1
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Tindall RR, Yang Y, Hernandez I, Qin A, Li J, Zhang Y, Gomez TH, Younes M, Shen Q, Bailey-Lundberg JM, Zhao Z, Kraushaar D, Castro P, Cao Y, Zheng WJ, Ko TC. Aging- and alcohol-associated spatial transcriptomic signature in mouse acute pancreatitis reveals heterogeneity of inflammation and potential pathogenic factors. J Mol Med (Berl) 2024:10.1007/s00109-024-02460-6. [PMID: 38940937 DOI: 10.1007/s00109-024-02460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/15/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
The rapidly aging population is consuming more alcohol, leading to increased alcohol-associated acute pancreatitis (AAP) with high mortality. However, the mechanisms remain undefined, and currently there are no effective therapies available. This study aims to elucidate aging- and alcohol-associated spatial transcriptomic signature by establishing an aging AAP mouse model and applying Visium spatial transcriptomics for understanding of the mechanisms in the context of the pancreatic tissue. Upon alcohol diet feeding and caerulein treatment, aging mice (18 months) developed significantly more severe AAP with 5.0-fold increase of injury score and 2.4-fold increase of amylase compared to young mice (3 months). Via Visium spatial transcriptomics, eight distinct tissue clusters were revealed from aggregated transcriptomes of aging and young AAP mice: five acinar, two stromal, and one islet, which were then merged into three clusters: acinar, stromal, and islet for the comparative analysis. Compared to young AAP mice, > 1300 differentially expressed genes (DEGs) and approximately 3000 differentially regulated pathways were identified in aging AAP mice. The top five DEGs upregulated in aging AAP mice include Mmp8, Ppbp, Serpina3m, Cxcl13, and Hamp with heterogeneous distributions among the clusters. Taken together, this study demonstrates spatial heterogeneity of inflammatory processes in aging AAP mice, offering novel insights into the mechanisms and potential drivers for AAP development. KEY MESSAGES: Mechanisms regarding high mortality of AAP in aging remain undefined. An aging AAP mouse model was developed recapturing clinical exhibition in humans. Spatial transcriptomics identified contrasted DEGs in aging vs. young AAP mice. Top five DEGs were Mmp8, Ppbp, Serpina3m, Cxcl13, and Hamp in aging vs. young AAP mice. Our findings shed insights for identification of molecular drivers in aging AAP.
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Affiliation(s)
- Rachel R Tindall
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA
| | - Yuntao Yang
- McWilliams School of Biomedical Informatics, UTHealth at Houston, Houston, TX, 77030, USA
| | | | - Amy Qin
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA
| | - Jiajing Li
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA
| | - Yinjie Zhang
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA
| | - Thomas H Gomez
- Center for Laboratory Animal Medicine and Care, UTHealth at Houston, Houston, TX, 77030, USA
| | - Mamoun Younes
- Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC, 20037, USA
| | - Qiang Shen
- Department of Interdisciplinary Oncology, Louisiana State Univ. Health Sciences Center, New Orleans, LA, 70112, USA
| | - Jennifer M Bailey-Lundberg
- Department of Anesthesiology, Critical Care and Pain Medicine, UTHealth at Houston, Houston, TX, 77030, USA
| | - Zhongming Zhao
- Center for Precision Health, McWilliams School of Biomedical Informatics, UTHealth at Houston, Houston, TX, 77030, USA
| | - Daniel Kraushaar
- Genomic and RNA Profiling Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Patricia Castro
- Human Tissue Acquisition & Pathology Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Yanna Cao
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA.
| | - W Jim Zheng
- McWilliams School of Biomedical Informatics, UTHealth at Houston, Houston, TX, 77030, USA.
| | - Tien C Ko
- Department of Surgery, UTHealth at Houston, Houston, TX, 77030, USA.
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2
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Malisauskaite G, Nizalova O, Gousia K, Teo H, Forder J. Understanding policy amenable risk factors: Alcohol consumption and long-term care use among people over 65 years old. Soc Sci Med 2024; 347:116746. [PMID: 38471406 DOI: 10.1016/j.socscimed.2024.116746] [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: 04/03/2023] [Revised: 02/01/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES This study aims to explore the effect of past alcohol consumption frequency on formal and informal long-term care (LTC) use in old age and explore the different channels through which it may affect LTC use. MOTIVATION The existing literature has mainly focused on risk factors associated with a nursing home entry, but this evidence is outdated, not UK-focused, and does not look into other types of care, such as informal care. The results of this study will help in modelling the future demand for various types of care and the corresponding public spending. METHODS We use the English Longitudinal Study of Ageing (ELSA) (2002-2017) dataset to conduct longitudinal, individual-level analysis. We explore how the previous frequency of alcohol consumption affects formal and informal care use. We focus on people aged 65 and over with no previous LTC use and run regressions with and without instrumental variables (IV) to estimate how alcohol consumption patterns in the previous wave (2 years before) affect formal and informal care use. For IV regressions, we use the polygenic score for alcohol use, available for a subsample of ELSA respondents, as an instrument while also accounting for sociodemographic characteristics, lifestyle choices, and health conditions. RESULTS The main IV estimates suggest that frequent alcohol consumption has a weakly significant positive effect on the onset of formal LTC care use compared to none/rare drinking. This relationship diminishes and is not statistically significant when we directly control for health status. We find no statistically significant effect towards informal LTC use. These results contrast with the estimates without IV, which suggest that frequent alcohol consumption is negatively associated with informal care use and no or weakly negative association with formal care use. DISCUSSION Our findings suggest that unobserved confounding is important when studying the relationship between alcohol consumption and LTC. We hypothesise that primarily alcohol effects LTC through its adverse effect on health. In addition, unobserved factors like preferences towards seeking care, social behaviour may be related to alcohol consumption and affect access to care. We speculate alcohol may have a damaging effect on personal relationships and could indicate the burden eventually falling on formal care. In as far as the polygenic score IV can account for unobserved preference-behaviour differences, the results (weakly) support the hypothesis that these latter processes are relevant, especially for informal care use.
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Affiliation(s)
- Gintare Malisauskaite
- PSSRU (Personal Social Services Research Unit), University of Kent, Canterbury, CT2 7NF, UK.
| | - Olena Nizalova
- PSSRU (Personal Social Services Research Unit), University of Kent, Canterbury, CT2 7NF, UK.
| | - Katerina Gousia
- PSSRU (Personal Social Services Research Unit), University of Kent, Canterbury, CT2 7NF, UK.
| | - Hansel Teo
- PSSRU (Personal Social Services Research Unit), University of Kent, Canterbury, CT2 7NF, UK.
| | - Julien Forder
- PSSRU (Personal Social Services Research Unit), University of Kent, Canterbury, CT2 7NF, UK.
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3
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Jo Nixon S, Garcia CC, Lewis B. WOMEN'S USE OF ALCOHOL: NEUROBIOBEHAVIORAL CONCOMITANTS AND CONSEQUENCES. Front Neuroendocrinol 2023:101079. [PMID: 37269931 DOI: 10.1016/j.yfrne.2023.101079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/02/2023] [Accepted: 05/27/2023] [Indexed: 06/05/2023]
Abstract
In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.
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Affiliation(s)
- Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Department of Psychology, Gainesville, FL; University of Florida, Department of Neuroscience, Gainesville; University of Florida, Center for Addiction Research & Education, Gainesville, FL.
| | - Christian C Garcia
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Center for Addiction Research & Education, Gainesville, FL
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Department of Psychology, Gainesville, FL; University of Florida, Department of Neuroscience, Gainesville; University of Florida, Center for Addiction Research & Education, Gainesville, FL
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4
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An intelligent mind in a healthy body? Predicting health by cognitive ability in a large European sample. INTELLIGENCE 2022. [DOI: 10.1016/j.intell.2022.101666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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5
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Theophilus R, Napier C, Oldewage-Theron W. If you drink alcohol, drink sensibly: a food-based dietary guideline for the elderly in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1954351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Rufus Theophilus
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Carin Napier
- Department of Food & Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
- Centre for Longitudinal Research, The University of Auckland, Auckland, New Zealand
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein, South Africa
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6
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Mejldal A, Andersen K, Behrendt S, Bilberg R, Christensen AI, Lau CJ, Möller S, Nielsen AS. History of healthcare use and disease burden in older adults with different levels of alcohol use. A register-based cohort study. Alcohol Clin Exp Res 2021; 45:1237-1248. [PMID: 33860951 DOI: 10.1111/acer.14615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Only a minority of individuals with problematic alcohol use ever seek alcohol treatment. Knowledge of general help-seeking behavior in the healthcare system can identify possibilities for prevention and intervention. METHOD The current study describes healthcare use, burden of disease, and prior morbidities over a 15-year period by current alcohol use behavior among Danish adults aged 60-70. The Danish National Health Survey 2013 and the baseline assessment of the Elderly Study (2014-2016) were linked to Danish national registers to collect annual information on healthcare use and morbidity for the 15 years prior to inclusion. Participants from the 3 largest Danish municipalities were divided into 4 groups with varying drinking patterns and no recent treatment [12-month abstinent (n = 691), low-risk drinkers (n = 1978), moderate-risk drinkers (n = 602), and high-risk drinkers (n = 467)], and a group of treatment-seeking individuals with a 12-month DSM-5 alcohol use disorder (AUD; n=262). Negative binomial regression models were utilized to compare rates of healthcare use and logistic regressions were used to compare odds of diagnoses. RESULTS Low-, moderate-, and high-risk drinkers had similar rates of past healthcare utilization (low-risk mean yearly number of contacts for primary care 7.50 (yearly range 6.25-8.45), outpatient care 0.80 (0.41-1.32) and inpatient care 0.13 (0.10-0.21)). Higher rates were observed for both the 12-month abstinent group (adjusted RR = 1.16-1.26) and the group with AUD (ARR = 1.40-1.60) compared to the group with low-risk alcohol consumption. Individuals with AUD had higher odds of previous liver disease (adjusted OR = 6.30), ulcer disease (AOR = 2.83), and peripheral vascular disease (AOR 2.71). Twelve-month abstinence was associated with higher odds of diabetes (AOR = 1.97) and ulcer disease (AOR = 2.10). CONCLUSIONS Looking back in time, we found that older adults had regular healthcare contacts, with those who received treatment for AUD having had the highest contact frequency and prevalence of alcohol-related diseases. Thus, healthcare settings are suitable locations for efforts at AUD prevention and intervention.
