1
|
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.
Collapse
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
| |
Collapse
|
2
|
Huang J, Chan SC, Ko S, Lok V, Zhang L, Lin X, Lucero-Prisno DE, Xu W, Zheng ZJ, Elcarte E, Withers M, Wong MCS. Updated disease distributions, risk factors, and trends of laryngeal cancer: a global analysis of cancer registries. Int J Surg 2024; 110:810-819. [PMID: 38000050 PMCID: PMC10871644 DOI: 10.1097/js9.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Though the laryngeal cancer only has 1% of the total cancer cases and related deaths, it is a type of head and neck cancers with the highest prevalence. This study aims to investigate the epidemiological trend of laryngeal cancer with updated data on the global distribution of the disease burden. MATERIALS AND METHODS The incidence and mortality rate of laryngeal cancer was extracted from GLOBOCAN (2020), Cancer Incidence in Five Continents series I-X, WHO mortality database , the Nordic Cancer Registries , and the Surveillance, Epidemiology, and End Results Program. The Global Health data exchanges for the prevalence of its associated risk factors. A Joinpoint regression analysis was used to calculate Average Annual Percentage Change (AAPC). RESULTS The age-standardised rate (ASR) of laryngeal cancer incidence and mortality were 2.0 and 1.0 per 100 000 worldwide. The Caribbean (ASR=4.0) and Central and Eastern Europe (ASR=3.6) had the highest incidence and mortality rate. Incidence and risk factors associated with laryngeal cancer included tobacco usage, alcohol consumption, poor diet, obesity, diabetes, hypertension, and lipid disorders. There was an overall decreasing trend in incidence, especially for males, but an increasing incidence was observed in female populations and younger subjects. CONCLUSIONS As overall global trends of laryngeal cancer have been decreasing, especially for the male population, this could possibly be attributed to reduced tobacco use and alcohol consumption. Decrease in mortality may be due to improved diagnostic methods and accessibility to treatment, yet disparity in trend remains potentially because of differences in the level of access to surgical care. Disparities in temporal trends across countries may require further research and exploration to determine other underlying factors influencing this.
Collapse
Affiliation(s)
- Junjie Huang
- The Jockey Club School of Public Health and Primary Care
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong
| | - Sze Chai Chan
- The Jockey Club School of Public Health and Primary Care
| | - Samantha Ko
- The Jockey Club School of Public Health and Primary Care
| | - Veeleah Lok
- Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Lin Zhang
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Suzhou
- The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Xu Lin
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Wanghong Xu
- School of Public Health, Fudan University, Shanghai
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Edmar Elcarte
- University of the Philippines, Manila, The Philippines
| | - Mellissa Withers
- Department of Population and Health Sciences, Institute for Global Health, University of Southern California, Los Angeles, United States
| | - Martin CS Wong
- The Jockey Club School of Public Health and Primary Care
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong
- Department of Global Health, School of Public Health, Peking University, Beijing, People’s Republic of China
| |
Collapse
|
3
|
Davies R, Doshi M. Prevention of oral diseases for the older person (Part 1). Br Dent J 2024; 236:35-41. [PMID: 38225311 DOI: 10.1038/s41415-023-6610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.
Collapse
Affiliation(s)
| | - Mili Doshi
- Dental and Maxillofacial, Surrey and Sussex Healthcare NHS Trust, Surrey, United Kingdom.
| |
Collapse
|
4
|
Stelander LT, Lorem GF, Høye A, Bramness JG, Wynn R, Grønli OK. The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: the Tromsø study 1994-2020. Arch Public Health 2023; 81:25. [PMID: 36797780 PMCID: PMC9933408 DOI: 10.1186/s13690-023-01035-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. METHODS This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows follow-up of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60-99 (53% women). PRIMARY OUTCOME MEASURES Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. PREDICTOR Average weekly alcohol consumption (non-drinker, < 100 g/week, ≥100 g/week). We fitted two-level logistic random effects models to examine how alcohol consumption was related to SRH, and Cox proportional hazards models to examine its relation to all-cause mortality. Both models were stratified by sex and adjusted for sociodemographic factors, pathology, biometrics, smoking and physical activity. In addition, all the confounders were examined for whether they moderate the relationship between alcohol and the health-related outcomes through interaction analyses. RESULTS We found that women who consumed ≥100 g/week had better SRH than those who consumed < 100 g/week; OR 1.85 (1.46-2.34). This pattern was not found in men OR 1.18 (0.99-1.42). We identified an equal mortality risk in both women and men who exceeded 100 g/week compared with those who consumed less than 100 g/week; HR 0.95 (0.73-1.22) and HR 0.89 (0.77-1.03), respectively. CONCLUSIONS There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100 g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specific risk factors in combination with the highest level of alcohol consumption led to adverse effects on self-rated health. In men it was the use of sleeping pills or tranquilisers and ≥ 20 years of smoking, in women it was physical illness and older age.
Collapse
Affiliation(s)
- Line Tegner Stelander
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway. .,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Geir Fagerjord Lorem
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Høye
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G. Bramness
- grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway ,Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway
| | - Rolf Wynn
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Kristian Grønli
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
5
|
McInerney K, Best D, Cross A. Characteristics of people who have received treatment for late-onset problem drinking and alcohol use disorder: A systematic review and narrative synthesis. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 40:100-126. [PMID: 37063815 PMCID: PMC10101163 DOI: 10.1177/14550725221143170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
Aims: The current review investigated the psychosocial characteristics of late-onset problem drinkers, an under-researched area of alcohol harm that accounts for one-third of older problem drinkers. Method: Following the PRISMA model, the protocol and search strategy included a scoping search and main search of nine databases. A total of 1,595 papers were identified; after screening, 26 papers were considered eligible and were included in the review. The review used an investigative framework comprising three categories: standardising age of onset; gender differences; and psychosocial and mental health characteristics. The review also investigated how meaning and purpose in life, and treatment have been reported in relation to this cohort. Findings/Conclusions: The combined onset ages of the reviews’ 26 papers (mean age = 52.69 years) and the participants’ self-reported age at onset (mean age = 56.79 years), suggest that late-onset alcohol use disorder (AUD)/problem drinking is likely to emerge at the age of 55 years and older. Moreover, there is a high prevalence of co-morbid mental health disorders among elderly, late-onset drinkers. Retirement was reported as the most prevalent psychosocial risk factor for late-onset problematic drinking; other late-life events included bereavement, loneliness and social isolation, and boredom. In the context of gender, women are at greater risk of developing late-onset problem drinking than men. Furthermore, late-onset problem drinkers, particularly women, are more treatment compliant than their early-onset counterparts, highlighting the case for bespoke treatments/interventions for late-onset problem drinkers. Finally, the role that meaning and purpose in life plays in late-onset problem drinking has been under-reported and requires further investigation.
