. J Am Med Dir Assoc 2020; 22:9-14.e1. [PMID: 32980241 DOI: 10.1016/j.jamda.2020.08.010] [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: 05/05/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 02/01/2023]
Abstract
Alcohol is one of the most widely available psychoactive substances globally. Many accept the risks associated with alcohol consumption for reasons such as social engagement and feelings of pleasure. Alcohol consumption in a nursing home (NH) setting highlights the moral and logistical challenges of balancing the need for a safe living and working environment with the dignity of risk (DoR) and personal autonomy of residents. This analysis explores public health, human rights, and legal frameworks in their approach to a NH resident's choice to drink alcohol. Key issues under the public health framework include the medical risks associated with alcohol consumption, whether residents with impaired cognitive functioning have the capacity to make a decision about alcohol consumption, and the practical and ethical implications of supplying alcohol to residents. Under a legal framework, NHs must consider the legal imperative to respect residents' rights, the possibility of liability in negligence, duties owed to employees, the existence of substitute decision-makers, and liquor licensing laws. Fundamental considerations under the human rights framework include the damaging psychological effects of risk-avoidance and the importance of inclusive risk assessment processes. Alcohol policies should incorporate elements from all 3 frameworks. There is limited data publicly available about alcohol policies in NHs. Further research is needed to establish current practice and to evaluate the merits and disadvantages of different policies. Establishing inclusive and thorough decision-making processes is key to achieving better consumer-directed care.
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Affiliation(s)
- Amelia Grossi
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Alice Holmes
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Joseph E Ibrahim
- Health Law and Aging Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia.
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Holton AE, Keeney C, Ryan B, Cousins G. Prevalence of potentially serious alcohol-medication interactions in older adults in a community pharmacy setting: a cross-sectional study. BMJ Open 2020; 10:e035212. [PMID: 32868351 PMCID: PMC7462154 DOI: 10.1136/bmjopen-2019-035212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Previous prevalence estimates of POtentially Serious Alcohol-Medication INteractions in Older adults (POSAMINO) are based on in-home inventories of medications; however, this method is associated with under-reporting of medications when compared with dispensing records. This study aims to estimate the prevalence of POSAMINO among community-dwelling older adults using drug dispensing data from the community pharmacy setting. DESIGN Cross-sectional study. SETTING Irish Community Pharmacy. PARTICIPANTS 1599 consecutive older adults presenting with a prescription to 1 of 120 community pharmacies nationwide; community-dwelling, aged ≥65 years, able to speak and understand English, with no evidence of cognitive impairment. The mean age of sample was 75.5 years (SD 6.5); 55% (n=884) female. MEASURES 38 POSAMINO criteria were identified using participants' pharmacy dispensing records linked to self-reported alcohol consumption (beverage-specific quantity and frequency measures) over the last 12 months. RESULTS The overall prevalence of POSAMINO in the study population was 28%, with 10% at risk of at least one POSAMINO criteria and 18% at risk of two or more. Exposure to POSAMINO most commonly involved cardiovascular agents (19%) and central nervous system agents (15%). Exposure to a higher number of POSAMINO criteria was associated with younger age (adjusted incident rate ratio (AIRR): 0.97; 95% CI: 0.95 to 0.98), male sex (AIRR: 0.55; 95% CI: 0.45 to 0.67) and a higher number of comorbidities (AIRR: 1.05; 95% CI: 1.01 to 1.13). CONCLUSION This study adds to the growing body of evidence, which suggests that older adults are vulnerable to potentially serious alcohol-medication interactions, particularly those involving cardiovascular and central nervous system agents, increasing their risk of orthostatic hypotension, gastrointestinal bleeds and increased sedation. Application of the POSAMINO criteria at the point of prescribing may facilitate the risk stratification of older adults and prioritise alcohol screening and brief alcohol interventions in those at greatest risk of harm.
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Affiliation(s)
- Alice E Holton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Cora Keeney
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Benedict Ryan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Gráinne Cousins
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Roche AM, Harrison NJ, Chapman J, Kostadinov V, Woodman RJ. Ageing and Alcohol: Drinking Typologies among Older Adults. J Aging Health 2020; 32:1486-1497. [PMID: 32583701 DOI: 10.1177/0898264320936953] [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] [Indexed: 12/14/2022]
Abstract
Objectives: Alcohol consumption and harms among older people are increasing. We examined different demographic characteristics and drinking patterns among an older population. Methods: Secondary analyses of nationally representative Australian data; subjects aged 50+ years (N = 10,856). Two-step cluster analysis was performed to identify demographic groups and alcohol consumption behaviours. Results: Three groups were identified: Group 1 (older, unmarried, and lived alone): >65 years, moderate drinkers, poorest health, psychological distress, social disadvantage, smokers, illicit drug users, and more frequent previous alcohol treatment. Group 3 (older married): >65 years, good health, low psychological distress, less likely to drink at risky levels, and one in five drank daily. Group 2 (younger married): 50-64 years, mostly employed, highest proportion of risky drinkers and of 5+ standard drinks per session, and liberal drinking attitudes with most concern from others about their drinking. Discussion: These demographic typologies can inform targeted prevention efforts for an estimated 1.3 million adults older than 50 years drinking at risky levels.