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Affiliation(s)
- Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Kjeld Andersen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, University of Southern Denmark, Odense C, Denmark.,Department of Mental Health Odense, Region of Southern Denmark, Vejle, Denmark
| | - Silke Behrendt
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Institute for Psychology, University of Southern Denmark, Odense C, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | | | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg Hospital, København, Denmark.,Frederiksberg Hospital, Frederiksberg, Denmark
| | - Sören Möller
- OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, University of Southern Denmark, Odense C, Denmark
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7
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Linden-Carmichael AN, Allen HK, Masters LD, Ansell EB, Lanza ST. Age-varying trends in alcohol and cannabis co-occurring use: Implications for prescription drug misuse. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:209-219. [PMID: 33175597 DOI: 10.1080/00952990.2020.1831003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Individuals who engage in alcohol and cannabis co-occurring use are at heightened risk for negative outcomes than individuals who only use alcohol or only use cannabis, but far less is known about implications of alcohol and cannabis co-occurring use for prescription drug misuse (PDM).Objectives: This study aimed to (1) identify whether co-occurring use was linked with greater risk for PDM across ages 18-60 and to determine ages at which this association was strongest, (2) determine whether associations remain after controlling for pain severity, and (3) test for gender differences.Methods: Cross-sectional data were from Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. The analytic sample included 20,120 (50.6%wt men) individuals aged 18-60 reporting past-year alcohol and/or cannabis use.Results: Time-varying effect models indicated that individuals reporting co-occurring use were at increased risk for PDM than individuals reporting single-substance use across all ages, with odds ratios peaking at >3 at age 34. After controlling for pain severity, associations were only slightly weakened. Associations were slightly stronger for men than women from ages 28 to 35.Conclusion: Co-occurring use was linked with heightened risk for PDM compared to individuals who used only one substance; co-occurring use may be important to target for PDM prevention. Identifying factors underlying study associations, beyond pain, and how these factors evolve with age are important avenues for prevention work.
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Affiliation(s)
- Ashley N Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, State College, PA, USA
| | - Hannah K Allen
- The Methodology Center, The Pennsylvania State University, State College, PA, USA
| | - Loren D Masters
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, State College, PA, USA
| | - Emily B Ansell
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Stephanie T Lanza
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, State College, PA, USA.,Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
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8
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Shenvi CL, Weaver MA, Biese KJ, Wang Y, Revankar R, Fatade Y, Aylward A, Busby‐Whitehead J, Platts‐Mills TF, D'Onofrio G. Identification and characterization of older emergency department patients with high-risk alcohol use. J Am Coll Emerg Physicians Open 2020; 1:804-811. [PMID: 33145524 PMCID: PMC7593462 DOI: 10.1002/emp2.12196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/31/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND High-risk alcohol use in the elderly is a common but underrecognized problem. We tested a brief screening instrument to identify high-risk individuals. METHODS This was a prospective, cross-sectional study conducted at a single emergency department. High-risk alcohol use was defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines as >7 drinks/week or >3 drinks/occasion. We assessed alcohol use in patients aged ≥ 65 years using the timeline follow back (TLFB) method as a reference standard and a new, 2-question screener based on NIAAA guidelines. The Alcohol Use Disorders Identification Test (AUDIT) and Cut down, Annoyed, Guilty, Eye-opener (CAGE) screens were used for comparison. We collected demographic information from a convenience sample of high- and low-risk drinkers. RESULTS We screened 2250 older adults and 180 (8%) met criteria for high-risk use. Ninety-eight high-risk and 124 low-risk individuals were enrolled. The 2-question screener had sensitivity of 98% (95% CI, 93%-100%) and specificity of 87% (95% CI, 80%-92%) using TLFB as the reference. It had higher sensitivity than the AUDIT or CAGE tools. The high-risk group was predominantly male (65% vs 35%, P < 0.001). They drank a median of 14 drinks per week across all ages from 65 to 92. They had higher rates of prior substance use treatment (17% vs 2%, P < 0.001) and current tobacco use (24% vs 9%, P = 0.004). CONCLUSION A rapid, 2-question screener can identify high-risk drinkers with higher sensitivity than AUDIT or CAGE screening. It could be used in concert with more specific questionnaires to guide treatment.
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Affiliation(s)
- Christina L. Shenvi
- Department of Emergency MedicineUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Mark A. Weaver
- Department of Mathematics and StatisticsElon UniversityElonNorth CarolinaUSA
| | - Kevin J. Biese
- Department of Emergency MedicineUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Yushan Wang
- Wake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | | | - Yetunde Fatade
- Department of Internal MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Aileen Aylward
- Department of Emergency MedicineUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Jan Busby‐Whitehead
- Division of GeriatricsUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Timothy F. Platts‐Mills
- Department of Emergency MedicineUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Gail D'Onofrio
- Department of Emergency MedicineYale School of MedicineNew HavenConnecticutUSA
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9
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Alshehri MM, Alenazi AM, Hoover JC, Alothman SA, Phadnis MA, Rucker JL, Befort CA, Miles JM, Kluding PM, Siengsukon CF. Effect of Cognitive Behavioral Therapy for Insomnia on Insomnia Symptoms for Individuals With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14647. [PMID: 31855189 PMCID: PMC6940863 DOI: 10.2196/14647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Insomnia symptoms are a common form of sleep difficulty among people with type 2 diabetes (T2D) affecting sleep quality and health outcomes. Several interventional approaches have been used to improve sleep outcomes in people with T2D. Nonpharmacological approaches, such as cognitive behavioral therapy for insomnia (CBT-I), show promising results regarding safety and sustainability of improvements, although CBT-I has not been examined in people with T2D. Promoting sleep for people with insomnia and T2D could improve insomnia severity and diabetes outcomes. Objective The objective of this study is to establish a protocol for a pilot randomized controlled trial (RCT) to examine the effect of 6 sessions of CBT-I on insomnia severity (primary outcome), sleep variability, and other health-related outcomes in individuals with T2D and insomnia symptoms. Methods This RCT will use random mixed block size randomization with stratification to assign 28 participants with T2D and insomnia symptoms to either a CBT-I group or a health education group. Outcomes including insomnia severity; sleep variability; diabetes self-care behavior (DSCB); glycemic control (A1c); glucose level; sleep quality; daytime sleepiness; and symptoms of depression, anxiety, and pain will be gathered before and after the 6-week intervention. Chi-square and independent t tests will be used to test for between-group differences at baseline. Independent t tests will be used to examine the effect of the CBT-I intervention on change score means for insomnia severity, sleep variability, DSCB, A1c, fatigue, sleep quality, daytime sleepiness, and severity of depression, anxiety, and pain. For all analyses, alpha level will be set at .05. Results This study recruitment began in February 2019 and was completed in September 2019. Conclusions The intervention, including 6 sessions of CBT-I, will provide insight about its effect in improving insomnia symptoms, sleep variability, fatigue, and diabetes-related health outcomes in people with T2D and those with insomnia symptoms when compared with control. Trial Registration ClinicalTrials.gov NCT03713996; https://clinicaltrials.gov/ct2/show/NCT03713996 International Registered Report Identifier (IRRID) DERR1-10.2196/14647
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Affiliation(s)
- Mohammed M Alshehri
- University of Kansas Medical Center, Lenexa, KS, United States.,Jazan University, Jazan, Saudi Arabia
| | - Aqeel M Alenazi
- University of Kansas Medical Center, Kansas City, KS, United States.,Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Jeffrey C Hoover
- University of Kansas Medical Center, Kansas City, KS, United States
| | | | - Milind A Phadnis
- University of Kansas Medical Center, Kansas City, KS, United States
| | - Jason L Rucker
- University of Kansas Medical Center, Kansas City, KS, United States
| | | | - John M Miles
- University of Kansas Medical Center, Kansas City, KS, United States
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10
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Abstract
Background: Injuries are considered as an emerging public health problem in India. Globally every year, injuries kill more than 5 million people, and by 2020, injuries will be the third-leading cause of death and disability worldwide. The study aimed to assess the prevalence and characteristics of nonfatal home injuries among the elderly in Tamil Nadu. Methodology: A cross-sectional analytical study was conducted among 1139 elderly (60 years and above), sampled from three districts of Tamil Nadu, India. Probability proportional to size sampling technique was used for sampling; a pretested questionnaire was used to collect the data. Results: Prevalence of nonfatal home injuries among elderly within the past 1 year was 14.6% (12.5–16.7 at 95% confidence interval), (n = 1003), among those injured, 94.5% were unintentionally injured and 5.5% were of intentional nature. When classified according to the types of injuries, majority of them had fall injuries (6.7%) followed by minor domestic injuries (5.4%), animal-related injury (0.2%), burn injuries (1.1%), road traffic injury (0.4%), and suicide attempt (0.8%). Majority of the respondents were in the age group of young-old, 60–69 years of age (84%), and there was more number of males (55%) in the study. Conclusion: The study reveals that nonfatal home injuries among elderly are an emerging public health problem, unintentional injuries contribute to the majority of the injuries, fall was the single largest contributor for all injuries among elderly.
