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Maleki N, Yunusa I, Karaye IM. Alcohol-Induced Mortality in the USA: Trends from 1999 to 2020. Int J Ment Health Addict 2023:1-13. [PMID: 37363762 PMCID: PMC10243241 DOI: 10.1007/s11469-023-01083-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
This study comprehensively examined trends in alcohol-induced overdose mortality in the USA between 1999 and 2020 by age, sex, race/ethnicity, census region, and type of injury. Using the CDC WONDER database, 605,948 alcohol-induced deaths were recorded. Mortality increased by 14.1% per year (95% CI 8.2, 20.3) from 2018 to 2020, with the highest rates among males, non-Hispanic Whites, individuals aged 55-64, and the Western census region. Rising trends were observed across racial/ethnic subgroups, except for American Indians/Alaska Natives, with annual increases of 17% among non-Hispanic Blacks, 14.3% among non-Hispanic Whites, 9.5% among Asian/Pacific Islanders, and 12.6% among Hispanics. Males, females, all age groups, and census regions also experienced increasing trends. In conclusion, this study underscores worsening alcohol-induced mortality in the recent two decades and the need for research to identify its determinants. Such research can guide evidence-based public health interventions to reduce excessive alcohol use consequences. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01083-1.
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Affiliation(s)
- Nasim Maleki
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Building 120, 2nd Avenue, MA 02129 Charlestown, USA
| | - Ismaeel Yunusa
- Clinical Pharmacy and Outcomes Sciences, University of South Carolina, 715 Sumter Street-CLS 311L, Columbia, SC 29208 USA
| | - Ibraheem M. Karaye
- Department of Population Health, Hofstra University, 106 Hofstra Dome, Hempstead, NY 11549 USA
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2
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Braun NJ, Gloppen KM, Roesler J. Trends in Deaths Fully Attributable to Alcohol in Minnesota, 2000-2018. Public Health Rep 2022; 137:1091-1099. [PMID: 34597527 PMCID: PMC9574312 DOI: 10.1177/00333549211044019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Overall trends in rates of fully alcohol-attributable mortality may mask disparities among demographic groups. We investigated overall, demographic, and geographic trends in fully alcohol-attributable mortality rates in Minnesota. METHODS We obtained mortality data from Minnesota death certificates and defined fully alcohol-attributable deaths as deaths that would not occur in the absence of alcohol. We calculated age-adjusted death rates during 2000-2018 using 5-year moving averages stratified by decedents' characteristics and geographic location. RESULTS Chronic conditions accounted for most of the alcohol-attributable deaths in Minnesota (89% during 2014-2018). Alcohol-attributable mortality rates per 100 000 population increased from an average rate of 8.0 during 2000-2004 to 12.6 during 2014-2018. During 2000-2018, alcohol-attributable mortality rates were highest among males (vs females), adults aged 55-64 (vs other ages), and American Indian/Alaska Native people (vs other racial and ethnic groups) and lowest among people aged ≤24 years and Asian or Pacific Islander people. During 2014-2018, the alcohol-attributable mortality rate among American Indian/Alaska Native people was more than 5 times higher than the overall mortality rate in Minnesota. CONCLUSIONS Results from this study may increase awareness of racial and ethnic disparities and continuing health inequities and inform public health prevention efforts, such as those recommended by the Community Preventive Services Task Force, including regulating alcohol outlet density and increasing alcohol taxes.