Collapse
|
6
|
Funk-White M, Moore AA, McEvoy LK, Bondi MW, Bergstrom J, Kaufmann CN. Alcohol use and cognitive performance: a comparison between Greece and the United States. Aging Ment Health 2022; 26:2440-2446. [PMID: 34842012 PMCID: PMC9161584 DOI: 10.1080/13607863.2021.1998355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/17/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To examine associations between alcohol use and cognitive performance among older adults in Greece and the United States, and assess potential differences due to differing drinking practices in the two countries. METHODS Data came from Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) and National Alzheimer's Coordinating Center Uniform Dataset (NACC). We examined those aged 65-90 years at baseline who had no cognitive impairment and complete data for cognitive and alcohol use variables (N = 1110 from HELIAD; N = 2455 from NACC). We examined associations between current alcohol use and frequency of such use with cognitive performance on various cognitive tasks stratified by gender. RESULTS In NACC, use of alcohol was associated with better cognitive performance. Men drinkers performed better than non-drinkers on Trail A (standardized mean 0.07 vs. -0.24, p<.001), Trail B (0.06 vs. -0.19, p=.001), and women drinkers performed better on Trail A (0.04 vs. -0.09, p=.016), Trail B (0.04 vs. -0.10, p=.005), verbal fluency (Animals: 0.05 vs. -0.13, p<.001; Vegetables: 0.04 vs. -0.09, p=.027), and MoCA (0.03 vs. -0.08, p=.039). In HELIAD, fewer differences were seen with only women drinkers exhibiting better performance than non-drinkers on the Boston Naming Task (0.11 vs. -0.05, p=.016). In general, more frequent drinkers performed better on cognitive tasks than less frequent drinkers, although this was only statistically significant in the NACC dataset. CONCLUSION While drinking alcohol may be associated with better cognitive performance across both the US and Greece, more research is needed to assess the cultural factors that may modify this association.
Collapse
Affiliation(s)
- Makaya Funk-White
- San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Alison A. Moore
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Mark W. Bondi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Christopher N. Kaufmann
- Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, FL, USA
| |
Collapse
|
7
|
Alcohol Use in Older Adults: A Systematic Review of Biopsychosocial Factors, Screening Tools, and Treatment Options. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00974-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
8
|
Sialino LD, Picavet HSJ, Wijnhoven HAH, Loyen A, Verschuren WMM, Visser M, Schaap LS, van Oostrom SH. Exploring the difference between men and women in physical functioning: How do sociodemographic, lifestyle- and health-related determinants contribute? BMC Geriatr 2022; 22:610. [PMID: 35864451 PMCID: PMC9306105 DOI: 10.1186/s12877-022-03216-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background To explore whether differences between men and women in the sensitivity to (strength of the association) and/or in the exposure to determinants (prevalence) contribute to the difference in physical functioning, with women reporting more limitations. Methods Data of the Doetinchem Cohort Study was used (n = 5856, initial ages 26–70 years), with follow-up measurements every 5 years (up to 20). Physical functioning (subscale SF-36, range:0–100), sex (men or women) and a number of socio-demographic, lifestyle- and health-related determinants were assessed. Mixed-model multivariable analysis was used to investigate differences between men and women in sensitivity (interaction term with sex) and in exposure (change of the sex difference when adjusting) to determinants of physical functioning. Results The physical functioning score among women was 6.55 (95%CI:5.48,7.61) points lower than among men. In general, men and women had similar determinants, but pain was more strongly associated with physical functioning (higher sensitivity), and also more prevalent among women (higher exposure). The higher exposure to low educational level and not having a paid job also contributed to the lower physical functioning score among women. In contrast, current smoking, mental health problems and a low educational level were more strongly associated with a lower physical functioning score among men and lower physical activity and higher BMI were more prevalent among men. Conclusions Although important for physical functioning among both men and women, our findings provide no indications for reducing the difference in physical functioning by promoting a healthy lifestyle but stress the importance of differences in pain, work and education.
Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03216-y.
Collapse
Affiliation(s)
- Lena Dirkje Sialino
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anne Loyen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura S Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| |
Collapse
|
9
|
Tschorn M, Schulze S, Förstner BR, Holmberg C, Spallek J, Heinz A, Rapp MA. Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe. Aging Ment Health 2022; 27:1001-1010. [PMID: 35639449 DOI: 10.1080/13607863.2022.2076208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU.Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week).Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender.Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.
Collapse
Affiliation(s)
- Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Susanne Schulze
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| | - Bernd R Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Christine Holmberg
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.,Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Jacob Spallek
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.,Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg (BTU-CS), Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit "Cognitive Sciences," Faculty of Human Science, University of Potsdam, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany
| |
Collapse
|
10
|
Karlsson N, Skagerström J, O'Donnell A, Abidi L, Thomas K, Nilsen P, Lid TG. Public perceptions of how alcohol consumption is dealt with in Swedish and Norwegian health care. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:243-255. [PMID: 35310609 PMCID: PMC8899254 DOI: 10.1177/1455072520985981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 12/16/2020] [Indexed: 11/23/2022] Open
Abstract
Aims: The aims of this study were to evaluate and compare popular beliefs and attitudes regarding alcohol conversations in healthcare in Sweden and Norway; and to explore which factors were associated with different levels of support for alcohol-prevention work in the two countries. Methods: Population-based cross-sectional surveys were conducted in Sweden (n = 3000) and Norway (n = 1208). Logistic regression was used to identify the characteristics of participants who were supportive of routine alcohol screening and brief intervention delivery. Results: A higher proportion of Swedish respondents agreed to a large extent that healthcare professionals should routinely ask about alcohol consumption. In addition, a higher proportion of Swedish respondents compared to respondents from Norway agreed that healthcare providers should only ask about patient’s alcohol consumption if this was related to specific symptoms. There were similar correlates of being supportive of routine alcohol screening and brief intervention delivery in both countries. Support was lower in both countries amongst moderate and risky drinkers, and among single adults or those on parental leave, but higher amongst older individuals. Having had an alcohol conversation in healthcare increased the level of support for alcohol prevention in routine healthcare among risky drinkers. Conclusions: There is a high level of support for preventative alcohol conversations in routine healthcare in Norway and Sweden, although there was a lower proportion of respondents who were positive to alcohol prevention in routine healthcare in Norway compared to Sweden. Experiencing alcohol conversation may positively affect risky drinkers’ attitudes towards and support for alcohol prevention. Thus, more frequent alcohol conversations in routine healthcare may also result in increased level of support for alcohol prevention among risky drinkers.
Collapse
Affiliation(s)
| | - Janna Skagerström
- Linköping University, Sweden; and Research and Development Unit in Region Östergötland, Linköping, Sweden
| | | | | | | | | | - Torgeir Gilje Lid
- Stavanger University Hospital, Norway; and University of Stavanger, Norway
| |
Collapse
|
11
|
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.