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Affiliation(s)
- Alex Joseph
- Division of Epidemiology, School of Public Health, SRM IST, Kancheepuram, Tamil Nadu, India
| | - M Bagavandas
- Division of Biostatistics, School of Public Health, SRM IST, Kancheepuram, Tamil Nadu, India
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11
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Nixon SJ, Lewis B. Clarifying the neurobehavioral sequelae of moderate drinking lifestyles and acute alcohol effects with aging. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:39-78. [PMID: 31733667 DOI: 10.1016/bs.irn.2019.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Epidemiological estimates indicate not only an increase in the proportion of older adults, but also an increase in those who continue moderate alcohol consumption. Substantial literatures have attempted to characterize health benefits/risks of moderate drinking lifestyles. Not uncommonly, reports address outcomes in a single outcome, such as cardiovascular function or cognitive decline, rather than providing a broader overview of systems. In this narrative review, retaining focus on neurobiological considerations, we summarize key findings regarding moderate drinking and three health domains, cardiovascular health, Type 2 diabetes (T2D), and cognition. Interestingly, few investigators have studied bouts of low/moderate doses of alcohol consumption, a pattern consistent with moderate drinking lifestyles. Here, we address both moderate drinking as a lifestyle and as an acute event. Review of health-related correlates illustrates continuing inconsistencies. Although substantive reductions in risk for cardiovascular and T2D events are reported, robust conclusions remain elusive. Similarly, whereas moderate drinking is often associated with enhanced cognition and lower dementia risk, few benefits are noted in rates of decline or alterations in brain structure. The effect of sex/gender varies across health domains and by consumption levels. For example, women appear to differentially benefit from alcohol use in terms of T2D, but experience greater risk when considering aspects of cardiovascular function. Finally, we observe that socially relevant alcohol doses do not consistently impair performance in older adults. Rather, older drinkers demonstrate divergent, but not necessarily detrimental, patterns in neural activation and some behavioral measures relative to younger drinkers. Taken together, the epidemiological and laboratory studies reinforce the need for greater attention to key individual differences and for the conduct of systematic studies sensitive to age-related shifts in neurobiological systems.
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Affiliation(s)
- Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States.
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States
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12
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Lee YH, Lu P, Chang YC, Shelley M, Lee YT, Liu CT. Associations of alcohol consumption status with activities of daily living among older adults in China. J Ethn Subst Abuse 2019; 20:428-443. [PMID: 31530097 DOI: 10.1080/15332640.2019.1664961] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND With the rapid growth of the elderly population and public health challenges in China, concerns arise related to disability associated with activities of daily living (ADLs) and alcohol consumption status. This study assesses the relationships of alcohol consumption status with basic daily activities among Chinese older adults. METHODS A total of 5,133 participants aged 60 years or above from three waves of the Chinese Longitudinal Healthy Longevity Survey (2009, 2012, and 2014) were analyzed. Independent ADL items included bathing, dressing, toileting, indoor moving, continence, and feeding (without others' assistance). Multilevel ordered logistic regression model estimation was used to examine the results of total scores based on the Katz index. Multilevel logistic regression models also were estimated to study each index item separately to examine differences across each of the six ADLs. Additional confirmatory factor analysis (CFA) was performed to examine the validity of the index. RESULTS Preliminary CFA showed that most items had good factor loadings (>0.700), except for continence (0.256) and feeding (0.481). Based on the ordered regression model, former (AOR = 0.412, 95% CI: 0.294, 0.579, p < 0.001) and non-alcohol consumption (AOR = 0.598, 95% CI: 0.447, 0.800, p < 0.001) were negatively associated with the total score. Non-alcohol consumption status was negatively associated with ADL items separately (all ps < 0.05), with the exceptions of continence and feeding. CONCLUSION Alcohol consumption may be associated with Chinese older adults' better ADLs. However, further clinical or experimental trials are needed to examine the impact of alcohol consumption on older adults' ADLs.
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Zanjani F, Allen HK, Beck KH. Alcohol, Driving, and Health among Community-dwelling Older Adults. HEALTH BEHAVIOR AND POLICY REVIEW 2019; 6:315-326. [PMID: 34095333 PMCID: PMC8174795 DOI: 10.14485/hbpr.6.4.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this investigation was to examine the relationships among alcohol use, driving behavior, and indicators of health among older adults. METHODS A sample of 818 adults ages 65 and older were recruited through the state motor vehicle administration and completed an online survey. Regression models were used to assess the associations between alcohol use, driving behaviors, and 6 health indicators. RESULTS Whereas more frequent alcohol use was associated with fewer health conditions, higher quantity alcohol use was associated with increased likelihood of having at least one health condition. Participants who drove several days a week and those who drove every day had higher perceived health status, a lower number of past-year health conditions, and a lower number of past-year health events when compared to less frequent drivers. Persons who had at least one past-year negative driving behavior or event were significantly less likely to have positive health status, had lower perceived health status, and had a higher number of past-year health conditions and events. CONCLUSIONS High quantity alcohol use and risky driving behavior among older adults are indicative of poorer health. Continued efforts are needed to educate older adults on the relationships among alcohol use, driving behavior, and health.
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Beck KH, Zanjani F, Allen HK. Social context of drinking among older adults: Relationship to alcohol and traffic risk behaviors. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2019; 64:161-170. [PMID: 33162781 PMCID: PMC7643866 DOI: 10.1016/j.trf.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Alcohol use among older adults is a major public health concern given potentially negative effects to health and functioning in this population. Little is known about context in which alcohol use among older adults occurs, or how context of use is associated with risk behaviors. METHOD Invitation letters were mailed to licensed drivers 65 years and older in Maryland. A total of 825 participants completed an online survey that assessed demographic characteristics, alcohol use, social context of drinking, and driving behaviors. RESULTS The analytic sample consisted of 604 older adult current drinkers (55% male). A factor analysis revealed three separate contexts of drinking: social facilitation, emotional comfort, and relaxation. Drinking in the context of social facilitation was associated with driving after drinking. Drinking in the context of emotional comfort was associated with getting drunk, driving after drinking, and running a stop sign or red light. Drinking in the context of relaxation was associated with traffic risk behaviors, including running a stop sign or red light and getting in a near crash or collision. CONCLUSIONS Understanding the social context of alcohol use among older adults may be useful for targeting and attempting to modify risky alcohol use and driving behaviors.
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Affiliation(s)
- Kenneth H. Beck
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Faika Zanjani
- Virginia Commonwealth University, College of Health Professions, 1200 E. Broad Street, Box 980233, Richmond, VA 23298, USA
| | - Hannah K. Allen
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
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Linden-Carmichael AN, Dziak JJ, Lanza ST. Dynamic Features of Problematic Drinking: Alcohol Use Disorder Latent Classes Across Ages 18-64. Alcohol Alcohol 2019; 54:97-103. [PMID: 30351364 DOI: 10.1093/alcalc/agy074] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/04/2018] [Indexed: 01/09/2023] Open
Abstract
Aims Alcohol use disorders (AUDs) are linked with numerous severe detrimental outcomes. Evidence suggests that there is a typology of individuals with an AUD based on the symptoms they report. Scant research has identified how these groups may vary in prevalence by age, which could highlight aspects of problematic drinking behavior that are particularly salient at different ages. Our study aimed to (a) identify latent classes of drinkers with AUD that differ based on symptoms of AUD and (b) examine prevalences of latent classes by age. Short summary Our findings advocate for personalized treatment approaches for AUD and highlight the need for carefully considering the role of age in prevention and intervention efforts. Methods We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Current drinkers aged 18-64 who met criteria for a past-year AUD were included (n = 5402). Results Latent class analysis (LCA) based on 11 AUD criteria revealed 5 classes: 'Alcohol-Induced Injury' (25%), 'Highly Problematic, Low Perceived Life Interference' (21%), 'Adverse Effects Only' (34%), 'Difficulty Cutting Back' (13%) and 'Highly Problematic' (7%). Using time-varying effect modeling (TVEM), each class was found to vary in prevalence across age. The Adverse Effects Only and Highly Problematic, Low Perceived Life Interference classes were particularly prevalent among younger adults, and the Difficulty Cutting Back and Alcohol-Induced Injury classes were more prevalent as age increased. Conclusions Findings suggest that experience of AUD is not only heterogeneous in nature but also that the prevalence of these subgroups vary across age.
