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Kady A, Grodin EN, Ray LA. Characterizing reward and relief/habit drinking profiles in a study of naltrexone, varenicline, and placebo. Alcohol Alcohol 2024; 59:agae044. [PMID: 38953743 PMCID: PMC11217986 DOI: 10.1093/alcalc/agae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION This study aims to clarify differences in mood, craving, and treatment response between reward and relief/habit individuals in a study of naltrexone, varenicline, and placebo. We hypothesized that relief/habit individuals would have a poorer mood during early abstinence and higher levels of alcohol craving than reward individuals. We hypothesized that reward individuals would demonstrate better drinking outcomes on naltrexone versus placebo. METHODS Data were culled from a randomized, double-blind, placebo-controlled human trial of 53 individuals (18F/16M) with alcohol use disorder randomized to varenicline (n = 19), naltrexone (n = 15), or matched placebo (n = 19). In this 6-day practice quit trial, participants attempted to abstain from drinking and completed daily diaries. Participants were classified into reward or relief/habit subgroups based on self-reported motivation for drinking. Multilinear models tested differences in mood and alcohol craving between reward and relief/habit individuals. General linear models tested differences between reward and relief/habit individuals' drinking outcomes on each medication versus placebo. RESULTS Relief/habit individuals showed decreases in positive mood and increases in negative mood over the quit attempt across medications, compared to reward individuals (P's < .05). Reward individuals' tension decreased on naltrexone, while relief/habit individuals' tension remained stable (F = 3.64, P = .03). Reward individuals in the placebo group had higher percent days abstinent than relief individuals in the placebo group (P < .001). DISCUSSION This study suggests relief/habit individuals' mood worsens during early abstinence. Our finding that reward individuals' tension decreased on naltrexone and increased on placebo may suggest a clinical response to the medication.
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Affiliation(s)
- Annabel Kady
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 51563, Los Angeles, CA 90095-1563, United States
| | - Erica N Grodin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza #4, Los Angeles, CA 90095, United States
- Brain Research Institute, University of California, Los Angeles, 695 Charles E Young Dr. S, Los Angeles, CA 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 51563, Los Angeles, CA 90095-1563, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza #4, Los Angeles, CA 90095, United States
- Brain Research Institute, University of California, Los Angeles, 695 Charles E Young Dr. S, Los Angeles, CA 90095, United States
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Smith JJ, Spanakis P, Gribble R, Stevelink SAM, Rona RJ, Fear NT, Goodwin L. Prevalence of at-risk drinking recognition: A systematic review and meta-analysis. Drug Alcohol Depend 2022; 235:109449. [PMID: 35461086 DOI: 10.1016/j.drugalcdep.2022.109449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is a prominent "treatment gap" in relation to at-risk drinking (ARD), whereby a minority of at-risk drinkers ever access treatment. Research suggests that recognition of problem drinking is a necessary precursor for help-seeking and treatment. OBJECTIVE This systematic review and meta-analysis aimed to estimate the prevalence of ARD recognition within those meeting criteria for ARD. METHOD PsycINFO, Web of Science, Scopus, and MEDLINE were searched using the terms: problem* AND (recogni* OR perceive* OR perception OR self-identif*) AND alcohol - to identify studies published in English between 2000 and 2022. Studies reported the frequency (weighted or unweighted) of participants meeting ARD criteria that also directly identified ARD, perceived a need for help, or endorsed a readiness to change. The prevalence of ARD recognition was estimated using a random-effects meta-analysis with 95% confidence intervals (CIs). RESULTS 17 studies were included which provided data for 33,349 participants with ARD. Most (n = 14) were US studies. ARD was self-identified via a single indicator in 7 studies, whereas recognition was assessed via stages of change in 4 studies and need for help in 6 studies. The pooled prevalence of ARD recognition was 31% (95% CI: 25%-36%), and subgroup analyses indicated alcohol use severity, measure of recognition, and population type to be significant sources of heterogeneity. CONCLUSIONS Most individuals with ARD fail to recognise their drinking problem so preventive approaches that promote recognition may be helpful. However, we must be cautious of how inconsistency in question framing affects self-reported problem recognition.