Collapse
|
12
|
Kabashi S, Gamboa D, Vindenes V, Berg T, Hilberg TA, Jørgenrud B, Lerdal A, Bogstrand ST. Multimorbidity, psychoactive substance use and psychological distress among acute medically ill patients: a cross-sectional study. BMJ Open 2021; 11:e052428. [PMID: 34815283 PMCID: PMC8611427 DOI: 10.1136/bmjopen-2021-052428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In order to target the complex health needs of patients with multimorbidity using psychoactive substances, knowledge regarding the association between substance use and multimorbidity in an acute setting is needed. AIMS Examine psychoactive substance use patterns among acute medically ill patients, and determine the association between multimorbidity and substance use, and psychological distress. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 2874 acute medically ill patients admitted to a medical emergency department in Oslo, Norway. MEASUREMENTS Primary outcome: multimorbidity recorded by the presence of ≥2 International Classification of Diseases 10th revision-physical and/or mental health conditions per patient, extracted from medical records. Predictor variables: self-reported data on age, sex, occupational status, psychological distress (Hopkins Symptom Check List-5), alcohol use (Alcohol Use Disorder Identification Test-4) and results from blood samples on psychoactive medicinal and illicit drugs. FINDINGS Of all patients, 57.2% had multimorbidity. Of these, 62.6% reported psychological distress, 85.5% consumed either alcohol, medicinal and/or illicit drugs and 64.4% combined alcohol with psychoactive medicinal drugs. Patients with risky alcohol use were more likely to have multimorbidity compared with patients with low-risk alcohol use (OR 1.53; 95% CI 1.05 to 2.24). Patients using psychoactive medicinal drugs were more likely to have multimorbidity compared with non-users (OR 1.34; 95% CI 1.07 to 1.67). CONCLUSION Multimorbidity was associated with psychoactive medicinal drug and risky alcohol use, and psychological distress. Substance use was widespread, with alcohol and psychoactive medicinal drugs most frequently combined. Monitoring substance use among multimorbid patients is necessary to develop tailored treatments, and reduce burden on the healthcare system.
Collapse
Affiliation(s)
- Saranda Kabashi
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Danil Gamboa
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thomas Berg
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | | | | | - Anners Lerdal
- Department of Interdiciplinary Health Sciencies, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
13
|
Wang JY, Zhang QW, Wen K, Wang C, Ji X, Zhang L. Temporal trends in incidence and mortality rates of laryngeal cancer at the global, regional and national levels, 1990-2017. BMJ Open 2021; 11:e050387. [PMID: 34645665 PMCID: PMC8515464 DOI: 10.1136/bmjopen-2021-050387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Laryngeal cancer is the most prevalent entity of head and neck cancer. Knowing the trends of incidence and mortality of laryngeal cancer is important for the reduction in related disease burden. DESIGN Population-based observational study. MAIN OUTCOMES AND MEASURES The incidence and mortality data of laryngeal cancer were retrieved from the Global Burden of Disease study 2017 online database. The estimated average percentage change was used to quantify the trends of laryngeal cancer incidence and mortality at the global, regional and national levels. RESULTS Globally, the numbers of incident cases and deaths due to laryngeal cancer increased 58.7% and 33.9%, respectively, from 1990 to 2017. However, the overall age-standardised incidence rate (ASIR) and age-standardised mortality rate decreased by 0.99% (95% CI 0.83% to 1.14%) and 1.62% (95% CI 1.50% to 1.74%) per year, respectively. These decreases were ubiquitous worldwide. However, unfavourable trends in the ASIR of laryngeal cancer were also observed in a total of 51 developing countries. CONCLUSIONS The incidence and mortality rates of laryngeal cancer have significantly decreased at the global level and in most countries over the past three decades. The regions that showed an increasing incidence trend deserve more attention.
Collapse
Affiliation(s)
- Jing-Yuan Wang
- Department of Otolarygology Head and Neck Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Qiang-Wei Zhang
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Kaixue Wen
- Department of Otolarygology Head and Neck Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Chen Wang
- Department of Otolarygology Head and Neck Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xiaolin Ji
- Department of Otolarygology Head and Neck Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Lixia Zhang
- Department of Otolarygology Head and Neck Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| |
Collapse
|
14
|
Wallhed Finn S, Lundin A, Sjöqvist H, Danielsson AK. Pharmacotherapy for alcohol use disorders - Unequal provision across sociodemographic factors and co-morbid conditions. A cohort study of the total population in Sweden. Drug Alcohol Depend 2021; 227:108964. [PMID: 34518028 DOI: 10.1016/j.drugalcdep.2021.108964] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pharmacotherapy for alcohol use disorders (AUD) is effective. However, knowledge about utilization of, and patient characteristics associated with prescriptions is scarce. The aim is to investigate prescriptions of pharmacotherapy for AUD in Sweden across time, sociodemographics, domicile and comorbid conditions. METHOD This is a national cohort study, comprising 132 733 adult patients with AUD diagnosis between 2007 and 2015. The exposure variables were age, sex, income, education, family constellation, domicile, origin, concurrent psychiatric and somatic co-morbid diagnoses. Logistic regression analyses were used to obtain odds ratios (OR) for any filled prescription of AUD pharmacotherapy; Acamprosate, Disulfiram, Naltrexone or Nalmefene during 12 months after AUD diagnosis. RESULTS During the study period, the proportion of individuals who received pharmacotherapy ranged between 22.80 and 23.94 % (χ2(64) = 72.00, p = .23). Female sex, age 31-45, higher education and income, living in a big city, co-habiting and born in Sweden, bar Norway, Denmark and Iceland, were associated with higher odds of pharmacotherapy. Concurrent somatic diagnosis was associated with lower odds of pharmacotherapy but psychiatric diagnosis higher (aOR = 0.61 95 % CI 0.59-0.63 and aOR = 1.61 95 % CI 1.57-1.66 respectively). CONCLUSIONS Pharmacotherapy for AUD is underutilized. The proportion of individuals with a prescription did not change between 2007 and 2015. Provision of treatment is unequal across different groups in society, where especially older age, lower income and education, and co-morbid somatic diagnosis were associated with lower odds of prescription. There is a need to develop treatment provision, particularly for individuals with co-morbid somatic conditions.
Collapse
Affiliation(s)
- Sara Wallhed Finn
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Mottagningen För alkohol och hälsa, Stockholm Center for Dependency Disorders, Health Care Services, Riddargatan 1, 114 35, Stockholm, Sweden.
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Region, Sweden
| | - Hugo Sjöqvist
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anna-Karin Danielsson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| |
Collapse
|
15
|
Risk Factors of Binge Drinking in Adults Across Gender and Age Groups: Sixth Korea National Health and Nutrition Examination Survey 2014. J Addict Nurs 2021; 31:E27-E37. [PMID: 33264208 DOI: 10.1097/jan.0000000000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alcohol consumption has significantly increased in South Korea, with binge drinking looming as a serious issue. This study aimed to identify differences in drinking characteristics and the risk factors of binge drinking across three age groups: young adults, middle-aged adults, and seniors. This study was a descriptive, secondary analysis study based on the data from the Korean National Health and Nutrition Examination Survey 2014. In this study, we analyzed data from 5,604 respondents aged 20 years and older using Rao-Scott chi-square and analysis of variance. To analyze the risk factors of binge drinking by gender and age groups, multiple logistic regression analysis was applied. Results indicated that the three age groups were significantly different in terms of sociodemographic characteristics, health-related behaviors, and drinking characteristics. Rates of binge drinking were much higher in young adults in both men and women. The factors influencing binge drinking varied by age group and gender; however, in both men and women, participants who drank alcohol once a month or more showed a significantly higher risk of binge drinking than those who did not across all age groups. Younger initial drinking age and daily smoking were key risk factors of binge drinking among young and middle-aged adults in both men and women. Given the findings from this study, interventions considering the differences in drinking characteristics and risk factors of binge drinking across the age groups as well as focusing on the risk of binge drinking among young adults must be developed in communities and clinical settings.