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Affiliation(s)
- Nicholas J. Braun
- Injury and Violence Prevention Section, Minnesota Department of Health, St. Paul, MN, USA
| | - Kari M. Gloppen
- Injury and Violence Prevention Section, Minnesota Department of Health, St. Paul, MN, USA
| | - Jon Roesler
- Injury and Violence Prevention Section, Minnesota Department of Health, St. Paul, MN, USA
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Trias-Llimós S, Spijker JJA. Educational differences in alcohol-related mortality and their impact on life expectancy and lifespan variation in Spain (2016-2018): a cross-sectional analysis using multiple causes of death. BMJ Open 2022; 12:e053205. [PMID: 35074816 PMCID: PMC8788229 DOI: 10.1136/bmjopen-2021-053205] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in alcohol-related mortality in Spain exists, and are postulated to contribute to inequalities in all-cause mortality. We aim to assess absolute and relative educational inequalities in alcohol-related mortality, and to estimate the role of alcohol in educational inequalities in both life expectancy and lifespan variation in Spain. METHODS We used multiple cause-of-death (MCOD) mortality data for individuals aged 30 and over for Spain (2016-2018) by educational attainment. We estimated by sex and educational attainment age-standardised alcohol-attributable mortality rates, relative and absolute indices of educational inequalities; and total life expectancy and lifespan variation at age 30 for all-cause mortality and after eliminating alcohol-attributable mortality. RESULTS The use of MCOD resulted in an additional 2543 annual alcohol-related deaths (+75% among men and +50% among women) compared with estimates derived from underlying causes of death. In absolute terms, educational inequalities were the highest among men aged 45-84 and among women aged 45-64. In relative terms, higher inequalities raised in working ages, whereas at older ages inequalities tended to be lower, although still important among men. Alcohol contributed to educational inequalities in life expectancy (men: 0.13 years (3.2%); women 0.02 years (0.7%)) and lifespan variation (2.1% and 1.4% for men and women, respectively). CONCLUSION Alcohol consumption remains an important lifestyle habit to be tackled in order to reduce socioeconomic inequalities in mortality in Spain, particularly among men.
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Affiliation(s)
- Sergi Trias-Llimós
- Centre d'Estudis Demografics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Jeroen J A Spijker
- Centre d'Estudis Demografics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra, Spain
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Kinjo A, Purevdorj B, Okada T, Kuwabara Y, Fujii M, Higuchi S, Osaki Y. Trends and differences in alcohol-related mortality rates by gender and by prefectures in Japan between 1995 and 2016. Drug Alcohol Depend 2021; 221:108586. [PMID: 33657468 DOI: 10.1016/j.drugalcdep.2021.108586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study aimed to identify increases in 100 % alcohol-related death (ARD) and any differences among prefectures between 1995-2016. METHODS Data from the national death registry on 100 % ARDs between 1995-2016 were extracted. Age-standardized mortality rate (ASMR) of 100 % ARD by year, gender, and gender ratio were calculated. After dividing the period into 1995-2005 and 2006-2016, the ASMRs of 100 % ARDs were calculated by prefecture. Additionally, based on geographical area, municipality size, or annual alcohol sales per adult in each prefecture, prefectures were divided into groups and analysed. RESULTS In total, 95,455 deaths were caused by 100 % ARD from 1995-2016. Men's ASMRs of 100 % ARD markedly increased from 4.0 per 100,000 in 1995 to 5.2 between 2010 and 2013, and gradually declined to 5.0 in 2016. Women's ASMRs increased steadily from 0.3 in 1995 to 0.8 in 2016. The gender ratio of ASMRs decreased from 13.3 in 1995 to 6.3 in 2016. The ASMR of one prefecture, which had reduced alcohol tax rates, was higher for both genders. Both men's and women's ASMRs were higher in the prefectures that had higher alcohol sales (6.3 [5.0-7.7] and 0.8 [0.6-1.1], respectively) compared to the prefectures that had lower alcohol sales (4.3 [4.0-4.7] p < 0.001 and 0.6 [0.5-0.6] p = 0.045, respectively). CONCLUSIONS The ASMR of 100 % ARD remained high for men and increased for women, and prefecture-level higher alcohol sales and lower tax rates correlated with the higher mortality rate. Increasing prices and taxes and reducing alcohol sales may contribute to a decrease in alcohol-related mortality.
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Affiliation(s)
- Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan.