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Affiliation(s)
- Jessica J Smith
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom.
| | | | - Rachael Gribble
- Department of Psychological Medicine, King's College London, London, United Kingdom; King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Sharon A M Stevelink
- Department of Psychological Medicine, King's College London, London, United Kingdom; King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Roberto J Rona
- Department of Psychological Medicine, King's College London, London, United Kingdom; King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, United Kingdom; Academic Department of Military Mental Health, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Laura Goodwin
- Division of Health Research, Lancaster University, Lancaster, United Kingdom; Liverpool Centre for Alcohol Research, Liverpool Centre for Alcohol Research, Liverpool Health Partners, Liverpool, United Kingdom
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Stull SW, Linden-Carmichael AN, Cloutier RM, Bonny AE, Lanza ST. Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:293-301. [PMID: 35100070 PMCID: PMC9933145 DOI: 10.1080/00952990.2021.2016786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Substance use disorders (SUDs) and mental health disorders may change and co-occur in complex patterns across adult ages, but these processes can be difficult to capture with traditional statistical approaches.Objective: To elucidate disorder prevalence and comorbidities across adult ages by using time-varying effect models (TVEMs), latent class analysis (LCA), and modeling latent class prevalences as complex functions of age.Methods: Data were drawn from participants who are 18-65 years old in the National Epidemiologic Survey on Alcohol and Related Conditions III (n = 30,999; 51% women) and a subsample who reported a past-year post-traumatic stress disorder (PTSD), mood, anxiety, or SUD based on DSM-5 diagnoses (n = 11,279). TVEM and LCA were used to examine age trends and comorbidity patterns across ages.Results: SUD prevalence peaked at age 23 (31%) and decreased thereafter, while mental health disorder prevalence was stable (20%-26% across all ages). The prevalence of five classes of individuals based on specific combinations of mental health and SUDs varied by age: the Alcohol Use Disorder class had the highest prevalence at age 26, whereas the Mood and Anxiety Disorder classes peaked around age 63. Interestingly, the Poly-Disorder class prevalence was greatest at age 18 but decreased sharply across young adulthood; however, the prevalence of the other high comorbidity class, PTSD with Mood or Anxiety Disorder, remained fairly constant across age, peaking at age 44.Conclusions: Multimorbid mental health disorders (excluding SUDs) persist in prevalence across adult ages. LCA, TVEM, and their integration together hold substantial potential to advance addiction research.
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Affiliation(s)
- Samuel W. Stull
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ashley N. Linden-Carmichael
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, 16802, USA
| | | | - Andrea E. Bonny
- Division of Adolescent Medicine, Nationwide Children’s Hospital, Columbus, OH, 43215,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, 43210
| | - Stephanie T. Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, USA.,The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, 16802, USA
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Heavy drinkers and the contexts of drinking among adults in Norway. Drug Alcohol Depend 2021; 229:109127. [PMID: 34781181 DOI: 10.1016/j.drugalcdep.2021.109127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/16/2021] [Accepted: 09/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is little knowledge about characteristics of the heaviest drinkers. This study aimed at exploring 1) socio-demographic characteristics and 2) drinking patterns and drinking contexts of heavy drinkers and other drinkers in Norway, applying various criteria for heavy drinking. METHODS Data from cross-sectional population surveys among adults in Norway (aged 16 +) in 2015 through 2018 (current drinkers, n = 6 940) were analysed. Two measures were applied to categorize heavy drinkers: 1) AUDIT score (10 +), and 2) annual consumption volume (445 + units) (both above 90th percentile). Social contexts of drinking included location (private homes, licensed premises); social company (partner/family, work mates, friends, no one); and weekend versus weekdays. RESULTS Heavy drinkers accounted for 10% of the sample and up to half of the total consumption. Heavy drinkers differed significantly from other drinkers with regard to age, education level and criterion; by AUDIT score, the prevalence of heavy drinkers decreased with increasing age and education level, whereas the opposite was the case for by volume. Compared to other drinkers, heavy drinkers drank relatively more often on weekdays and relatively more often alone, and more frequently at licenced premises. CONCLUSIONS In Norway, the distribution of alcohol consumption is heavily skewed, and the heaviest drinkers differ from the rest of the population in several aspects. This group of drinkers represent an important target for public policy, and there is a need for further knowledge of this group enabling more targeted interventions in addition to policies aimed at reducing the per-capita consumption.