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Affiliation(s)
- Ashley N Linden-Carmichael
- Department of Biobehavioral Health and the Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health, University Park, PA, USA
| | - John J Dziak
- The Methodology Center, The Pennsylvania State University, 408 Health and Human Development Building, University Park, PA, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health and the Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health, University Park, PA, USA
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16
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Dezengrini E. Knowledge of the characteristics and properties of wine before consumers. BIO WEB OF CONFERENCES 2019. [DOI: 10.1051/bioconf/20191204013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The understanding of the satisfaction of wine consumers and the reasons why it is consumed presents a challenge, since there is not much research on this subject. For this reason, a consumer satisfaction survey was carried out to observe the relevant and determinant attributes related to the reasons why they drink wine. A total of 300 consumers, between 21 and 88 years old, were interviewed in the city of Cascavel, in the state of Paraná. It was noted that 57.67% of consumers reported as “important” or “very important” the fact that wine contributes to the prevention of heart diseases, a determining attribute when choosing wine, regardless of the side dishes. About 55% of the interviewees considered the fact that the wine is aromatic and fruity as “important” or “very important”. On the attribute indicating that wine is good to forget the problems, only 14.34% of consumers consider it “important” or “very important” at the time of the choice. The item response theory was observed to be an important tool to evaluate the level of satisfaction of wine consumers.
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Han JT, Park IS, Kang SB, Seo BG. Developing the High-Risk Drinking Scorecard Model in Korea. Osong Public Health Res Perspect 2018; 9:231-239. [PMID: 30402378 PMCID: PMC6202019 DOI: 10.24171/j.phrp.2018.9.5.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey. Methods Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression. Results This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors. Conclusion A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.
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Affiliation(s)
- Jun-Tae Han
- Department of Student Aid Policy Research, Korea Student Aid Foundation, Daegu, Korea
| | - Il-Su Park
- Department of Health Management, Uiduk University, Gyeongju, Korea
| | - Suk-Bok Kang
- Department of Statistics, Yeungnam University, Gyeongsan, Korea
| | - Byeong-Gyu Seo
- Department of Statistics, Yeungnam University, Gyeongsan, Korea
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Doubova SV, Ferreira-Hermosillo A, Pérez-Cuevas R, Barsoe C, Gryzbowski-Gainza E, Valencia JE. Socio-demographic and clinical characteristics of type 1 diabetes patients associated with emergency room visits and hospitalizations in Mexico. BMC Health Serv Res 2018; 18:602. [PMID: 30075779 PMCID: PMC6091092 DOI: 10.1186/s12913-018-3412-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To describe the demographic and clinical characteristics of Type 1 diabetes (T1D) patients affiliated with the Mexican Institute of Social Security (IMSS) and ascertain the socio-demographic and clinical risk factors associated with emergency room (ER) visits and diabetes-related hospitalizations. METHODS We conducted secondary data analysis of a cross-sectional study. The study included T1D patients 18 years of age and older who in 2016 attended follow-up visits at the endocrinology department of two IMSS tertiary care hospitals in Mexico City. The study variables included demographics, acute and chronic complications, and healthcare services utilization. Multiple Poisson and negative binomial regressions served to determine the association between the study covariates and the dependent variables: ER visits and diabetes-related hospitalizations. RESULTS The study included 192 patients, of which 29.2% were men; average age was 32.3 years, with only 13.6% controlled (glycosylated hemoglobin (HbA1C) < 7%); the mean HbA1C was 9.2, and 64.6% presented chronic complications. During 2016, 39.0% visited ER services, and 33.9% were hospitalized. The common risk factors for ER visits and hospitalization were older age at the beginning of diabetes, severe acute complications, chronic microvascular and macrovascular complications, and other comorbidities. Female sex, high school education, depression, and repeated visits to the endocrinologist were associated with ER visits, whereas active smoking and the interaction between diabetes duration > 10 years and HbA1c > 9.0% were additional risk factors for hospitalization. CONCLUSION The poor clinical conditions of T1D patients contribute to explain the escalating demand for health services for diabetes patients at the IMSS. The identification of risk factors enables focalizing interventions to improve the health outcomes of T1D patients and reduce the proportion of ER visits and hospital admissions.
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Affiliation(s)
- Svetlana V. Doubova
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Col. Doctores, 06720 Mexico City, Mexico
| | - Aldo Ferreira-Hermosillo
- Unidad de Investigación en Endocrinología Experimental, Hospital de Especialidades del CMN siglo XXI, Mexico City, Mexico
| | - Ricardo Pérez-Cuevas
- Center for Health Systems Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Casper Barsoe
- Diabetes Health Economics & Reimbursement, Medtronic, Devonshire St 18000, Northridge, CA 91325-1219 USA
| | | | - Juan E. Valencia
- Diabetes Health Economics & Reimbursement, Medtronic, NW 41st Street 9850, Miami, FL 33178 USA
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Krug RDR, Schneider IJC, Giehl MWC, Antes DL, Confortin SC, Mazo GZ, Xavier AJ, d'Orsi E. Sociodemographic, behavioral, and health factors associated with positive self-perceived health of long-lived elderly residents in Florianópolis, Santa Catarina, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180004. [PMID: 30088589 DOI: 10.1590/1980-549720180004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to identify the factors associated with positive self-perceived health of long-lived elderly (80+) individuals. This cross-sectional study was conducted in the city of Florianópolis, Santa Catarina, Brazil, and included 239 elderly participants from the EpiFloripa Ageing Project. We used collection instruments to verify sociodemographic and economic data, self-reported health status, falls, and lifestyle. Then, we identified factors associated with positive self-perceived health using a Poisson regression adjusted for sex. We found that a positive self-reported health status was more prevalent among the long-lived elderly who were not depressed (PR = 0.49), and among those who consumed alcohol (PR = 1.99). Understanding which variables may interfere in the self-perceived health of the long-lived elderly can result in better health options for this population, mainly, new methods to prevent depression. Additionally, this information can help reduce costs associated with hospitalizations, medications and health treatments, all of which are very common among the long-lived elderly.
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Affiliation(s)
- Rodrigo de Rosso Krug
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | | | - Danielle Ledur Antes
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Susana Cararo Confortin
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Giovana Zarpellon Mazo
- Programa de Pós-Graduação em Ciências do Movimento Humano, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - André Junqueira Xavier
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Eleonora d'Orsi
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Shah M, Paulson D, Nguyen V. Alcohol Use and Frailty Risk among Older Adults over 12 Years: The Health and Retirement Study. Clin Gerontol 2018; 41:315-325. [PMID: 28990855 DOI: 10.1080/07317115.2017.1364681] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The primary goal was to examine the relationship between alcohol use and frailty, a variable characterizing late-life decline, in a national, longitudinal survey of older adults living in the United States. METHODS The sample drawn from the Health and Retirement Study included 9,499 stroke-free participants over age 65 in 2000. The sample was 59.1% female, and had a mean age of 74.25 years (SD = 6.99). Follow-up data was from 2004, 2008, and 2012. Frailty was defined phenotypically using the Paulson-Lichtenberg Frailty Index (PLFI). Alcohol use was measured via self-report. Control variables included age, race, education, socio-economic status (SES), depressive symptomatology, medical burden score, body mass index (BMI), and partner status. With abstinent participants as the reference group, logistic regressions were conducted to determine prevalent frailty at 2000, and Cox's proportional hazard models were utilized to determine time to incident frailty over a 12-year period. RESULTS Results revealed that age, depressive symptomatology, and medical burden score were significant positive correlates of prevalent and incident frailty (p < .05) for both males and females. Logistic regressions revealed that consumption of 1-7 alcoholic drinks per week was associated with reduced prevalent frailty (OR = .49, p < .001) for females. Survival analysis results reveal that compared with nondrinkers, males and females who reportedly consumed 1-7 drinks per week had a decreased probability of incident frailty (HR = .78-081, p < .05). CONCLUSIONS Findings suggest that moderate alcohol use confers reduced frailty risk for both older men and women. Future research should examine the mechanism(s) relating alcohol consumption and frailty. CLINICAL IMPLICATIONS Findings support extant literature suggesting some healthcare benefits may be associated with moderate drinking.
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Affiliation(s)
- Mona Shah
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
| | - Daniel Paulson
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
| | - Vu Nguyen
- a Department of Psychology , University of Central Florida , Orlando , Florida, USA
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21
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Lewis B, Garcia CC, Nixon SJ. Drinking patterns and adherence to "low-risk" guidelines among community-residing older adults. Drug Alcohol Depend 2018; 187:285-291. [PMID: 29698895 PMCID: PMC6324529 DOI: 10.1016/j.drugalcdep.2018.02.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Older adults constitute a rapidly expanding proportion of the U.S. POPULATION Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance. METHODS Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern. RESULTS Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups. CONCLUSIONS These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults.
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Affiliation(s)
- Ben Lewis
- University of Florida, Department of Psychiatry, PO Box 100256, 1149 Newell Dr., L4-100 Gainesville, FL, 32610, USA.
| | - Christian C Garcia
- University of Florida, Department of Psychiatry, PO Box 100256, 1149 Newell Dr., L4-100 Gainesville, FL, 32610, USA
| | - Sara Jo Nixon
- University of Florida, Department of Psychiatry, PO Box 100256, 1149 Newell Dr., L4-100 Gainesville, FL, 32610, USA
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Towers A, Philipp M, Dulin P, Allen J. The "Health Benefits" of Moderate Drinking in Older Adults may be Better Explained by Socioeconomic Status. J Gerontol B Psychol Sci Soc Sci 2018; 73:649-654. [PMID: 27927745 DOI: 10.1093/geronb/gbw152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 11/10/2016] [Indexed: 12/29/2022] Open
Abstract
Objectives To assess whether a relationship between alcohol use and health exists for older adults before and after controlling for proxy and full indicators of socioeconomic status (SES). Method Secondary analysis of data from 2,908 participants in the New Zealand Longitudinal Study of Ageing (2012) completing measures of alcohol use, health, SES proxies (income, education) and SES. Sample mean age was 65, 52% were female, more than 80% were drinkers, and more than 75% had educational qualifications. Results Moderate drinkers had better health and SES than heavier or nondrinkers. The positive influence of moderate alcohol consumption on health was observed for men and women when controlling for SES proxies, but was substantially reduced in women and completely disappeared for men when controlling for full SES. Discussion SES plays a key role in presumed "heath benefits" of moderate alcohol consumption for older adults. It accounts for any alcohol-health relationship in a sample of men of whom 45% consume at least one drink daily, and substantially attenuates the association between alcohol and health in a sample of women who are not frequent drinkers. Prior research may have missed the influence of SES on this alcohol-health relationship due to the use of incomplete SES measures.