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Affiliation(s)
- Ann M Roche
- 1065Flinders University, Adelaide, Australia
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van den Brandt PA, Brandts L. Alcohol consumption in later life and reaching longevity: the Netherlands Cohort Study. Age Ageing 2020; 49:395-402. [PMID: 32037449 PMCID: PMC7187870 DOI: 10.1093/ageing/afaa003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/11/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND whether light-to-moderate alcohol intake is related to reduced mortality remains a subject of intense research and controversy. There are very few studies available on alcohol and reaching longevity. METHODS we investigated the relationship of alcohol drinking characteristics with the probability to reach 90 years of age. Analyses were conducted using data from the Netherlands Cohort Study. Participants born in 1916-1917 (n = 7,807) completed a questionnaire in 1986 (age 68-70 years) and were followed up for vital status until the age of 90 years (2006-07). Multivariable Cox regression analyses with fixed follow-up time were based on 5,479 participants with complete data to calculate risk ratios (RRs) of reaching longevity (age 90 years). RESULTS we found statistically significant positive associations between baseline alcohol intake and the probability of reaching 90 years in both men and women. Overall, the highest probability of reaching 90 was found in those consuming 5- < 15 g/d alcohol, with RR = 1.36 (95% CI, 1.20-1.55) when compared with abstainers. The exposure-response relationship was significantly non-linear in women, but not in men. Wine intake was positively associated with longevity (notably in women), whereas liquor was positively associated with longevity in men and inversely in women. Binge drinking pointed towards an inverse relationship with longevity. Alcohol intake was associated with longevity in those without and with a history of selected diseases. CONCLUSIONS the highest probability of reaching 90 years was found for those drinking 5- < 15 g alcohol/day. Although not significant, the risk estimates also indicate to avoid binge drinking.
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Affiliation(s)
- Piet A van den Brandt
- Department of Epidemiology, Maastricht University Medical Centre, GROW- School for Oncology and Developmental Biology, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University Medical Centre, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Lloyd Brandts
- Department of Epidemiology, Maastricht University Medical Centre, GROW- School for Oncology and Developmental Biology, Maastricht, The Netherlands
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O'Donnell A, Hanratty B, Schulte B, Kaner E. Patients' experiences of alcohol screening and advice in primary care: a qualitative study. BMC FAMILY PRACTICE 2020; 21:68. [PMID: 32321440 PMCID: PMC7178930 DOI: 10.1186/s12875-020-01142-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 04/14/2020] [Indexed: 12/16/2022]
Abstract
Background Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient perspective. We used Normalization Process Theory (NPT) informed interviews to explore patients’ views on alcohol screening and brief advice in routine primary healthcare. Methods Semi-structured qualitative interviews with 22 primary care patients who had been screened for heavy drinking and/or received brief alcohol advice were analysed thematically, informed by Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflexive monitoring). Results We found mixed understanding of the adverse health consequences of heavy drinking, particularly longer-term risks. There was some awareness of current alcohol guidelines but these were viewed flexibly, depending on the individual drinker and drinking context. Most described alcohol screening as routine, with clinicians viewed as trustworthy and objective. Patients enacted a range of self-regulatory techniques to limit their drinking but perceived such strategies as learned through experience rather than based on clinical advice. However, most saw alcohol advice as a valuable component of preventative healthcare, especially those experiencing co-occurring health conditions. Conclusions Despite strong acceptance of the screening role played by primary care clinicians, patients have less confidence in the effectiveness of alcohol advice. Primary care-based alcohol brief advice needs to reflect how individuals actually drink, and harness strategies that patients already commonly employ, such as self-regulation, to boost its relevance.