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Effect of chronic alcohol intake on motor functions on the elderly. Neurosci Lett 2021; 745:135630. [PMID: 33440234 DOI: 10.1016/j.neulet.2021.135630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
Alcohol use disorder (AUD) is a chronic and progressive disease influenced by genetic, psychosocial, and environmental factors. The consequences of alcohol consumption involve alterations in neural circuits of emotion and cognition, as well as in the motor planning circuit. Furthermore, during the natural aging process, several biochemical and functional alterations are also observed with neurological consequences. Thus, considering the consequences of chronic alcohol consumption on neural systems and natural aging process, we aimed to analyze the degree of motor and functional impairment in elderly with chronic alcohol consumption. Sixty elderly underwent an analysis of alcohol consumption profile (Alcohol Use Disorders Identification Test - AUDIT) that divided them into a control group (CON) and an alcohol group (ALC). The analysis of quality of life was performed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the analysis of motor function was performed using the Borg Scale, the Six-Minute Walk Test (6MWT) and the Motor Scale for Elderly (MSE). We were able to conclude that the misuse of alcohol by the elderly promotes significant physical limitations. These limitations result in a worsening of functional capacity of walking and various dimensions of motor ability: fine motor skill, global coordination, balance, body scheme, spatial organization, temporal organization, and general motor aptitude. Besides the physical limitations caused by alcohol use, the quality of life in their physical, mental, and social aspects was reduced. Thus, actions are required to help the elderly understand these losses and exercise control over alcohol misuse.
Collapse
|
19
|
Aubut V, Wagner V, Cousineau MM, Bertrand K. Problematic Substance Use, Help-Seeking, and Service Utilization Trajectories among Seniors: An Exploratory Qualitative Study. J Psychoactive Drugs 2020; 53:18-26. [PMID: 32990172 DOI: 10.1080/02791072.2020.1824045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Problematic substance use has a significant impact on the health of a large proportion of people aged 65 years and older. Along with population growth, there is an increase in seniors enrolling for treatment in Québec (Canada). This study explores the perspectives of older adults related to their substance use experiences, help-seeking and utilization of addiction treatment services. In-depth interviews were conducted with 11 seniors receiving addiction treatment in two area in Québec. Thematic analysis highlight that seniors' experiences, life contexts, and social participation influence their substance use. Help-seeking process can be triggered by realizing the extent of substance use, while barriers and facilitators shape this experience. Utilization of addiction treatment services was mainly perceived positively. Several characteristics and components of services enable seniors to have positive experiences. Substance use can be employed as an adaptation strategy to get through hardships or ease loneliness and boredom. Talking to people, such as family, friends or professionals, is important to older adults' developing trust and engaging in a process to change substance use habits. Based upon these results, clinical recommendations to take into account the complex needs of seniors seeking treatment and related to their social environment are formulated.
Collapse
Affiliation(s)
- Valérie Aubut
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Institut universitaire sur les dépendances, Direction de l'enseignement universitaire et de la recherche, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC,Canada.,Recherche et intervention sur les substances psychoactives-Québec group, Université du Québec à Trois-Rivières - Centre universitaire de Québec, Trois-Rivières, QC, Canada
| | - Vincent Wagner
- Institut universitaire sur les dépendances, Direction de l'enseignement universitaire et de la recherche, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC,Canada.,Recherche et intervention sur les substances psychoactives-Québec group, Université du Québec à Trois-Rivières - Centre universitaire de Québec, Trois-Rivières, QC, Canada.,Department of Community Health Sciences, Addiction Research Study Program, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Marthe Cousineau
- School of Criminology, Assistant Dean, Graduate Studies, Professional Training and Partners, Faculty of Arts and Sciences, Université de Montréal, Montréal, QC, Canada
| | - Karine Bertrand
- Institut universitaire sur les dépendances, Direction de l'enseignement universitaire et de la recherche, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC,Canada.,Recherche et intervention sur les substances psychoactives-Québec group, Université du Québec à Trois-Rivières - Centre universitaire de Québec, Trois-Rivières, QC, Canada.,Department of Community Health Sciences, Addiction Research Study Program, University of Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|
20
|
Rossow I, Træen B. Alcohol use among older adults: A comparative study across four European countries. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:526-543. [PMID: 35308653 PMCID: PMC8899285 DOI: 10.1177/1455072520954335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/12/2020] [Indexed: 01/07/2023] Open
Abstract
Aims: (i) To examine whether mean consumption and prevalence of at-risk drinking are highly correlated across samples of older adults, and (ii) to explore whether sociodemographic and health characteristics of alcohol use differ across countries. Method: Cross-sectional surveys were conducted in four European countries, Norway, Denmark, Belgium, and Portugal, applying identical data collection methods and survey instruments in general population samples of older adults aged 60 to 75 years. Alcohol consumption was measured as units of alcohol per week, which provided the basis for categorising the two outcome measures: abstention (0 units/week) and at-risk drinking (8+ units/week). Cross-tabulations and logistic regression models were estimated to examine associations between sociodemographic and health characteristics on the one hand and alcohol abstention and at-risk drinking on the other. Results: Prevalence of abstention was highest in Portugal and lowest in Denmark, whereas at-risk drinking was more prevalent in Denmark and Belgium compared to Norway and Portugal. Among country- and gender-specific samples of drinkers, there was a strong positive correlation between mean consumption and prevalence of at-risk drinkers. Female gender characterised abstention, whereas male gender characterised at-risk drinking in all four countries. Other sociodemographic characteristics and indicators of health and wellbeing were differently associated with abstention and at-risk drinking across the four countries. Conclusions: A strong regularity in the distribution of alcohol consumption was observed in the samples of older adults. Gender was the only common factor associated with drinking behaviour across the four countries.
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
Depression and alcohol misuse among older adults: exploring mechanisms and policy impacts using agent-based modelling. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1243-1253. [PMID: 30918978 DOI: 10.1007/s00127-019-01701-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/22/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE To: (1) explore how multi-level factors impact the longitudinal prevalence of depression and alcohol misuse among urban older adults (≥ 65 years), and (2) simulate the impact of alcohol taxation policies and targeted interventions that increase social connectedness among excessive drinkers, socially isolated and depressed older adults; both alone and in combination. METHODS An agent-based model was developed to explore the temporal co-evolution of depression and alcohol misuse prevalence among older adults nested in a spatial network. The model was based on Los Angeles and calibrated longitudinally using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS Interventions with a social component targeting depressed and socially isolated older adults appeared more effective in curbing depression prevalence than those focused on excessive drinkers. Targeting had similar impacts on alcohol misuse, though the effects were marginal compared to those on depression. Alcohol taxation alone had little impact on either depression or alcohol misuse trajectories. CONCLUSIONS Interventions that improve social connectedness may reduce the prevalence of depression among older adults. Targeting considerations could play an important role in determining the success of such efforts.