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Affiliation(s)
- Andy Towers
- School of Public Health, Massey University, Palmerston North, New Zealand
| | - Michael Philipp
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Patrick Dulin
- Department of Psychology, University of Alaska, Anchorage
| | - Joanne Allen
- School of Psychology, Massey University, Palmerston North, New Zealand
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Zanjani F, Allen H, Schoenberg N, Martin C, Clayton R. Acceptability of intervention materials to decrease risk for alcohol and medication interactions among older adults. EVALUATION AND PROGRAM PLANNING 2018; 67:160-166. [PMID: 29334631 PMCID: PMC5835203 DOI: 10.1016/j.evalprogplan.2017.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The majority of older adults take prescription or over-the-counter medications and about half consume alcohol regularly. Despite high risk for alcohol medication interactions (AMI), few community-level interventions exist to prevent AMI. The current study assessed the acceptability of educational materials created for use in a brief intervention to prevent AMI among older adults. METHODS Older adults from two senior centers reviewed intervention materials (poster, patient and pharmacist brochures, and public service announcement) and participated in a pre and post-test to provide feedback and to assess changes in AMI-related awareness and intentions. RESULTS Post-test data showed positive feedback and an increase in participant understanding of AMI prevention, with statistically significant changes in perceived importance of messaging surrounding risky alcohol use and potential consequences of AMI. DISCUSSION The intervention materials were positively received, and participant feedback indicated that the collective presentation of all the materials was the most preferred tool for educating the community. With positive trends in awareness and knowledge, intervention effectiveness needs to be further evaluated in future large-scale studies. LESSONS LEARNED This study provides health education specialists with tools to prevent alcohol and medication interactions among older adults.
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Affiliation(s)
- Faika Zanjani
- Virginia Commonwealth University, School of Allied Health Professions, 730 East Broad Street, Richmond, VA, 23298, USA.
| | - Hannah Allen
- University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD, 20742, USA.
| | - Nancy Schoenberg
- University of Kentucky College of Public Health, 111 Washington Ave., Lexington, KY, 40536, USA.
| | - Catherine Martin
- University of Kentucky College of Medicine, UK Medical Center MN 150, Lexington, KY, 40536, USA.
| | - Richard Clayton
- University of Kentucky College of Public Health, 111 Washington Ave., Lexington, KY, 40536, USA.
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Zanjani F, Allen H, Schoenberg N, Martin C, Clayton R. Sustained Intervention Effects on Older Adults' Attitudes Towards Alcohol and Medication Interactions. AMERICAN JOURNAL OF HEALTH EDUCATION 2018; 49:66-73. [PMID: 30740192 DOI: 10.1080/19325037.2017.1414641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background Older adults are at risk for experiencing alcohol and medication interactions (AMI) given concomitant alcohol and medication use. However, there have been limited efforts to develop and evaluate AMI prevention interventions. Purpose The current study examined sustained intervention effects on older adults' attitudes, awareness, and intentions regarding AMI. Methods A sample of N = 134 older adults completed assessments before and after exposure to AMI risk educational materials (Times 1 and 2). N = 97 participants (72%) were reached for a three-month follow-up phone call (Time 3). Results There was a positive linear trend over time in the number of identified AMI side effects. While knowledge of intervention messages remained high and stable over time, quadratic trends for perceived importance of AMI messages indicated positive short-term effects that did not sustain over time. Few differences by drinking status were found. Discussion This intervention had positive short-term effects on AMI awareness, intentions, and perceived messaging importance, but these short-term effects were only maintained over time for awareness. Translation to Health Education Practice This study provides Certified Health Education Specialists with a model for planning and evaluating a brief intervention to prevent AMI among older adults.
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Affiliation(s)
- Faika Zanjani
- Virginia Commonwealth University School of Allied Health Professions,
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25
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Vafeas C, Graham R, de Jong G, Sharp J, Ngune I, Maes S. Alcohol consumption patterns of older adults: a study in a regional town in Western Australia. Contemp Nurse 2017; 53:647-657. [PMID: 29279033 DOI: 10.1080/10376178.2017.1421051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM This study aimed to demonstrate that opportunistic health screening at health expos can provide an overall impression of alcohol consumption patterns. DESIGN A repeated cross-sectional survey design, completed over a four-year period (2011-2014), was used to assess the risk of harmful alcohol consumption, within a community setting of older adults, in the South West region of Western Australia. METHODS An alcohol screening survey (AUDIT) was used to collect data on alcohol consumption patterns on those aged 65 years and over. A total of 411 surveys were completed. RESULTS There was a statistically significant difference in mean risk scores across the four years (p < .001). 6.3-22.2% of survey completers presented as 'risky', and a further 3.8-12.3% as 'high risk' in terms of alcohol consumption. CONCLUSIONS Opportunistic screening for alcohol consumption during health expos can aid the identification of at-risk individuals who may require further education or treatment.
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Affiliation(s)
- Caroline Vafeas
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Renee Graham
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Gideon de Jong
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Jennie Sharp
- b School of Nursing & Midwifery , Edith Cowan University , Bunbury , Australia
| | - Irene Ngune
- c School of Nursing, Midwifery & Paramedicine , Curtin University , Bentley , Australia
| | - Saskia Maes
- d Edith Cowan College, Edith Cowan University , Joondalup , Australia
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Chavez LJ, Liu CF, Tefft N, Hebert PL, Devine B, Bradley KA. The Association Between Unhealthy Alcohol Use and Acute Care Expenditures in the 30 Days Following Hospital Discharge Among Older Veterans Affairs Patients with a Medical Condition. J Behav Health Serv Res 2017; 44:602-624. [PMID: 27585803 PMCID: PMC5332352 DOI: 10.1007/s11414-016-9529-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hospital readmissions and emergency department (ED) visits within 30 days of discharge are costly. Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use. Veterans Affairs (VA) patients age ≥65 years with past-year alcohol screening, hospitalized for a medical condition, were included. VA and Medicare health care utilization data were used. Two-part models adjusted for patient demographics. Among 416,050 hospitalized patients, 25% had 30-day acute care use. Nondrinking patients (n = 267,746) had increased probability of acute care use, mean utilization days, and expenditures (difference of $345; 95% CI $268-$423), relative to low-risk drinkers (n = 105,023). High-risk drinking patients (n = 5,300) had increased probability of acute care use and mean utilization days, but not expenditures. Although these patients did not have greater acute care expenditures than low-risk drinking patients, they may nevertheless be vulnerable to poor post-discharge outcomes.
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Affiliation(s)
- Laura J Chavez
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA.
| | - Chuan-Fen Liu
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
- Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Nathan Tefft
- Bates College, 2 Andrews Rd, Lewiston, ME, 04240, USA
| | - Paul L Hebert
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
- Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Beth Devine
- Department of Pharmacy, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
| | - Katharine A Bradley
- Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
- Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
- Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
- Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA
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Liu Y, Xie Y, Brossoie N, Roberto KA, Redican KJ. Alcohol Consumption and Factors Associated With Depressive Symptoms Among Older Adults in Mainland China. AMERICAN JOURNAL OF HEALTH EDUCATION 2017. [DOI: 10.1080/19325037.2017.1358123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Affiliation(s)
- Yujun Liu
- Virginia Polytechnic Institute and State University
| | - Yimeng Xie
- Virginia Polytechnic Institute and State University
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Linden-Carmichael AN, Vasilenko SA, Lanza ST, Maggs JL. High-Intensity Drinking Versus Heavy Episodic Drinking: Prevalence Rates and Relative Odds of Alcohol Use Disorder Across Adulthood. Alcohol Clin Exp Res 2017; 41:1754-1759. [PMID: 28800154 DOI: 10.1111/acer.13475] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Heavy episodic drinking (HED) or consuming 4+/5+ drinks in 1 occasion for women/men is linked consistently with alcohol-related harms. Recent research suggests that many individuals drink at levels more than twice this cutoff (8+/10+ drinks), commonly referred to as "high-intensity drinking." Prevalence rates of high-intensity drinking and its dynamic association with alcohol use disorder (AUD) across all ages, however, remain unknown. The current study used data from a nationally representative sample to document age-varying prevalence rates of HED-only drinking and high-intensity drinking, prevalence rates of AUD for HED-only drinkers and high-intensity drinkers, and relative odds of experiencing an AUD for high-intensity drinkers as compared to HED-only drinkers. METHODS Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. The final analytic sample consisted of past-year drinkers aged 18 to 64 years (n = 22,776). RESULTS Time-varying effect modeling revealed that high-intensity drinking and HED-only drinking were equally prevalent during young adulthood and prevalence rates of both types of drinking generally became less common with increasing age. At all ages, high-intensity drinkers were at 3 or more times greater odds of meeting criteria for an AUD than HED-only drinkers. The association between high-intensity relative to HED-only drinking was strongest earlier in adulthood with approximately 83% of 18-year-old high-intensity drinkers having AUD relative to 42% of HED-only drinkers. CONCLUSIONS Future research aiming to identify drinkers most at risk of harms and in need of treatment may benefit from assessing the extent to which an individual exceeds the 8+/10+ threshold of drinking.