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Affiliation(s)
- Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Buiding, Richardson Road, Newcastle, NE2 4AX, UK.
| | - Barbara Hanratty
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Buiding, Richardson Road, Newcastle, NE2 4AX, UK
| | - Bernd Schulte
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Buiding, Richardson Road, Newcastle, NE2 4AX, UK
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Gough B, Madden M, Morris S, Atkin K, McCambridge J. How do older people normalise their drinking?: An analysis of interviewee accounts. Appetite 2020; 146:104513. [DOI: 10.1016/j.appet.2019.104513] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/15/2019] [Accepted: 11/09/2019] [Indexed: 11/15/2022]
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Abstract
Substance use disorder prevalence in older adults is increasing as the baby boom generation ages. Of the different substances with concern for misuse and use disorder, alcohol, prescription drugs, and illicit drugs are the leading causes. High-risk drinking and alcohol use disorder is the leading substance use disorder in older adults. Prescription drug misuse and use disorder in older adults are the second leading cause for substance use disorder and most commonly involves prescription opioids and benzodiazepines. Illicit drug use in older adults is also increasing. Substance use disorders are difficult to recognize in older adults due to medical comorbidity, neurocognitive impairment, and functional decline. Older adults are also more susceptible to drug effects due to decreased hepatic and renal clearance of the substances. Older adults should be screened and assessed for substance use disorders, and when diagnosed, non-pharmacologic as well as pharmacologic intervention should be performed.
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Affiliation(s)
- Lynsey Seim
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Priyanka Vijapura
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Sandeep Pagali
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - M Caroline Burton
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Bareham BK, Kaner E, Spencer L, Hanratty B. Health and social care providers' perspectives of older people's drinking: A systematic review and thematic synthesis of qualitative studies. Age Ageing 2020; 49:afaa005. [PMID: 32080741 PMCID: PMC7187873 DOI: 10.1093/ageing/afaa005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 10/01/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND alcohol may increase risks to late-life health, due to its impact on conditions or medication. Older adults must weigh up the potential risks of drinking against perceived benefits associated with positive roles of alcohol in their social lives. Health and social care workers are in a key position to support older people's decisions about their alcohol use. OBJECTIVE to systematically review and synthesise qualitative studies exploring health and social care providers' views and experiences of older people's drinking and its management in care services. METHOD a pre-specified search strategy was applied to five electronic databases from inception to June 2018. Grey literature, relevant journals, references and citations of included articles were searched. Two independent reviewers sifted and quality-appraised articles. Included study findings were analysed through thematic synthesis. RESULTS 18 unique studies were included. Four themes explained findings: uncertainty about drinking as a legitimate concern in care provision for older people; the impact of preconceptions on work with older adults; sensitivity surrounding alcohol use in later life; and negotiating responsibility for older adults' alcohol use. Discipline- and country-specific patterns are highlighted. CONCLUSIONS reservations about addressing alcohol could mean that service providers do not intervene with older adults. Judgements of whether older care recipients' drinking warrants intervention are complex. Providers will need support and training to recognise and provide appropriate intervention for drinking amongst older care recipients.
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Affiliation(s)
- Bethany Kate Bareham
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Liam Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Barbara Hanratty
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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Chapman J, Harrison N, Kostadinov V, Skinner N, Roche A. Older Australians' perceptions of alcohol-related harms and low-risk alcohol guidelines. Drug Alcohol Rev 2019; 39:44-54. [PMID: 31829473 DOI: 10.1111/dar.13022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/21/2019] [Accepted: 11/24/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND AIMS Australia has an ageing population. Given the concomitant increase in the numbers and proportion of risky drinkers among older adults, research examining contributory factors is a priority. The current study examined older adults' estimates of the NHMRC low-risk drinking guidelines, consumption patterns and associated harms and self-identification of drinking type. DESIGN AND METHODS Data from respondents aged 50+ years (N = 11 886) in the 2016 National Drug Strategy Household Survey were subjected to secondary analyses. Estimates of low-risk drinking levels, perceived level of harm from current drinking, self-identification of drinking type and awareness of standard drinks and labelling were included. Data were examined for those aged 50-59 years and 60+. RESULTS Seventeen percent of older Australians drank at both long-term and short-term risk levels. Approximately 39% of males and 11% of females overestimated the long-term low-risk levels and 54% of males and 20% of females overestimated the short-term low-risk levels. Overestimation was highest among risky drinkers. Most older risky drinkers were aware of standard drinks and labelling; however, less than half perceived their drinking as harmful, instead identifying as social drinkers. DISCUSSION AND CONCLUSIONS Although substantial gaps are evident in older respondents' estimates of low-risk drinking, additional public awareness campaigns are likely to be of limited use. Older peoples' engagement with the public health system presents 'windows of opportunity' to provide targeted, age-appropriate harm reduction strategies. Appropriate intervention and policy responses are required to direct resources to this emerging area of concern.