Collapse
|
23
|
Denham AMJ, Wynne O, Baker AL, Spratt NJ, Turner A, Magin P, Palazzi K, Bonevski B. An online cross-sectional survey of the health risk behaviours among informal caregivers. Health Promot J Austr 2019; 31:423-435. [PMID: 31529552 DOI: 10.1002/hpja.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/30/2019] [Accepted: 09/08/2019] [Indexed: 12/13/2022] Open
Abstract
ISSUE ADDRESSED Informal caregivers may experience unique barriers to engaging in healthy lifestyles, consequently increasing their risk of chronic disease. Among a convenience sample of informal caregivers, this study aimed to: (a) assess the self-reported health risk behaviours of low fruit and vegetable consumption, low physical activity, current smoking and hazardous alcohol consumption; (b) examine the demographic, caree condition and country of residence variables associated with each health risk behaviour; and (c) report the engagement in multiple health risk behaviours. METHODS An online cross-sectional survey among caregivers in Australia, Canada, New Zealand, the United Kingdom and the United States was conducted. Self-reported health risk behaviours were assessed and compared to key Australian healthy living guidelines. Logistic regression modelling identified participant factors associated with each health risk behaviour. RESULTS Overall, 384 caregivers were included in the analysis. Hazardous alcohol consumption was the only self-reported health risk behaviour which was much higher than in the general population (60.0%). Caregiver age (P = .018) and country of residence (P = .015) were associated with hazardous alcohol consumption. A majority of caregivers reported engaging in three health risk behaviours (55.0%). CONCLUSIONS Caregivers are engaging in a range of health risk behaviours; however, rates of hazardous alcohol consumption among the sample were high. Health promotion interventions targeted to address alcohol consumption should consider caregiver age and country of residence. SO WHAT?: This study highlights the health risk behaviours caregivers engage in across a number of countries, and suggests that caregivers require further support to manage alcohol consumption in particular.
Collapse
Affiliation(s)
- Alexandra M J Denham
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Neil J Spratt
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Biomedical Sciences and Pharmacy, University of Newcastle, University Drive, Callaghan, NSW, Australia.,Department of Neurology, Hunter New England Local Health District, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia.,IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Parker Magin
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Kerrin Palazzi
- HMRI Clinical Research Design and Statistics (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| |
Collapse
|
24
|
Affiliation(s)
- Duncan Stewart
- Department of Health Sciences, University of York, York, UK
| | | |
Collapse
|
25
|
Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men - the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study. BMC Geriatr 2019; 19:113. [PMID: 30999872 PMCID: PMC6472008 DOI: 10.1186/s12877-019-1114-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/24/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Little is known about factors associated with alcohol consumption and use of drugs with addiction potential in older adults. The aim of this study was to explore the association between socio-demographic variables, physical and mental health and the later (11 years) use of frequent drinking, prescribed drugs with addiction potential and the possible combination of frequent drinking and being prescribed drugs with addiction potential in older adults (≥ 65 years). METHODS In this longitudinal study, we used data from two surveys of the Nord-Trøndelag Health Study (HUNT2 1995-1997 and HUNT3 2006-2008), a population based study in Norway. We totally included 10,656 individuals (5683 women) aged 54 years and older when they participated in HUNT2. Frequent drinking was defined as drinking alcohol 4 days or more per week. Data on prescribed drugs with addiction potential were drawn from the Norwegian Prescription Database. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. RESULTS The typical frequent drinker in HUNT3 was younger, more educated, lived in urban areas, and reported smoking and drinking frequently in HUNT2 compared to the non-frequent drinker in HUNT3. The typical user of prescribed drugs with addiction potential in HUNT3 was an older woman who smoked and was in poor health, suffered from anxiety, had been hospitalized in the last 5 years and used anxiety or sleep medication every week or more often in HUNT2. The typical individual in HUNT3 with the possible combination of frequent drinking and being prescribed drugs with addiction potential had more education, smoked, drank frequently and used anxiety or sleep medication in HUNT2. CONCLUSION Individuals who were identified as frequent drinkers in HUNT2 were more likely to be frequent drinkers in HUNT3, and to have the possible combination of frequent drinking and being prescribed drugs with addiction potential in HUNT3. Health care professionals need to be aware of use of alcohol among older adults using drugs with addiction potential.
Collapse
Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
| |
Collapse
|
26
|
Bareham BK, Kaner E, Spencer LP, Hanratty B. Drinking in later life: a systematic review and thematic synthesis of qualitative studies exploring older people's perceptions and experiences. Age Ageing 2019; 48:134-146. [PMID: 29733341 PMCID: PMC6322501 DOI: 10.1093/ageing/afy069] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 04/12/2018] [Indexed: 11/20/2022] Open
Abstract
Background alcohol presents risks to the health of older adults at levels that may have been ‘safer’ earlier in life. Moderate drinking is associated with some health benefits, and can play a positive role in older people’s social lives. To support healthy ageing, we must understand older people’s views with regards to their drinking. This study aims to synthesise qualitative evidence exploring the perceptions and experiences of alcohol use by adults aged 50 years and over. Methods a pre-specified search strategy was applied to Medline, PsychINFO, Scopus, Applied Social Sciences Index and Abstracts and Cumulative Index to Nursing and Allied Health Literature databases from starting dates. Grey literature, relevant journals, references and citations of included articles were searched. Two independent reviewers sifted articles and assessed study quality. Principles of thematic analysis were applied to synthesise the findings from included studies. Results of 2,056 unique articles identified, 25 articles met inclusion criteria. Four themes explained study findings: routines and rituals of older people’s drinking; self-image as a responsible drinker; perceptions of alcohol and the ageing body; and older people’s access to alcohol. Differences between gender, countries and social patterns are highlighted. Conclusions older people perceive themselves as controlled and responsible drinkers. They may not recognise risks associated with alcohol, but appreciate its role in sustaining social and leisure activities important to health and well-being in later life. These are important considerations for intervention development. Drinking is routinised across the life course and may be difficult to change in retirement.