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Guertler D, Moehring A, Krause K, Tomczyk S, Freyer-Adam J, Baumann S, Bischof G, Rumpf HJ, Batra A, Wurm S, John U, Meyer C. Latent alcohol use patterns and their link to depressive symptomatology in medical care patients. Addiction 2021; 116:1063-1073. [PMID: 32918508 DOI: 10.1111/add.15261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/26/2020] [Accepted: 09/04/2020] [Indexed: 01/28/2023]
Abstract
AIMS To investigate latent patterns of alcohol use and bingeing by gender and their association with depressive symptom severity and individual depressive symptoms. DESIGN Cross-sectional data were collected from January 2017 to March 2018 as part of a joint screening recruiting for different intervention studies. SETTING Ambulatory practices and general hospitals from three sites in Germany. PARTICIPANTS A total of 5208 male and 5469 female proactively recruited alcohol users aged 18-64 years. MEASUREMENTS Frequency and typical quantity of alcohol use, frequency of bingeing, alcohol-related problems (assessed by the Alcohol Use Disorder Identification Test); depressive symptom severity, individual depressive symptoms (assessed with the Patient Health Questionnaire-8); and socio-demographics and health-related variables. FINDINGS Latent categorical analysis identified six patterns of alcohol use, with the majority of patients engaging in 'light use plus no or occasional bingeing' (males: 41.85%; females: 64.04%), followed by 'regular use plus occasional bingeing' (males: 34.03%; females: 16.17%). Multinomial logistic regression analyses (three-step approach with correction for classification uncertainty, as implemented in the Mplus R3STEP command) controlling for socio-demographics and health-related variables revealed that severity of depressive symptoms was positively associated with 'frequent use plus frequent bingeing' when compared with 'light use plus no or occasional bingeing' [relative risk ratio (RRR)male = 1.07, 95% confidence interval (CI) = 1.03-1.11; RRRfemale = 1.09, 95% CI = 1.04-1.14]. Severity of depressive symptoms was negatively associated with 'regular use plus occasional bingeing' for males (RRRmale = 0.98, 95% CI = 0.95-1.00) and positively with 'occasional use plus occasional bingeing' for females (RRRfemale = 1.03, 95% CI = 1.01-1.05) when compared with 'light use plus no or occasional bingeing'. Individual depressive symptoms were differentially associated with alcohol use patterns, with depressed mood, poor appetite or overeating, feelings of worthlessness or guilt and psychomotor agitation or retardation, being especially pronounced in the 'frequent use plus frequent bingeing' class (RRRsmale = 1.72-2.36; RRRsfemale = 1.99-2.17). CONCLUSIONS Patterns of 'frequent alcohol use plus frequent bingeing' and 'occasional alcohol use plus occasional bingeing' appear to have positive associations with depression when compared with 'light alcohol use plus no or occasional bingeing'.