| | - Bolormaa Purevdorj
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan
| | - Tomomi Okada
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan
| | - Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka-shi, Kanagawa, 239-0841, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Nishi-cho 86, Yonago-shi, Tottori, 683-8503, Japan
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Wiers CE, Martins De Carvalho L, Hodgkinson CA, Schwandt M, Kim SW, Diazgranados N, Wang G, Goldman D, Volkow ND. TSPO polymorphism in individuals with alcohol use disorder: Association with cholesterol levels and withdrawal severity. Addict Biol 2021; 26:e12838. [PMID: 31713961 DOI: 10.1111/adb.12838] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/29/2019] [Accepted: 09/08/2019] [Indexed: 01/19/2023]
Abstract
The translocator protein (TSPO) transports cholesterol into mitochondria and is involved in steroidogenesis. The TSPO polymorphism rs6971 influences binding of cholesterol and other TSPO ligands including positron-emission tomography (PET) imaging radiotracers. Although it is recognized that alcohol increases plasma high-density lipoproteins (HDLs), its effects on total cholesterol and triglycerides along with its relationship to TSPO genotype have not been assessed. Here, we evaluated whether plasma cholesterol and triglycerides are disrupted in alcohol use disorder (AUD) and their association with rs6971 in 932 AUD participants (DSM IV or 5) and 546 controls. AUD participants compared with controls had significantly higher plasma levels of total cholesterol, HDL, and triglycerides, but not of low-density lipoprotein (LDL). In the AUD group only, TSPO rs6971 had a significant effect on plasma levels of cholesterol, LDL, and triglycerides (AA (n = 62) > AG (n = 319) > GG (n = 551)), but not on HDL levels. Additionally, we showed a significant effect of TSPO rs6971 on withdrawal scores (Clinical Institute Withdrawal Assessment for Alcohol [CIWA]), with higher scores in AA (n = 50) compared with AG (n = 238) and GG (n = 428). CIWA scores in AUD participants correlated negatively with LDL and positively with HDL, but not with total cholesterol or triglycerides. These findings corroborate elevated plasma cholesterol and HDL levels in AUD and document significant increases in triglycerides. We also reveal for the first time an association in AUD participants between TSPO rs6971 genotype and plasma cholesterol, LDL, and triglyceride levels (not for HDL) and with withdrawal severity. Mediation analyses revealed that LDL (but not HDL) influenced the association between TSPO and alcohol withdrawal severity.
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Affiliation(s)
- Corinde E. Wiers
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | | | - Colin A. Hodgkinson
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - Melanie Schwandt
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - Sung Won Kim
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - Nancy Diazgranados
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - Gene‐Jack Wang
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - David Goldman
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
| | - Nora D. Volkow
- National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda Maryland
- National Institute on Drug Abuse National Institutes of Health Bethesda Maryland
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Lyu J, Zhang W, Li W, Wang S, Zhang J. Epidemic of chronic diseases and the related healthy lifestyle interventions in rural areas of Shandong Province, China. BMC Public Health 2020; 20:606. [PMID: 32357867 PMCID: PMC7195749 DOI: 10.1186/s12889-020-08729-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/17/2020] [Indexed: 12/21/2022] Open
Abstract
Background There were amounts of previous studies on chronic diseases, but few studies on the prevalence of chronic disease and the healthy lifestyle intervention in recent years, China. This study aimed to investigate the prevalence of chronic disease and the implementation of healthy lifestyle intervention in rural areas of China, so as to put forward health promotion measures to control the chronic diseases effectively. Method A large cross-sectional study (N = 2168) on community diagnosis and chronic disease was carried out in Shandong province, China. The chronic disease questionnaire and the healthy lifestyle intervention questionnaires were recruited to survey the chronic diseases and the implementation of healthy lifestyle intervention. Physical examination and biochemical indicators examination were carried out by the medical staffs and clinical laboratory. Results The current diagnosed prevalence of hypertension, diabetes, hyperlipidemia for total sample, female, male were 24.97, 24.6, 25.5, 7.60, 8.9, 6.0 and 40.27%, 45.9, 33.3% respectively in rural China. The one-year prevalence of myocardial infarction (MI) and stroke of the total sample, female, male were 1.06, 1.0, 1.1 and 2.09%, 2.2, 2.0% respectively. Healthy lifestyles interventions were not effective in rural China. The current active smoking rate and passive smoking rate were 25.68 and 42.65%. 27.86% of the population drunk alcohol within a month and 47.01% of them participated in the actions to control salt daily intake. Only 1.07 and 7.89% of the population participated in medium to high intensity physical exercises. Conclusions The prevalence of common chronic diseases were still high and the implementation of healthy lifestyle intervention were not optimal in rural area, China. Challenges to prevent chronic diseases were still severe, so medical institutes, government and individuals would put forward effective strategies to reduce the prevalence and public health promotion project should be effectively strengthened.