Collapse
Affiliation(s)
- Bethany Kate Bareham
- Institute of Health and Society, Newcastle University The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| | - Liam Patrick Spencer
- Institute of Health and Society, Newcastle University The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| | - Barbara Hanratty
- Institute of Health and Society, Newcastle University The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| |
Collapse
|
27
|
Sirlanci M, Rosen IG. Deconvolving the input to random abstract parabolic systems: a population model-based approach to estimating blood/breath alcohol concentration from transdermal alcohol biosensor data. INVERSE PROBLEMS 2018; 34:125006. [PMID: 31892764 PMCID: PMC6938217 DOI: 10.1088/1361-6420/aae791] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The distribution of random parameters in, and the input signal to, a distributed parameter model with unbounded input and output operators for the transdermal transport of ethanol are estimated. The model takes the form of a diffusion equation with the input, which is on the boundary of the domain, being the blood or breath alcohol concentration (BAC/BrAC), and the output, also on the boundary, being the transdermal alcohol concentration (TAC). Our approach is based on the reformulation of the underlying dynamical system in such a way that the random parameters are treated as additional spatial variables. When the distribution to be estimated is assumed to be defined in terms of a joint density, estimating the distribution is equivalent to estimating a functional diffusivity in a multi-dimensional diffusion equation. The resulting system is referred to as a population model, and well-established finite dimensional approximation schemes, functional analytic based convergence arguments, optimization techniques, and computational methods can be used to fit it to population data and to analyze the resulting fit. Once the forward population model has been identified or trained based on a sample from the population, the resulting distribution can then be used to deconvolve the BAC/BrAC input signal from the biosensor observed TAC output signal formulated as either a quadratic programming or linear quadratic tracking problem. In addition, our approach allows for the direct computation of corresponding credible bands without simulation. We use our technique to estimate bivariate normal distributions and deconvolve BAC/BrAC from TAC based on data from a population that consists of multiple drinking episodes from a single subject and a population consisting of single drinking episodes from multiple subjects.
Collapse
Affiliation(s)
- Melike Sirlanci
- Department of Mathematics, University of Southern California
| | - I. G. Rosen
- Department of Mathematics, University of Southern California
| |
Collapse
|
28
|
Dauber H, Pogarell O, Kraus L, Braun B. Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:40. [PMID: 30400930 PMCID: PMC6220462 DOI: 10.1186/s13011-018-0176-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/22/2018] [Indexed: 11/25/2022]
Abstract
Background In western countries demographic changes are leading to an ageing society. Consequently, the number of older adults with alcohol use disorders (AUDs) will rise and the demand of treatment is likely to increase. However, thus far not many older adults with an AUD are seeking treatment and little is known about the efficacy of treatment for older adults. The present study aimed at determining the proportion of older adults with an AUD in addiction treatment, particular characteristics and treatment outcomes of this clientele. Methods Using data of 10,860 patients with an AUD aged 60 and over that are documented within the national German addiction care system we conducted exploratory analyses with regard to prevalence, sociodemographic, disorder- and treatment-related variables. Results Overall, we found a low proportion of older patients in treatment due to AUDs, but highly positive treatment outcomes. With regard to sociodemographic and disorder-related characteristics, older females and late-onset patients in particular constitute a unique clientele. Conclusions The low service utilisation on the one hand but good treatment prognosis on the other emphasise the need to promote treatment seeking among older adults with AUDs. In this context, the special characteristics we found among older patients may contribute to better reach this population and to improve provisions of targeted treatment approaches.
Collapse
Affiliation(s)
- Hanna Dauber
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany. .,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Nußbaumstr. 7, 80336, Munich, Germany.
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Nußbaumstr. 7, 80336, Munich, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany.,Department of Public Health Sciences, Stockholm University, 10691, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös-Loránd-University, Budapest, 1053, Hungary
| | - Barbara Braun
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany
| |
Collapse
|
29
|
Holton A, Boland F, Gallagher P, Fahey T, Kenny R, Cousins G. Life Course Transitions and Changes in Alcohol Consumption Among Older Irish Adults: Results From The Irish Longitudinal Study on Ageing (TILDA). J Aging Health 2018; 31:1568-1588. [PMID: 29947553 DOI: 10.1177/0898264318783080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The objective of this study was to determine whether trajectories of older adults' alcohol consumption are influenced by the following life course transitions, relationship status, employment status, and self-rated health. Method: Volume and frequency of drinking were harmonized across first three waves of The Irish Longitudinal Study on Ageing (TILDA; N = 4,295). Multilevel regression models were used to model frequency, average weekly consumption, and heavy episodic drinking. Results: Men and women drank more frequently over time, with frequency decreasing with age for women. Average weekly consumption decreased over time and with increasing age. Transitions in self-rated health, particularly those reflecting poorer health, were associated with lower frequency and weekly consumption. Heavy episodic drinking decreased with age. Men who were retired across all waves were more likely to engage in heavy episodic drinking at baseline. Discussion: Despite the decline in average weekly consumption and heavy episodic drinking, the observed quantities consumed and the increase in frequency of consumption suggest that older Irish adults remain vulnerable to alcohol-related harms.
Collapse
Affiliation(s)
- Alice Holton
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Fiona Boland
- 2 HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Paul Gallagher
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Tom Fahey
- 2 HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Roseanne Kenny
- 3 The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Gráinne Cousins
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| |
Collapse
|
30
|
Kelly S, Olanrewaju O, Cowan A, Brayne C, Lafortune L. Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis. Age Ageing 2018; 47:175-184. [PMID: 28985250 PMCID: PMC6016606 DOI: 10.1093/ageing/afx132] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/29/2017] [Indexed: 11/22/2022] Open
Abstract
Background harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified. Methods two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA. Results thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) −0.18 (95% CI −0.28, −0.07) and 12 months (6 studies; 2,788 participants SMD −0.16 (95% CI −0.32, −0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect. Conclusions alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes.
Collapse
Affiliation(s)
- Sarah Kelly
- Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| | - Olawale Olanrewaju
- Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| | - Andy Cowan
- Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| | - Louise Lafortune
- Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| |
Collapse
|
31
|
Luis MAV, Garcia MVDL, Barbosa SP, Lima DWDC. O uso de álcool entre idosos atendidos na Atenção Primária à Saúde. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo: Verificar o padrão do uso de álcool entre idosos atendidos em um serviço de Atenção Primária à Saúde e descrever a relação do uso desta substância com as variáveis sociodemográficas. Métodos: Estudo observacional, transversal, quantitativo, com idosos de um serviço de saúde de Atenção Primária de município do interior de São Paulo/Brasil. De um total de 750 idosos, foram incluídos 112; entrevistados 85 e a amostra final foi de 25 que auto relataram uso de álcool. Os dados do estudo foram obtidos através de entrevistas para aplicação de instrumentos: questionário sociodemográfico, Michigan Alcoholism Screenig Test-Geriatric Version (MAST-G); Alcohol Use Disorders Identification Test (AUDIT). Resultados: Predominou o sexo feminino (56%), a condição de aposentados (56%), a idade média foi 69,8 anos (variação entre 60 e 83 anos), níveis de escolaridade, desde curso superior completo até não possuir grau de instrução, média de 7,4 anos estudados. No AUDIT, 15 idosos (60%) pontuaram entre 8 e 14, portanto uso de risco e 10 (40%) tiveram escore 7 incluídos no uso de baixo risco. No MAST-G, os 25 pacientes (100%) sugerem ter problema relacionado ao uso do álcool. Conclusão: O estudo contribui no que diz respeito à situação do uso de álcool por idosos e isto está na constatação de que, na população estudada, existe maior número de mulheres em situação de risco. Estas questões devem ser consideradas na abordagem e investigações pelos profissionais de saúde, na perspectiva de realizarem estratégias para o tratamento global e humanizado do idoso usuário de álcool.