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Affiliation(s)
- Janine Chapman
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Nathan Harrison
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Victoria Kostadinov
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Natalie Skinner
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Ann Roche
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
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Bhanu C, Avgerinou C, Kharicha K, Bauernfreund Y, Croker H, Liljas A, Rea J, Kirby-Barr M, Hopkins J, Walters K. 'I've never drunk very much water and I still don't, and I see no reason to do so': a qualitative study of the views of community-dwelling older people and carers on hydration in later life. Age Ageing 2019; 49:111-118. [PMID: 31819953 PMCID: PMC6911653 DOI: 10.1093/ageing/afz141] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Indexed: 12/11/2022] Open
Abstract
Background dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable. Little research has focused on the views of community-dwelling older people on hydration, healthy drinking and the perceived importance of drinking well in later life. Objectives to understand community-dwelling older people and informal carers’ views on hydration in later life and how older people can be supported to drink well. Methods qualitative study using interviews and a focus group exploring hydration and nutrition in later life (24 older people at risk of malnutrition and dehydration, 9 informal carers) and thematic analysis. Results this article presents the findings on hydration alone. Four themes are presented: perceptions of healthy drinking, barriers to and facilitators of drinking in later life and supporting older people to drink well. The perceived importance of adequate hydration in later life was polarised. Concerns about urinary incontinence and knowledge gaps were significant barriers. Consideration of individual taste preference and functional capacity acted as facilitators. Distinct habitual drinking patterns with medications and meals exist within individuals. Many relied on thirst at other times or when fluid demands are greater (such as hot weather), a known unreliable prompt in later life. Conclusions older people could be supported to drink well by building upon existing habitual drinking patterns. Primary care and public health should consider individual barriers, facilitators and tailored education. A multidisciplinary approach to promote hydration should be incorporated into care for older people with more complex needs.
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Affiliation(s)
- Cini Bhanu
- Department of Primary Care and Population Health, University College London, UK
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, UK
| | - Kalpa Kharicha
- Department of Primary Care and Population Health, University College London, UK
| | | | - Helen Croker
- Health Behaviour Research Centre, University College London, UK
| | - Ann Liljas
- Department of Primary Care and Population Health, University College London, UK
| | - Jennifer Rea
- Department of Primary Care and Population Health, University College London, UK
| | - Maggie Kirby-Barr
- Patient and Public Involvement Representative, Department of Primary Care and Population Health, University College London, UK
| | - Jane Hopkins
- Patient and Public Involvement Representative, Department of Primary Care and Population Health, University College London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, UK
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Veerbeek MA, Ten Have M, van Dorsselaer SA, Oude Voshaar RC, Rhebergen D, Willemse BM. Differences in alcohol use between younger and older people: Results from a general population study. Drug Alcohol Depend 2019; 202:18-23. [PMID: 31284118 DOI: 10.1016/j.drugalcdep.2019.04.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/02/2019] [Accepted: 04/22/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Prevention of problematic alcohol use is mainly focused on younger adults, while heavy drinking in middle-aged and older adults might be more frequent with more impact on functioning and health care use. Therefore, alcohol use and alcohol disorder in both age groups was compared. To facilitate age-specific prevention, it was examined whether risk factors of heavy drinking and impact on functioning and health care use differs across the life-span. METHODS Data of people (23-70 years) were used from the Netherlands Mental Health Survey and Incidence Study-2 (N = 4618), a general population-based cohort. Heavy alcohol use was defined as >14 drinks/week for women and >21 drinks/week for men. Alcohol disorder was defined as DSM-IV disorder of alcohol abuse and/or alcohol dependence. (Multinomial) logistic regression analyses were used to study risk factors of alcohol use and associations between alcohol use and health care use and functioning. RESULTS The past-year prevalence of heavy alcohol was higher in older (55-70 years) compared to younger people (6.7% versus 3.8%), whereas alcohol disorder was less prevalent (1.3% versus 3.9%). Heavy alcohol use was associated with higher level of education in older adults compared to younger adults. Other characteristics of problematic alcohol use and its impact on functioning and health care use did not differ between age groups. CONCLUSIONS Heavy drinking is more prevalent among middle-aged and older people. Contrary to younger adults, prevention of heavy alcohol use in those aged 55-70 should focus on higher educated people.
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Affiliation(s)
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | | | - Richard C Oude Voshaar
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
| | - Didi Rhebergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, The Netherlands.
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Alfred L. Routine health checks can provide opportunities for alcohol health promotion in older adults who identify as responsible drinkers. Evid Based Nurs 2019; 22:91. [PMID: 30975692 DOI: 10.1136/ebnurs-2019-103082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Lolita Alfred
- Faculty of Health Sciences, School of Health and Social Work, University of Hull, Hull, UK
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