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Affiliation(s)
- Juncheng Lyu
- Department of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China.
| | - Wen Zhang
- Department of Psychiatry, Binzhou People's Hospital, Binzhou, Shandong, China
| | - Wei Li
- Department of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China.
| | - Suzhen Wang
- Department of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250000, China.,Department of Sociology, State University of New York College at Buffalo, Buffalo, USA
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Spillane S, Shiels MS, Best AF, Haozous EA, Withrow DR, Chen Y, Berrington de González A, Freedman ND. Trends in Alcohol-Induced Deaths in the United States, 2000-2016. JAMA Netw Open 2020; 3:e1921451. [PMID: 32083687 PMCID: PMC7043198 DOI: 10.1001/jamanetworkopen.2019.21451] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Notable increases in mortality from alcohol-induced causes over the past 2 decades in the United States have been reported. However, comprehensive assessments of trends in alcohol-induced mortality by sex, age, race/ethnicity, and social and geographic factors are lacking. OBJECTIVE To examine trends in alcohol-induced mortality rates from 2000 to 2016, comparing results by demographic characteristics including sex, race/ethnicity, age, county-level socioeconomic status, and geographic location. DESIGN, SETTING, AND PARTICIPANTS This serial cross-sectional study used US national vital statistics data for years 2000 to 2016 for all US residents older than 15 years. Data analysis was conducted from January to September 2019. EXPOSURES Trends in alcohol-induced mortality by sex, race/ethnicity, age, county-level socioeconomic status (ie, median income, percentage of unemployed residents, percentage of residents with a bachelor's degree), rurality level, and US state. MAIN OUTCOMES AND MEASURES Alcohol-induced mortality, ie, deaths for which alcohol holds a population-attributable fraction of 1. Deaths were expressed per 100 000 residents as absolute and age-standardized rates. Mortality trends were measured as average annual percentage changes (AAPCs) for the entire period (ie, 2000-2016) and annual percentage changes (APCs) for individual periods of change within the study period. RESULTS A total of 425 045 alcohol-induced deaths were identified from 2000 to 2016 (2000: 19 627 deaths; 14 979 [76.3%] men; 2016: 34 857 deaths; 25 213 [73.3%] men). The rate of alcohol-induced deaths increased substantially among men (AAPC, 1.4%; 95% CI, 1.0% to 1.8%) and women (AAPC, 3.1%; 95% CI, 2.6% to 3.6%) and accelerated recently (men, 2012-2016: APC, 4.2%; 95% CI, 3.1% to 5.3%; women, 2013-2016: APC, 7.1%; 95% CI, 5.1% to 9.1%). The largest increases by race/ethnicity were observed among American Indian and Alaska Native men (AAPC, 3.3%; 95% CI, 2.6% to 4.0%), American Indian and Alaska Native women (AAPC, 4.2%; 95% CI, 3.8% to 4.6%), and white women (AAPC, 4.1%; 95% CI, 3.6% to 4.7%). Despite initial declines among black women, black men, and Latino men (eg, Latino men, 2000-2003: APC, -5.1%; 95% CI, -9.8% to -0.1%; 2003-2013: APC, -0.6%; 95% CI, -1.4% to 0.2%), increases occurred later in the study period (eg, Latino men, 2013-2016: APC, 4.1%; 95% CI, 0.3% to 8.1%). The rates of increase varied by age group and in turn by racial/ethnic group. Among white individuals, large absolute increases occurred in midlife (eg, men aged 55-59 years, 2000-2003: 25.5 deaths per 100 000 residents; 2013-2016: 43.3 deaths per 100 000 residents; women aged 50-54 years, 2000-2003: 7.4 deaths per 100 000 residents; 2013-2016: 16.5 deaths per 100 000 residents), although APCs were also large for ages 25 to 34 years, ranging from 4.6% to 6.9% per year among men and from 7.3% to 12.0% among women. Among American Indian and Alaska Native individuals, increases throughout the age range were observed, with the largest absolute increase occurring for ages 45 to 49 years among men (2000-2013: 113.6 deaths per 100 000 residents; 2013-2016: 193.1 deaths per 100 000 residents) and for ages 50 to 54 among women (2000-2013: from 56.1 deaths per 100 000 residents; 2013-2016: 105.1 deaths per 100 000 residents). CONCLUSIONS AND RELEVANCE This study found large increases in alcohol-induced death rates across age and racial/ethnic subgroups of the US population, which have accelerated over recent years. Large increases in alcohol-induced deaths among younger age groups may be associated with future increases in alcohol-related disease.