Collapse
|
32
|
Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Use of alcohol and drugs with addiction potential among older women and men in a population-based study. The Nord-Trøndelag Health Study 2006-2008 (HUNT3). PLoS One 2017; 12:e0184428. [PMID: 28886172 PMCID: PMC5590962 DOI: 10.1371/journal.pone.0184428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 08/23/2017] [Indexed: 02/06/2023] Open
Abstract
Background Little is known about the consumption habits of older adults in Norway with respect to alcohol and the use of drugs with addiction potential, such as benzodiazepines, z-hypnotics and opioids, among regular drinkers. We studied the prevalence of self-reported consumption of alcohol on a regular basis in community-living older men and women (≥ 65 years). Furthermore, we investigated the prevalence of dispensed prescribed drugs with addiction potential in older men and women who were regular drinkers. Methods We used data from the Nord-Trøndelag Health Study 2006–2008 (HUNT3). Of 12,361 older adults in the HUNT3 study, 11,545 had answered the alcohol consumption item and were included in our study. Regular drinkers were defined as consuming alcohol one or more days a week. Data on dispensed drugs with addiction potential were drawn from the Norwegian Prescription Database. Addiction potential was defined as at least one prescription for benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years. Results In total 28.2% of older Norwegian adults were regular drinkers. Men in the study were more likely to be regular drinkers than women. Drugs with addiction potential were used by 32.4% of participants, and were more commonly used by women. Nearly 12% of participants used benzodiazepines, 19% z-hypnotics and 12.4% opioids. Among regular drinkers, 29% used drugs with addiction potential, which was also more common among women. Adjusted for age, gender and living situation, use of z-hypnotics was associated with regular alcohol intake, while use of opioids was associated with no regular alcohol intake. Conclusion The prevalence of the use of drugs with addiction potential was high in a Norwegian population of older adults who reported regular consumption of alcohol. Strategies should be developed to reduce or prevent alcohol consumption among older adults who use drugs with addiction potential.
Collapse
Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S. Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
| |
Collapse
|
33
|
Du Y, Wolf IK, Knopf H. Psychotropic drug use and alcohol consumption among older adults in Germany: results of the German Health Interview and Examination Survey for Adults 2008-2011. BMJ Open 2016; 6:e012182. [PMID: 27855095 PMCID: PMC5073532 DOI: 10.1136/bmjopen-2016-012182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The use and combined use of psychotropic drugs and alcohol among older adults is a growing public health concern and should be constantly monitored. Relevant studies are scarce in Germany. Using data of the most recent national health survey, we analyse prevalence and correlates of psychotropic drug and alcohol use among this population. METHODS Study participants were people aged 60-79 years (N=2508) of the German Health Interview and Examination Survey for Adults 2008-2011. Medicines used during the last 7 days were documented. Psychotropic drugs were defined as medicines acting on the nervous system (ATC code N00) excluding anaesthetics (N01), analgesics/antipyretics (N02B), but including opiate codeines used as antitussives (R05D). Alcohol consumption in the preceding 12 months was measured by frequency (drinking any alcohol-containing beverages at least once a week/a day) and quantity (alcohol consumed in grams/day; cut-offs: 10/20 g/day for women/men defining moderate and risky drinking). SPSS complex sample module was used for analysis. RESULTS 21.4% of study participants use psychotropic medications, 66.9% consume alcohol moderately and 17.0% riskily, 51.0% drink alcohol at least once a week and 18.4% daily, 2.8% use psychotropic drugs combined with daily alcohol drinking. Among psychotropic drug users, 62.7% consume alcohol moderately, 14.2% riskily. The most frequently used psychotropic medications are antidepressants (7.9%) and antidementia (4.2%). Factors associated with a higher rate of psychotropic drug use are female sex, worse health status, certified disability and polypharmacy. Risky alcohol consumption is positively associated with male sex, smoking, upper social class, better health status, having no disability and not living alone. CONCLUSIONS Despite the high risk of synergetic effects of psychotropic drugs and alcohol, a substantial part of older psychotropic drug users consume alcohol riskily and daily. Health professionals should talk about the additional health risks of alcohol consumption when prescribing psychotropic drugs to older adults.
Collapse
Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Ingrid-Katharina Wolf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| |
Collapse
|
34
|
Gupta H, Pettigrew S, Lam T, Tait RJ. A Systematic Review of the Impact of Exposure to Internet-Based Alcohol-Related Content on Young People's Alcohol Use Behaviours. Alcohol Alcohol 2016; 51:763-771. [PMID: 27522028 DOI: 10.1093/alcalc/agw050] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/01/2016] [Indexed: 12/21/2022] Open
Abstract
AIMS To conduct a systematic review of studies exploring the relationship between exposure to Internet-based alcohol-related content and alcohol use among young people. METHODS Searches of electronic databases and reference lists of relevant articles were conducted to retrieve studies of relevance up until December 2015. Full texts of the studies that met the inclusion criteria were read, appraised for quality using the Kmet forms and guidelines, and included in this review. RESULTS Fifteen relevant studies were identified. The included studies were a mix of cross-sectional, longitudinal, experimental and qualitative studies conducted in the USA, the UK, Australia and New Zealand. The age range of the participants involved in these studies was 12-25 years. Included studies employed a variety of study designs and a range of different exposure variables and outcome measures. Studies demonstrated significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people. CONCLUSION Exposure to alcohol-related content on the Internet might predispose young people to patterns of alcohol use by promoting alcohol as a natural and vital part of life. However, the research exploring the influence of this novel form of advertising on young people's alcohol use is emergent, and comprised primarily of cross-sectional studies. To evaluate the direction of the association between exposure to online alcohol-related content and alcohol use, we call for further research based on longitudinal designs. SHORT SUMMARY From 15 relevant studies identified, this review reports significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people, with different influences found at different stages of alcohol use.