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Affiliation(s)
- Ashley N Linden-Carmichael
- Department of Biobehavioral Health and The Methodology Center (ANL-C, STL), The Pennsylvania State University, University Park, Pennsylvania
| | - Sara A Vasilenko
- The Methodology Center (SAV), The Pennsylvania State University, University Park, Pennsylvania
| | - Stephanie T Lanza
- Department of Biobehavioral Health and The Methodology Center (ANL-C, STL), The Pennsylvania State University, University Park, Pennsylvania
| | - Jennifer L Maggs
- Human Development and Family Studies (JLM), The Pennsylvania State University, University Park, Pennsylvania
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Kuerbis AN, Hail L, Moore AA, Muench FJ. A pilot study of online feedback for adult drinkers 50 and older: Feasibility, efficacy, and preferences for intervention. J Subst Abuse Treat 2017; 77:126-132. [PMID: 28476264 DOI: 10.1016/j.jsat.2017.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
Abstract
Normative (NF) and personalized feedback (PF) are moderately effective brief interventions for at-risk drinking middle-aged and older adults. This study tested the feasibility of online feedback for drinkers 50 and older. This study's aims were to identify whether there is differential effectiveness of PF over NF in prompting drinkers 50years old and older to plan for change and to determine potential preferences for intervention among adult drinkers 50 and older with practical knowledge about computers. METHOD Using Amazon's Mechanical Turk, 138 male and female drinkers aged 50 to 75+ were recruited to complete an online survey that asked about their: perceptions of their drinking, quantity and frequency of drinking, and any comorbid health and/or mental health disorders/medications. They were then provided either NF or PF. NF provided information about how participants' drinking compared to their same age and gendered peers. PF provided information about level of risk to health and provided recommendations for safe levels of drinking. After feedback, participants were evaluated for their reactions (e.g., "How much does this worry you?") and their plan to change their drinking. Participants were asked about preferences for interventions. RESULTS 80% of participants rated themselves a no or low-risk drinker, yet 52.2% were found to be at-risk drinkers. Overall, participants reported feedback was helpful, and 43.9% made some kind of plan to change. Participants in NF were significantly more likely to make a plan for change than those in PF. Participants reported that they most preferred an online (40.9%) or a brief in-person (31.8%) intervention. CONCLUSION Findings revealed that brief online feedback was feasible, though limited to those who are computer knowledgeable. Unexpectedly, NF outperformed PF, suggesting that peer comparisons may be more motivating for adults 50 and older than previously thought. Finally, an online intervention appears to be a preferred intervention for alcohol use among this particular group of drinkers.
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Affiliation(s)
- Alexis N Kuerbis
- Hunter College at the City University of New York, United States.
| | - Lisa Hail
- Department of Psychiatry, University of California San Francisco, United States
| | - Alison A Moore
- Division of Geriatrics, University of California San Diego, United States
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30
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Abstract
Older people consume less alcohol than any other adult age group. However, in recent years survey data on alcohol consumption in the United Kingdom have shown that while younger age groups have experienced a decline in alcohol consumption, drinking behaviours among the elderly have not reduced in the same way. This paper uses data from the English Longitudinal Study of Ageing to analyse both the frequency and quantity of older adult's alcohol consumption using a lifecourse approach over a ten-year period. Overall drinking declined over time and the analysis examined how socio-economic characteristics, partnership, employment and health statuses were associated with differences in drinking behaviours and how these changed over time. Higher wealth and level of education were associated with drinking more and drinking more frequently for men and women. Poorer self-rated health was associated with less frequent consumption and older people with poor and deteriorating health reported a steeper decline in the frequency of alcohol consumption over time. Men who were not in a partnership drank more than other men. For women, loss of a partner was associated with a steeper decline in drinking behaviours. These findings have implications for programmes to promote responsible drinking among older adults as they suggest that, for the most part, characteristics associated with sustaining wellbeing in later life are also linked to consuming more alcohol.
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31
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Canham SL, Mauro PM, Kaufmann CN, Sixsmith A. Association of Alcohol Use and Loneliness Frequency Among Middle-Aged and Older Adult Drinkers. J Aging Health 2016; 28:267-84. [PMID: 26082130 PMCID: PMC4681688 DOI: 10.1177/0898264315589579] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We examined the association between alcohol use, at-risk drinking, and binge drinking, and loneliness in a sample of middle-aged and older adults. METHOD We studied participants aged 50+ years from the 2008 wave of the Health and Retirement Study who reported alcohol use. We ran separate multinomial logistic regressions to assess the association of three alcohol use outcomes (i.e., weekly alcohol consumption, at-risk drinking, and binge drinking) and loneliness. RESULTS After adjusting for covariates, being lonely was associated with reduced odds of weekly alcohol consumption 4 to 7 days per week, but not 1 to 3 days per week, compared with average alcohol consumption 0 days per week in the last 3 months. No association was found between at-risk drinking or binge drinking and loneliness. DISCUSSION Results suggest that among a sample of community-based adults aged 50+, loneliness was associated with reduced alcohol use frequency, but not with at-risk or binge drinking.
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Affiliation(s)
- Sarah L. Canham
- Gerontology Research Centre, Simon Fraser University, 2800 - 515 West Hastings Street Vancouver, BC V6B 5K3, 604-618-7933
| | - Pia M. Mauro
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Rm. 894, Baltimore, MD 21205, 443-287-0147
| | - Christopher N. Kaufmann
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Rm. 798, Baltimore, MD 21205, 323-528-2786
| | - Andrew Sixsmith
- Gerontology Research Centre, Simon Fraser University, 2800 - 515 West Hastings Street Vancouver, BC V6B 5K3, 778-782-5375
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32
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Acute Behavioral and Long-Term Health Effects of Moderate Alcohol Use in Older Adults. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0087-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Raivio M, Kautiainen H, Immonen S, Pitkälä K. Alcohol use and happiness among retired Finns living in Spain compared to those in Finland. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.11.005] [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]
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Holdsworth C, Mendonça M, Pikhart H, Frisher M, de Oliveira C, Shelton N. Is regular drinking in later life an indicator of good health? Evidence from the English Longitudinal Study of Ageing. J Epidemiol Community Health 2016; 70:764-70. [PMID: 26797821 PMCID: PMC4975801 DOI: 10.1136/jech-2015-206949] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/01/2016] [Indexed: 02/02/2023]
Abstract
Background Older people who drink have been shown to have better health than those who do not. This might suggest that moderate drinking is beneficial for health, or, as considered here, that older people modify their drinking as their health deteriorates. The relationship between how often older adults drink and their health is considered for two heath states: self-rated health (SRH) and depressive symptoms. Methods Data were analysed from the English Longitudinal Study of Ageing (ELSA), a prospective cohort study of older adults, using multilevel ordered logit analysis. The analysis involved 4741 participants present at wave 0, (1998/1999 and 2001), wave 4 (2008/2009) and wave 5 (2010/2011). The outcome measure was frequency of drinking in last year recorded at all three time points. Results Older adults with fair/poor SRH at the onset of the study drank less frequently compared with adults with good SRH (p<0.05). Drinking frequency declined over time for all health statuses, though respondents with both continual fair/poor SRH and declining SRH experienced a sharper reduction in the frequency of their drinking over time compared with older adults who remained in good SRH or whose health improved. The findings were similar for depression, though the association between depressive symptoms and drinking frequency at the baseline was not significant after adjusting for confounding variables. Conclusions The frequency of older adults’ drinking responds to changes in health status and drinking frequency in later life may be an indicator, rather than a cause, of health status.
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Affiliation(s)
- Clare Holdsworth
- School of Physical and Geographical Sciences, Keele University, Keele, UK
| | - Marina Mendonça
- School of Physical and Geographical Sciences, Keele University, Keele, UK
| | - Hynek Pikhart
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Nicola Shelton
- Department of Epidemiology & Public Health, University College London, London, UK
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Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1609-40. [PMID: 26210739 PMCID: PMC4618096 DOI: 10.1007/s00127-015-1088-0] [Citation(s) in RCA: 270] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/28/2015] [Indexed: 01/12/2023]
Abstract
PURPOSE The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking. METHOD NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized. RESULT The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers. CONCLUSIONS Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, New York, NY, 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3077, Rockville, MD, 20852, USA.
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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
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Frisher M, Mendonça M, Shelton N, Pikhart H, de Oliveira C, Holdsworth C. Is alcohol consumption in older adults associated with poor self-rated health? Cross-sectional and longitudinal analyses from the English Longitudinal Study of Ageing. BMC Public Health 2015. [PMID: 26205898 PMCID: PMC4513636 DOI: 10.1186/s12889-015-1993-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increases in alcohol related mortality and morbidity have been reported among older people in England over the last decade. There is, however, evidence that drinking is protective for some health conditions. The validity of this evidence has been questioned due to residual confounding and selection bias. The aim of this study is to clarify which drinking profiles and other demographic characteristics are associated with poor self-rated health among a community-based sample of older adults in England. The study also examines whether drinking designated as being "increasing-risk" or "higher-risk" is associated with poorer self-rated health. METHOD This study used data from Wave 0, Wave 1 and Wave 5 of the English Longitudinal Study of Ageing [ELSA]. Logistic regression analysis, was used to examine the association between drinking profiles (based on quantity and frequency of drinking) and self-rated health, adjusting for gender, age, wealth, social class, education, household composition, smoking and body mass index [BMI]. RESULTS Twenty percent of the sample reported drinking above the recommended level at wave 0. Rates of poor self-rated health were highest among those who had stopped drinking, followed by those who never drank. The rates of poor self-rated health among non-drinkers were significantly higher than the rates of poor self-rated health for any of the groups who reported alcohol consumption. In the adjusted logistic regression models there were no drinking profiles associated with significantly higher rates of poor self-rated health relative to occasional drinkers. CONCLUSIONS Among those who drank alcohol, there was no evidence that any pattern of current alcohol consumption was associated with poor self-rated health, even after adjustment for a wide range of variables. The results associated with the stopped drinking profile indicate improvement in self-rated health can be associated with changes in drinking behaviour. Although several limitations of the study are noted, policy makers may wish to consider how these findings should be translated into drinking guidelines for older adults.