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Affiliation(s)
- Susan Spillane
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Meredith S. Shiels
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ana F. Best
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Emily A. Haozous
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Diana R. Withrow
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Yingxi Chen
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Amy Berrington de González
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Neal D. Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Han BH, Moore AA, Sherman S, Palamar JJ. Prevalence and correlates of binge drinking among older adults with multimorbidity. Drug Alcohol Depend 2018; 187:48-54. [PMID: 29627405 PMCID: PMC5959772 DOI: 10.1016/j.drugalcdep.2018.01.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 11/28/2017] [Accepted: 01/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Binge drinking among older adults has increased in the past decade. Binge drinking is associated with unintentional injuries, medical conditions, and lower health-related quality of life. No studies have characterized multimorbidity among older binge drinkers. METHODS We examined past 30-day binge alcohol use and lifetime medical conditions among adults age ≥50 from the National Survey on Drug Use and Health from 2005 to 2014. Self-reported lifetime prevalence of 13 medical conditions and medical multimorbidity (≥2 diseases) among binge drinkers were compared to non-binge drinkers. Multivariable logistic regression models were used to examine correlates of binge alcohol use among older adults with medical multimorbidity. RESULTS Among adults aged ≥50, 14.4% reported past-month binge drinking. Estimated prevalence of medical multimorbidity was lower (21.4%) among binge drinkers than non-binge drinkers (28.3%; p < 0.01). Binge drinkers were more likely to use tobacco and illegal drugs than non-binge drinkers (ps < 0.001). In the adjusted model, among older adults with multimorbidity, higher income (AOR = 1.44, p < 0.05), past-month tobacco use (AOR = 2.55, p < 0.001) and substance use disorder for illegal drugs (AOR = 1.80, p < 0.05) was associated with increased odds of binge alcohol use. CONCLUSION The prevalence of multimorbidity was lower among current binge drinkers compared to non-binge drinkers, possibly because older adults in good health are apt to drink more than adults in poorer health. Current use of tobacco and substance use disorder were associated with an increased risk for binge drinking among older adults with multimorbidity. Binge drinking by older adults with multimorbidity may pose significant health risks especially with the concurrent use of other substances.
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Affiliation(s)
- Benjamin H. Han
- New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, USA,Center for Drug Use and HIV Research, New York University Rory College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, USA
| | - Alison A. Moore
- University of California, San Diego, Department of Medicine, Division of Geriatrics, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Scott Sherman
- New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, 550 First Avenue, BCD 615, New York, NY 10016, USA,Center for Drug Use and HIV Research, New York University Rory College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, USA,VA New York Harbor Healthcare System, New York, NY 10010, USA,New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, USA
| | - Joseph J. Palamar
- Center for Drug Use and HIV Research, New York University Rory College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, USA,New York University Langone Medical Center, Department of Population Health, 550 First Avenue, New York, NY 10016, USA
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Trias-Llimós S, Martikainen P, Mäkelä P, Janssen F. Comparison of different approaches for estimating age-specific alcohol-attributable mortality: The cases of France and Finland. PLoS One 2018; 13:e0194478. [PMID: 29566081 PMCID: PMC5864025 DOI: 10.1371/journal.pone.0194478] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/05/2018] [Indexed: 12/19/2022] Open
Abstract
Background Accurate estimates of the impact of alcohol on overall and age-specific mortality are crucial for formulating health policies. However, different approaches to estimating alcohol-attributable mortality provide different results, and a detailed comparison of age-specific estimates is missing. Methods Using data on cause of death, alcohol consumption, and relative risks of mortality at different consumption levels, we compare eight estimates of sex- and age-specific alcohol-attributable mortality in France (2010) and Finland (2013): five estimates using cause-of-death approaches (with one accounting for contributory causes), and three estimates using attributable fraction (AF) approaches. Results AF-related approaches and the approach based on alcohol-related underlying and contributory causes of death provided estimates of alcohol-attributable mortality that were twice as high as the estimates found using underlying cause-of-death approaches in both countries and sexes. The differences across the methods were greatest among older age groups An inverse U-shape in age-specific alcohol-attributable mortality (peaking at around age 65) was observed for cause-of-death approaches, with this shape being more pronounced in Finland. AF-related approaches resulted in different estimates at older ages: i.e., mortality was found to increase with age in France; whereas in Finland mortality estimates depended on the underlying assumptions regarding the effects of alcohol consumption on cardiovascular mortality. Conclusions While the most detailed approaches (i.e., the AF-related approach and the approach that includes underlying and contributory causes) are theoretically able to provide more accurate estimates of alcohol-attributable mortality, they–especially the AF approaches- depend heavily on data availability and quality. To enhance the reliability of alcohol-attributable mortality estimates, data quality for older age groups needs to be improved.