Collapse
Affiliation(s)
- Himanshu Gupta
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia
| | - Simone Pettigrew
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia
| | - Tina Lam
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia
| |
Collapse
|
35
|
Gavens L, Goyder E, Hock ES, Harris J, Meier PS. Alcohol consumption after health deterioration in older adults: a mixed-methods study. Public Health 2016; 139:79-87. [PMID: 27387049 DOI: 10.1016/j.puhe.2016.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/21/2016] [Accepted: 05/24/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine if and how older adults modify their drinking after health deterioration, and the factors that motivate changing or maintaining stable drinking behaviour. STUDY DESIGN Explanatory follow-up mixed-methods research. METHODS The association between health deterioration and changes in alcohol consumption was examined using secondary data from the English Longitudinal Study of Ageing, a biennial prospective cohort study of a random sample of adults aged 50 years and older living in England. Data were collected through a personal interview and self-completion questionnaire across three waves between 2004 and 2009. The sample size (response rate) across the three waves was 8781 (49.9%), 7168 (40.3%) and 6623 (37.3%). The Chi-squared test was used to examine associations between diagnosis with a long-term condition or a worsening of self-rated health (e.g. from good to fair or fair to poor) and changes in drinking frequency (e.g. everyday, 5-6 days per week, etc.) and volume (ethanol consumed on a drinking day) between successive waves. In-depth interviews with 19 older adults recently diagnosed with a long-term condition were used to explore the factors that influenced change or maintenance in alcohol consumption over time. A purposive sampling strategy was used to recruit a diverse sample of current and former drinkers from voluntary and community organizations in the north of England. An inductive approach was used to analyze the data, facilitating the development of an a posteriori framework for understanding drinking change. RESULTS There was no significant relationship between health deterioration and changes in drinking volume over time. There was however a significant association between health deterioration and changes in drinking frequency between successive waves (χ2 = 15.24, P < 0.001 and χ2 = 17.28, P < 0.001). For example, of participants reporting health deterioration between the first two waves, 47.6% had stable drinking frequency, 23.4% increased their drinking frequency and 29% reported decreased drinking frequency. In comparison, of participants reporting no health deterioration, 52.7% reported stable frequency, 20.8% increased frequency and 26.4% decreased frequency. In qualitative interviews, older adults described a wide range of factors that influence changes in drinking behaviour: knowledge gained from talking to healthcare professionals, online and in the media; tangible negative experiences that were attributed to drinking; mood and emotions (e.g. joy); the cost of alcohol; pub closures; and changes in social roles and activities. Health was just one part of a complex mix of factors that influenced drinking among older adults. CONCLUSION Patterns of drinking change after health deterioration in older adults are diverse, including stable, increasing and decreasing alcohol consumption over time. Although health motivations to change drinking influence behaviour in some older adults, social and financial motivations to drink are also important in later life and thus a holistic approach is required to influence behaviour.
Collapse
Affiliation(s)
- L Gavens
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - E Goyder
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - E S Hock
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - J Harris
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - P S Meier
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| |
Collapse
|
36
|
Paccou J, Edwards MH, Ward K, Jameson K, Moon R, Dennison E, Cooper C. Relationships between bone geometry, volumetric bone mineral density and bone microarchitecture of the distal radius and tibia with alcohol consumption. Bone 2015; 78:122-9. [PMID: 25959415 DOI: 10.1016/j.bone.2015.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/29/2015] [Accepted: 05/01/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE Chronic heavy alcohol consumption is associated with bone density loss and increased fracture risk, while low levels of alcohol consumption have been reported as beneficial in some studies. However, studies relating alcohol consumption to bone geometry, volumetric bone mineral density (vBMD) and bone microarchitecture, as assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), are lacking. METHODS Here we report an analysis from the Hertfordshire Cohort Study, in which we studied associations between HR-pQCT measures at the distal radius and tibia and alcohol consumption in 376 participants (198 men and 178 women) aged 72.1-81.4 years. RESULTS A total of 30 (15.2%), 90 (45.5%) and 78 (39.4%) men drank minimal/none (<1 unit/week), low (≥1 unit/week and <11 units/week) and moderate/high (≥11 units/week) amounts of alcohol respectively. These figures were 74 (41.8%), 80 (45.2%) and 23 (13.0%) respectively in women for minimal/none (<1 unit/week), low (≥1 unit/week and <8 units/week) and moderate/high (≥8 units/week). At the distal radius, after adjustment for confounding factors (age, BMI, smoking status, dietary calcium intake, physical activity and socioeconomic status and years since menopause and HRT use for women), men that drank low alcohol had lower cortical thickness (p=0.038), cortical vBMD (p=0.033), and trabecular vBMD (p=0.028) and higher trabecular separation (p=0.043) than those that drank none/minimal alcohol. Similar differences were shown between minimal/none and moderate/high alcohol although these only reached statistical significance for the cortical parameters. Interestingly, after similar adjustment, women showed similar differences in the trabecular compartment between none/minimal alcohol and low alcohol at the distal tibia. However, women that drank moderate/high alcohol had significantly higher trabecular vBMD (p=0.007), trabecular thickness (p=0.026), and trabecular number (p=0.042) and higher trabecular separation (p=0.026) at the distal radius than those that drank low alcohol. CONCLUSIONS Our results suggest that alcohol consumption (low and moderate/high) may have a detrimental impact on bone health in men in both the cortical and trabecular compartments at the distal radius with similar results in women in the trabecular compartment between none/minimal alcohol and low alcohol at the distal tibia suggesting that avoidance of alcohol may be beneficial for bone health.
Collapse
Affiliation(s)
- Julien Paccou
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Department of Rheumatology, Lille University Hospital, Lille 2, 59037 Lille cedex, France
| | - Mark Hiley Edwards
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Kate Ward
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge CB1 9NL, UK
| | - Karen Jameson
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Rebecca Moon
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Victoria University, Wellington, New Zealand
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford OX3 5UG, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton SO16 6YD, UK.
| |
Collapse
|
37
|
Parikh RB, Junquera P, Canaan Y, Oms JD. Predictors of binge drinking in elderly Americans. Am J Addict 2015; 24:621-7. [DOI: 10.1111/ajad.12275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/14/2015] [Accepted: 08/08/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Roopali B. Parikh
- Department of Psychiatry; Larkin Community Hospital; South Miami Florida
| | | | - Yusef Canaan
- Department of Psychiatry; Larkin Community Hospital; South Miami Florida
| | - Juan D. Oms
- Department of Psychiatry; Larkin Community Hospital; South Miami Florida
| |
Collapse
|
38
|
Abstract
OBJECTIVES This paper looks into the socioeconomic determinants of risk of harmful alcohol drinking and of the transitions between risk categories over time among the population aged 50 or over in England. SETTING Community-dwellers across England. PARTICIPANTS Respondents to the English Longitudinal Survey of Ageing, waves 4 and 5. RESULTS (Confidence level at 95% or higher, except when stated): ▸ Higher risk drinking falls with age and there is a non-linear association between age and risk for men, peaking in their mid-60s. ▸ Retirement and income are positively associated with a higher risk for women but not for men. ▸ Education and smoking are positively associated for both sexes. ▸ Loneliness and depression are not associated. ▸ Caring responsibilities reduce risk among women. ▸ Single, separated or divorced men show a greater risk of harmful drinking (at 10% confidence level). ▸ For women, being younger and having a higher income at baseline increase the probability of becoming a higher risk alcohol drinker over time. ▸ For men, not eating healthily, being younger and having a higher income increase the probability of becoming a higher risk alcohol drinker. Furthermore, the presence of children living in the household, being lonely, being older and having a lower income are associated with ceasing to be a higher risk alcohol drinker over time. CONCLUSIONS Several socioeconomic factors found to be associated with high-risk alcohol consumption behaviour among older people would align with those promoted by the 'successful ageing' policy framework.
Collapse
|