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Affiliation(s)
- Martin Frisher
- School of Pharmacy, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Marina Mendonça
- School of Physical and Geographical Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Nicola Shelton
- Department of Epidemiology and Public Health, University College, London, UK.
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College, London, UK.
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College, London, UK.
| | - Clare Holdsworth
- School of Physical and Geographical Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.
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Affiliation(s)
- Celia Wilkinson
- School of Exercise and Health Sciences, Edith Cowan University, Perth, Australia. .,National Drug Research Institute, Curtin University, Perth, Australia.
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Julie Dare
- School of Exercise and Health Sciences, Edith Cowan University, Perth, Australia
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Canham SL, Kaufmann CN, Mauro PM, Mojtabai R, Spira AP. Binge drinking and insomnia in middle-aged and older adults: the Health and Retirement Study. Int J Geriatr Psychiatry 2015; 30:284-91. [PMID: 24798772 PMCID: PMC4221579 DOI: 10.1002/gps.4139] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 04/04/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alcohol use in later life has been linked to poor sleep. However, the association between binge drinking, which is common among middle-aged and older adults, and insomnia has not been previously assessed. METHODS We studied participants aged 50 years and older (n = 6027) from the 2004 Health and Retirement Study who reported the number of days they had ≥4 drinks on one occasion in the prior 3 months. Participants also reported the frequency of four insomnia symptoms. Logistic regression analyses assessed the association between binge drinking frequency and insomnia. RESULTS Overall, 32.5% of participants had >0 to ≤2 binge drinking days/week; and 3.6% had >2 binge drinking days/week. After adjusting for demographic variables, medical conditions, body mass index, and elevated depressive symptoms, participants who binged >2 days/week had a 64% greater odds of insomnia than non-binge drinkers (adjusted odds ratio [aOR] = 1.64, 95% confidence interval [CI] = 1.09-2.47, p = 0.017). Participants reporting >0 to ≤2 binge days/week also had a 35% greater odds of insomnia than non-binge drinkers (aOR = 1.35, 95% CI = 1.15-1.59, p = 0.001). When smoking was added to the regression model, these associations fell just below the level of significance. CONCLUSIONS Results suggest that binge drinking is associated with a greater risk of insomnia among adults aged 50 years and older, although this relationship may be driven in part by current smoking behavior. The relatively high prevalence of both binge drinking and sleep complaints among middle-aged and older populations warrants further investigation into binge drinking as a potential cause of late-life insomnia.
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Affiliation(s)
- Sarah L. Canham
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Christopher N. Kaufmann
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Pia M. Mauro
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205
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40
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Sacco P, Unick GJ, Zanjani F, Camlin EAS. Hospital outcomes in major depression among older adults: differences by alcohol comorbidity. J Dual Diagn 2015; 11:83-92. [PMID: 25671685 PMCID: PMC4718396 DOI: 10.1080/15504263.2014.993295] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The prevalence of depression in older adults has been increasing over the last 20 years and is associated with economic costs in the form of treatment utilization and caregiving, including inpatient hospitalization. Comorbid alcohol diagnoses may serve as a complicating factor in inpatient admissions and may lead to overutilization of care and greater economic cost. This study sought to isolate the comorbidity effect of alcohol among older adult hospital admissions for depression. METHODS We analyzed a subsample (N = 8,480) of older adults (65+) from the 2010 Nationwide Inpatient Sample who were hospitalized with primary depression diagnoses, 7,741 of whom had depression only and 739 of whom also had a comorbid alcohol disorder. To address potential selection bias based on drinking and health status, propensity score matching was used to compare length of stay, total costs, and disposition between the two groups. RESULTS Bivariate analyses showed that older persons with depression and alcohol comorbidities were more often male (59.9% versus 34.0%, p <.001) and younger (70.9 versus 75.9 years, p <.001) than those with depression only. In terms of medical comorbidities, those with depression and alcohol disorders experienced more medical issues related to substance use (e.g., drug use diagnoses, liver disease, and suicidality; all p <.001), while those with depression only experienced more general medical problems (e.g., diabetes, renal failure, hypothyroid, and dementia; all p <.001). Propensity score matched models found that alcohol comorbidity was associated with shorter lengths of stay (on average 1.08 days, p <.02) and lower likelihood of post-hospitalization placement in a nursing home or other care facility (OR = 0.64, p <.001). No significant differences were found in overall costs or likelihood of discharge to a psychiatric hospital. CONCLUSIONS In older adults, depression with alcohol comorbidity does not lead to increased costs or higher levels of care after discharge. Comorbidity may lead to inpatient hospitalization at lower levels of severity, and depression with alcohol comorbidity may be qualitatively different than non-comorbid depression. Additionally, increased costs and negative outcomes in this population may occur at other levels of care such as outpatient services or emergency department visits.
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Affiliation(s)
- Paul Sacco
- a School of Social Work , University of Maryland , Baltimore , Maryland , USA
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Ettner SL, Xu H, Duru OK, Ang A, Tseng CH, Tallen L, Barnes A, Mirkin M, Ransohoff K, Moore AA. The effect of an educational intervention on alcohol consumption, at-risk drinking, and health care utilization in older adults: the Project SHARE study. J Stud Alcohol Drugs 2014; 75:447-57. [PMID: 24766757 DOI: 10.15288/jsad.2014.75.447] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the effectiveness of a patient-provider educational intervention in reducing at-risk drinking among older adults. METHOD This was a cluster-randomized controlled trial of 31 primary care providers and their patients ages 60 years and older at a community-based practice with seven clinics. Recruitment occurred from July 2005 to August 2007. Eligibility was determined by telephone and a baseline mailed survey. A total of 1,186 at-risk drinkers were identified by the Comorbidity Alcohol Risk Evaluation Tool. Follow-up patient surveys were administered at 3, 6, and 12 months after baseline. Study physicians and their patients were randomly assigned to usual care (n = 640 patients) versus the Project SHARE (Senior Health and Alcohol Risk Education) intervention (n = 546 patients), which included personalized reports, educational materials, drinking diaries, physician advice during office visits, and telephone counseling delivered by a health educator. Main outcomes were alcohol consumption, at-risk drinking (overall and by type), alcohol discussions with physicians, health care utilization, and screening and intervention costs. RESULTS At 12 months, the intervention was significantly associated with an increase in alcohol-related discussions with physicians (23% vs. 13%; p ≤ .01) and reductions in at-risk drinking (56% vs. 67%; p ≤ .01), alcohol consumption (-2.19 drinks per week; p ≤ .01), physician visits (-1.14 visits; p = .03), emergency department visits (16% vs. 25%; p ≤ .01), and nonprofessional caregiving visits (12% vs. 17%; p ≤ .01). Average variable costs per patient were $31 for screening and $79 for intervention. CONCLUSIONS The intervention reduced alcohol consumption and at-risk drinking among older adults. Effects were sustained over a year and may have been associated with lower health care utilization, offsetting screening and intervention costs.
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Affiliation(s)
- Susan L Ettner
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Haiyong Xu
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - O Kenrik Duru
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Alfonso Ang
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Chi-Hong Tseng
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Louise Tallen
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Ahava Center for Spiritual Living, Lexington, Kentucky (current affiliation)
| | - Andrew Barnes
- Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California, Department of Healthcare Policy and Research, School of Medicine, Virginia Commonwealth University, Richmond, Virginia (current affiliation)
| | - Michelle Mirkin
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Private practice, Los Angeles, California (current affiliation)
| | | | - Alison A Moore
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, California
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42
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Gell L, Meier PS, Goyder E. Alcohol consumption among the over 50s: international comparisons. Alcohol Alcohol 2014; 50:1-10. [PMID: 25433252 DOI: 10.1093/alcalc/agu082] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIM Research exploring alcohol consumption patterns and behaviour change among older adults is relatively scarce, often necessitating reliance on international evidence. To understand the degree to which findings may be generalizable across countries, this review compares recent epidemiological evidence from developed countries on the prevalence of abstention and potentially problematic alcohol consumption in older adults. METHODS Medline, EMBASE, Web of Science and PsychInfo were searched for English language publications, identifying 21 peer-reviewed publications and six reports, including data from 17 national surveys and 10 general practice and community samples published since 2000. RESULTS Of the developed countries for which data are available on adults aged over 50 years, rates of past 12-month abstention and former drinking are lowest in England and Finland, and highest in Korea and the USA. The prevalence of binge drinking varies widely between studies, whilst rates of alcohol dependence are broadly similar. CONCLUSIONS Older adults in developed countries report different rates of abstention and alcohol consumption. This places obvious limitations on the extrapolation of results from specific research findings and policy strategies to other countries.