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Affiliation(s)
- Sergi Trias-Llimós
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Pia Mäkelä
- Alcohol, Drugs and Addictions Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
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Smith-Bernardin S, Carrico A, Max W, Chapman S. Utilization of a Sobering Center for Acute Alcohol Intoxication. Acad Emerg Med 2017; 24:1060-1071. [PMID: 28493551 DOI: 10.1111/acem.13219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/22/2017] [Accepted: 02/24/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective was to describe the population utilizing a sobering center for public alcohol intoxication and compare between single-visit users, repeat users, and high users. METHODS We conducted a secondary analysis of 1,271 adults cared for in a sobering center from July 2014 to June 2015. We divided the population into three groups-single use (one visit), repeat users (two to five visits), and high (six or more) users-and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs. RESULTS The population was primarily male, middle-aged, and ethnically diverse. Compared to single-visit users (n = 869), repeat (n = 287) and high users (n = 115) were older, were more likely to be currently homeless, and had spent more time homeless. Repeat and high users had significantly higher rates of hypertension, liver disease, diabetes, depression, psychoses, and drug abuse diagnoses compared to single-visit users. In addition to sobering visits, utilization of ambulance and ED and related costs were significantly greater for the high users compared to repeat and single-visit users. CONCLUSIONS From an overall heterogeneous population, more frequent utilizers of the sobering center, both high and repeat users compared to low users, had significantly greater prevalence of chronic disorders, service utilization, and homelessness. Findings indicate that a sobering center can have a prominent role in the care for those with acute alcohol intoxication, particularly those individuals with chronic public intoxication who are likewise homeless. Further longitudinal research could offer important insights as to the population served over time, investigating changes in utilization and efforts toward health and housing stabilization.
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Affiliation(s)
- Shannon Smith-Bernardin
- School of Nursing; Department of Social & Behavioral Sciences; University of California at San Francisco; San Francisco CA
- The Alcohol Research Group; Emeryville CA
| | - Adam Carrico
- Department of Public Health Sciences; Division of Prevention Science & Community Health; University of Miami Health System; Miami FL
| | - Wendy Max
- The Institute for Health & Aging; University of California at San Francisco; San Francisco CA
| | - Susan Chapman
- School of Nursing; Department of Social & Behavioral Sciences; University of California at San Francisco; San Francisco CA
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Tu W, Chu C, Li S, Liangpunsakul S. Development and validation of a composite score for excessive alcohol use screening. J Investig Med 2016; 64:1006-11. [PMID: 27001945 DOI: 10.1136/jim-2015-000033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2016] [Indexed: 02/01/2023]
Abstract
This study was undertaken to develop a composite measure that combines the discriminant values of individual laboratory markers routinely used for excessive alcohol use (EAU) for an improved screening performance. The training sample consisted of 272 individuals with known history of EAU and 210 non-alcoholic individuals. The validation sample included 100 EAU and 75 controls. We used the estimated regression coefficients and the observed marker values to calculate the individual's composite screening score; this score was converted to a probability measure for excessive drinking in the given individual. A threshold value for the screening score based on an examination of the estimated sensitivity and specificity associated with different threshold values was proposed. Using regression coefficients estimated from the training sample, a composite score based on the levels of aspartate aminotransferase, alanine aminotransferase, per cent carbohydrate-deficient transferrin and mean corpuscular volume was calculated. The areas under the receiver operating characteristic curve (AUC) value of the selected model was 0.87, indicating a strong discriminating power and the AUC was better than that of each individual test. The score >0.23 corresponded to a sensitivity of 90% and a specificity of nearly 60%. The AUC value remained at a respectable level of 0.83 with the sensitivity and specificity at 91% and 49%, respectively, in the validation sample. We developed a novel composite score by using a combination of commonly used biomakers. However, the development of the mechanism-based biomarkers of EAU is needed to improve the screening and diagnosis of EAU in clinical practice.
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Affiliation(s)
- Wanzhu Tu
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Chenghao Chu
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shanshan Li
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA Roudebush veterans Administration Medical Center, Indianapolis, Indiana, USA
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