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Affiliation(s)
- Diana Guertler
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Anne Moehring
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Kristian Krause
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Institute of Psychology, Department of Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Jennis Freyer-Adam
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany.,Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Sophie Baumann
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany.,Institute and Policlinic for Occupational and Social Medicine, Technische Universität Dresden, Germany
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck, Lübeck, Germany
| | - Hans-Juergen Rumpf
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck, Lübeck, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Susanne Wurm
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany
| | - Christian Meyer
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany
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Miller K, Laha-Walsh K, Albright DL, McDaniel J. Changes in alcohol use during the COVID-19 pandemic among a sample of cannabis users. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1875069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Kyle Miller
- Department of Public Health, School of Human Sciences, Carbondale, Illinois, USA
| | - Kirsten Laha-Walsh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - David L. Albright
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Justin McDaniel
- Department of Public Health, School of Human Sciences, Carbondale, Illinois, USA
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Tucker JS, Huang W, Green HD, Pollard MS. Patterns of Substance Use and Associations with Mental, Physical, and Social Functioning: A Latent Class Analysis of a National Sample of U.S. Adults Ages 30-80. Subst Use Misuse 2021; 56:131-139. [PMID: 33167746 PMCID: PMC7984420 DOI: 10.1080/10826084.2020.1843059] [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] [Indexed: 01/10/2023]
Abstract
Trends show increased substance use among adults, yet little research on general population samples has examined differential patterns of licit and illicit substance use that can inform prevention and treatment efforts. This study identifies distinct patterns (classes) of substance use among 30- to 80-year olds, identifies demographic subgroups with the highest probability of class memberships, and compares classes on key indicators of functioning. Method: Participants (n = 1,877) were from the RAND American Life Panel. Online survey measures included current alcohol, tobacco, cannabis, and nonmedical prescription drug use, as well as mental, physical, and social functioning. Results: Latent class analysis identified four classes: "Lighter Drinking" (46.6%), "Abstaining" (33.7%), "Heavy Drinking with Cigarette/Cannabis Use" (17.1%), and "Cigarette Smoking with Prescription Drug/Cannabis Use" (2.6%). Of these classes, "Cigarette Smoking with Prescription Drug/Cannabis Use" reported the worst mental and physical functioning, and greater loneliness than the "Lighter Drinking" class. "Heavy Drinking with Cigarette/Cannabis Use" reported worse mental and physical functioning than the "Lighter Drinking" class and less social support than the "Lighter Drinking" and "Abstaining" classes. The "Abstaining" class reported consistently worse functioning than the "Lighter Drinking" class. Both polysubstance use classes were associated with younger age, less education, and lower income, and heavy drinking polysubstance use was associated with being male and unmarried. Conclusions: Although lighter drinking was the most common pattern, 20% of adults were classified into two polysubstance use classes associated with poorer functioning. Targeted efforts may be needed to reach certain subgroups of adults who are particularly susceptible to polysubstance use.
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Affiliation(s)
| | | | - Harold D Green
- Indiana University School of Public Health, Department of Applied Health Science, Bloomington, Indiana, USA
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Lian J, Cai Y, Tu D, Xi C. Developing and Validating an Item Bank for Alcohol Use Disorder Screening in the Chinese Population by Using the Computerized Adaptive Testing. Front Psychol 2020; 11:1652. [PMID: 32733347 PMCID: PMC7360790 DOI: 10.3389/fpsyg.2020.01652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To detect the individual’s severity of alcohol use disorder (AUD) in an effective and accurate manner, this study aimed to build an item bank for AUD screening and derive the computerized adaptive testing (CAT) version of AUD (CAT-AUD). Methods The initial CAT-AUD item bank was selected from the Chinese version of the questionnaires related to AUD according to the DSM-5 criteria. Then 915 valid Chinese samples, covering the healthy individuals and the AUD high-risk individuals, completed the initial CAT-AUD item bank. By testing the unidimensionality, test fit, item fit, discrimination parameter and differential item functioning of the initial item bank, the final CAT-AUD item bank confirming to the requirements of the item response theory (IRT) were obtained. Subsequently, the CAT-AUD simulation study based on the real data of the final item bank conducted to detect characteristics, reliability, validity, and predictive utility (sensitivity and specificity) of CAT-AUD. Results The CAT-AUD item bank meeting the IRT psychometric measurement requirements could be well geared into the graded response model. The Pearson’s correlation between the estimated theta via CAT-AUD and the estimated theta via the full-length item bank reached 0.95, and the criterion-related validity was 0.63. CAT-AUD can provide highly reliable test results for subjects whose theta above −0.8 with an average of 16 items. Besides, the predictive utility of CAT-AUD was better than AUDIT and AUDIT-C. Conclusion In brief, the CAT-AUD developed in this study can effectively screen the AUD high-risk group and accurately measure the AUD severity of individuals.