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Affiliation(s)
- Lucy Gell
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
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43
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Clapp JD, Reed MB, Martel B, Gonzalez MC, Ruderman D. Drinking Behavior Among Low-Income Older Adults: A Multimethod Approach to Estimating Alcohol Use. Alcohol Clin Exp Res 2014; 38:2862-8. [DOI: 10.1111/acer.12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 08/11/2014] [Indexed: 11/29/2022]
Affiliation(s)
- John D. Clapp
- College of Social Work ; The Ohio State University; Columbus Ohio
| | - Mark B. Reed
- School of Social Work ; San Diego State University; San Diego California
| | | | - Maria C. Gonzalez
- School of Social Work ; San Diego State University; San Diego California
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44
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Abstract
Although the myth that older adults do not use mood-altering substances persists, evidence suggests that substance use among older adults has been underidentified for decades. The baby boom generation is unique in its exposure to, attitudes toward, and prevalence of substance use-causing projected rates of substance use to increase over the next twenty years. Given their unique biological vulnerabilities and life stage, older adults who misuse substances require special attention. Prevalence rates of substance use and misuse among older adults, methods of screening and assessment unique to older adults, and treatment options for older adults are reviewed.
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Affiliation(s)
- Alexis Kuerbis
- Department of Mental Health Services and Policy Research, Research Foundation for Mental Hygiene, Inc, Columbia University Medical Center, 3 Columbus Circle, Suite 1404, New York, NY 10019, USA.
| | - Paul Sacco
- University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA
| | - Dan G Blazer
- Department of Psychiatry and Behavioral Sciences, Academic Development, Duke University, DUMC 3003, Durham, NC 27710, USA
| | - Alison A Moore
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA
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45
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Wilkinson C, Dare J. Shades of Grey: The Need for a Multi-disciplinary Approach to Research Investigating Alcohol and Ageing. J Public Health Res 2014; 3:180. [PMID: 25170507 PMCID: PMC4140383 DOI: 10.4081/jphr.2014.180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 10/10/2013] [Accepted: 10/16/2013] [Indexed: 11/23/2022] Open
Abstract
This paper calls for an increase in multi-disciplinary research on the issue of alcohol and ageing, to ensure public health interventions reflect the complex and diverse needs of older drinkers. Older people (65+ years) represent a unique segment of the population; compared to adolescents and younger people, they are more likely to have a range of co-morbid conditions and be taking prescribed medication, and are more physiologically vulnerable to the effects of alcohol. This suggests that from a public health perspective, alcohol use by older people is problematic. However, as with younger people, alcohol use is closely associated with socialisation and social engagement. While social engagement is important at all stages of life, it is particularly critical as people age, when many of the formal social roles which provide a catalyst for social integration shift or are lost. Currently, however, there is little evidence of an integrated public health response to the complex issue of alcohol and ageing. That is, what is needed is a concurrent acknowledgement of the health problems that may be associated with contraindicated alcohol use, versus the potential health benefits that can accrue from social drinking. This will require a holistic rather than reductionist approach that integrates biomedical and social science insights to develop a more comprehensive and nuanced understanding of the implications of alcohol use amongst diverse populations of older people. Significance for public healthWith the rapid ageing of the global population and concerns about recent increases in the consumption of alcohol amongst older people, the issue of alcohol and ageing is becoming an important public health issue. However, there remains little research that adopts a holistic multi-disciplinary perspective. Such research is important and may offer the best way forward in terms of unravelling the complexity of competing risks and benefits associated with low to moderate drinking amongst older people.
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Affiliation(s)
- Celia Wilkinson
- Edith Cowan University, Joondalup, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Julie Dare
- Edith Cowan University, Joondalup, Australia
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46
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Interactions between age and moderate alcohol effects on simulated driving performance. Psychopharmacology (Berl) 2014; 231:557-66. [PMID: 24030469 PMCID: PMC3947134 DOI: 10.1007/s00213-013-3269-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
RATIONALE There is a substantial body of literature documenting the deleterious effects of both alcohol consumption and age on driving performance. There is, however, limited work examining the interaction of age and acute alcohol consumption. OBJECTIVES The current study was conducted to determine if moderate alcohol doses differentially affect the driving performance of older and younger adults. METHODS Healthy older (55-70) and younger (25-35) adults were tested during a baseline session and again following consumption of one of three beverages [0.0 % (placebo), 0.04 % or 0.065 % target breath alcohol concentration]. Measures of driving precision and average speed were recorded. RESULTS Older adults performed more poorly on precision driving measures and drove more slowly than younger adults at baseline. After controlling for baseline performance, interactions between alcohol and age were observed following beverage consumption on two measures of driving precision with older adults exhibiting greater impairment as a result of alcohol consumption. CONCLUSIONS These data provide evidence that older adults may be more susceptible to the effects of alcohol on certain measures of driving performance. An investigation of mechanisms accounting for alcohol's effects on driving in older and younger adults is required. Further evaluation using more complex driving environments is needed to assess the real-world implication of this interaction.
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47
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Sacco P, Smith CA, Harrington D, Svoboda DV, Resnick B. Feasibility and Utility of Experience Sampling to Assess Alcohol Consumption Among Older Adults. J Appl Gerontol 2014; 35:106-20. [PMID: 24652928 DOI: 10.1177/0733464813519009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 12/08/2013] [Indexed: 11/15/2022] Open
Abstract
In the literature on alcohol use and aging, drinking has often been conceptualized as a means of coping with negative feelings, such as stress, yet much of the literature on older adults and drinking has utilized cross-sectional or other data ill-suited for exploring dynamic processes. Experience sampling methods have the ability to measure and analyze dynamic processes in real time, such as relations between alcohol use and mood states. Nonetheless, these approaches are intensive and may burden respondents. Therefore, this study evaluated the feasibility, acceptability, and validity of a modified daily diary to measure alcohol use and explored alternate methods of collecting diary data. Findings suggest that a modified diary was acceptable and not burdensome. Respondents were reluctant to consider technology (e.g., cellphone)-based means of data collection. Measures of alcohol use showed little within-person variation suggesting that for those who drink at all, drinking is a daily habit.
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48
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Kaplan MS, Huguet N, Feeny D, McFarland BH, Caetano R, Bernier J, Giesbrecht N, Oliver L, Ramage-Morin P, Ross NA. The association between alcohol use and long-term care placement among older Canadians: a 14-year population-based study. Addict Behav 2014; 39:219-24. [PMID: 24169370 DOI: 10.1016/j.addbeh.2013.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 08/15/2013] [Accepted: 09/09/2013] [Indexed: 11/17/2022]
Abstract
Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors.
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49
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Nogueira EL, Cataldo Neto A, Cauduro MHF, Ulrich LEF, Spanemberg L, DeCarli GA, Gomes I. Prevalence and Patterns of Alcohol Misuse in a Community-Dwelling Elderly Sample in Brazil. J Aging Health 2013; 25:1340-57. [PMID: 24179052 DOI: 10.1177/0898264313506461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: The aim of this study was to estimate prevalence and patterns of lifetime alcohol misuse. Method: This was a cross-sectional study of a representative sample of 1,078 individuals aged 60 or more. Structured interview included sociodemographic, lifestyle, health data, and the five alcohol misuse screening questions of the Self-Reporting Questionnaire. Results: Prevalence of misuse was 6.5%. Men, aged 60 to 69, low educational level, separated/divorced, and tobacco smoking were independently associated with lifetime alcohol misuse. Odds ratios show increasing association with levels of alcohol misuse groups in males, low-educated, and tobacco users. Persons aged 60 to 69, 4 to 7 education years, and non-White ethnicity were significantly associated with the major alcohol misuse score. Discussion: Younger elderly were more exposed to alcohol than previous cohorts. Thus, problems with alcohol in old age will possibly increase as they grow older. The results of this study call attention to a field of lacking evidence in alcohol-related problems of older persons.
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Affiliation(s)
| | | | | | | | - Lucas Spanemberg
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Geraldo A. DeCarli
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irenio Gomes
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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50
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Ryu SY, Crespi CM, Maxwell AE. Drinking patterns among Korean adults: results of the 2009 Korean community health survey. J Prev Med Public Health 2013; 46:183-91. [PMID: 23946876 PMCID: PMC3740223 DOI: 10.3961/jpmph.2013.46.4.183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 05/31/2012] [Indexed: 11/30/2022] Open
Abstract
Objectives In Korea, the proportion of deaths due to alcohol is estimated at 8.9%, far exceeding the global estimate of 3.8%. Therefore, this study was performed to examine the factors associated with low-risk, moderate-risk, and high-risk drinking patterns in Korean adults and to identify target populations for prevention and control of alcohol-related diseases and deaths. Methods We analyzed data from 230 715 Korean adults aged 19 years and older who participated in the 2009 Korean Community Health Survey. Multinomial logistic regression analysis was used to examine associations between socio-demographic and health-related factors and patterns of alcohol use. Results A substantially larger proportion of men than women engaged in high risk (21.2% vs. 3.4%) and moderate-risk alcohol use (15.5% vs. 8.2%). In both sexes, moderate- and high-risk uses were associated with younger age, higher income, being currently employed, smoking, being overweight/obese, and good self-rated health. Conclusions Given the large proportion of the population that is engaging in moderate- and high-risk drinking and given the social norms that support this behavior, public health policies and campaigns to reduce alcohol consumption targeting the entire population are indicated.
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Affiliation(s)
- So Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea.
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