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Bray BC, Dziak JJ, Lanza ST. Age trends in alcohol use behavior patterns among U.S. adults ages 18-65. Drug Alcohol Depend 2019; 205:107689. [PMID: 31707270 PMCID: PMC6957076 DOI: 10.1016/j.drugalcdep.2019.107689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Although much of the work on risky alcohol use behaviors, such as heavy drinking, focuses on adolescence and young adulthood, these behaviors are associated with negative health consequences across all ages. Existing studies on age trends have focused on a single alcohol use behavior across many ages, using methods such as time-varying effect modeling, or a single age period with many behaviors, using methods such as latent class analysis. This study integrates aspects of both modeling approaches to examine age trends in alcohol use behavior patterns across ages 18-65. METHODS Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III were used to identify past-year alcohol use behavior patterns among a nationally representative sample of U.S. adults (n = 30,997; 51.1% women; 63.5% White Non-Hispanic) and flexibly estimate nonlinear trends in the prevalences of those patterns across ages 18-65. RESULTS Five patterns were identified: Non-Drinkers, Frequent Light Drinkers, Infrequent Heavy Episodic Drinkers, Frequent Heavy Episodic Drinkers, and Extreme Drinkers. Pattern prevalences were allowed to vary flexibly across the entire age range. Prevalences of the Infrequent Heavy Episodic and Extreme Drinkers peaked around ages 22-24, but peaked for Frequent Heavy Episodic Drinkers around age 49. Non-Drinkers were most prevalent across all ages except during the early 20 s when Extreme Drinkers were more prevalent. Around ages 24-30, the Non-, Frequent Light, and Extreme Drinkers were approximately equally prevalent. CONCLUSIONS The approach used here holds promise for understanding characteristics associated with behavior patterns at different ages and long-term age trends in complex behaviors.
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Affiliation(s)
- Bethany C. Bray
- The Methodology Center, The Pennsylvania State University, 404 Health and Human Development Bldg, University Park, PA 16802, United States,Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 S Wolcott Ave, Chicago, IL 60612, United States
| | - John J. Dziak
- The Methodology Center, The Pennsylvania State University, 404 Health and Human Development Bldg, University Park, PA 16802, United States
| | - Stephanie T. Lanza
- The Methodology Center, The Pennsylvania State University, 404 Health and Human Development Bldg, University Park, PA 16802, United States,Edna Bennett Piece Prevention Research Center, The Pennsylvania State University, 302 Biobehavioral Health Bldg, University Park, PA 16802, United States,Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Bldg, University Park, PA 16802, United States
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Neuropsychological latent classes at enrollment and postmortem neuropathology. Alzheimers Dement 2019; 15:1195-1207. [PMID: 31420203 DOI: 10.1016/j.jalz.2019.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We classified individuals based on their baseline performance on cognitive measures and investigated the association between cognitive classifications and neuropathological findings ∼7 years later, as an external validator. METHODS Brain autopsies of 779 decedents were examined. Baseline latent class analysis on 10 neuropsychological measures was previously assigned: mixed-domains impairment (n = 39, 5%), memory-specific impairment (n = 210, 27%), frontal impairment (n = 113, 14.5%), average cognition (n = 360, 46.2%), and superior cognition (n = 57, 7.3%). Linear regressions and risks ratios were used to examine the relation of latent class assignment at enrollment with neuropathological indices. RESULTS Amyloid β, tau, and transactive response DNA-binding protein 43 were associated with mixed-domains impairment and memory-specific impairment classes ∼7 years before death. Moderate arteriolosclerosis was associated with membership in the frontal impairment class. DISCUSSION Our findings support the use of latent class models that incorporate more comprehensive neuropsychological measures to classify cognitive impairment.
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