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Andrus EC, Brouwer AF, Meza R, Eisenberg MC. Latent Class Analysis of Sexual Partnerships and Substance Use Across Generations. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02960-z. [PMID: 39192054 DOI: 10.1007/s10508-024-02960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/06/2024] [Accepted: 07/13/2024] [Indexed: 08/29/2024]
Abstract
Sexually transmitted infections (STIs) remain an important public health concern for people of all age groups, with older age groups experiencing a notable increase in STI burden. Historically, most research into STI risk behaviors has focused on adolescents and young adults, leaving a paucity of research on the ways STI risk factors change over the life course. Additionally, age and cohort trends in STI risk factors can be challenging to investigate with standard statistical tools as they can be collinear and are subject to sociocultural and generational influences. To help address these issues, we used multi-group latent class analysis to identify and compare risk behavior profiles defined by responses to three sexual activity and three substance use variables, across and within four age groups. We identified six behavior profiles in the unstratified dataset and five behavior profiles in each of the four age stratified groups. The five behavior profiles identified in each of the age categories appear to reflect a similar set of five underlying profile "archetypes," with the exact composition of each age category's five profiles varying in the magnitude that specific behaviors are endorsed. Interestingly, despite the similarity of profiles across the four age groups, analyses indicate that the experience of belonging to any one of these five archetypes differs by age group. This variance is likely due group specific age, period, and cohort effects, and may indicate that, when estimating one's STI risk, it is better to compare them to their peers than to the population as a whole.
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Affiliation(s)
- Emily C Andrus
- Department of Epidemiology, University of Michigan, 2663 SPH Tower, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Andrew F Brouwer
- Department of Epidemiology, University of Michigan, 2663 SPH Tower, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, 2663 SPH Tower, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- British Columbia Cancer Research Center, Vancouver, BC, Canada
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan, 2663 SPH Tower, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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Hu J, Kulkarni N, Maliha P, Grossberg G. Prevalence and Treatment of Substance Misuse in Older Adults: Beyond Early Adulthood. Subst Abuse Rehabil 2024; 15:87-98. [PMID: 39045315 PMCID: PMC11264375 DOI: 10.2147/sar.s375653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
Substance misuse, traditionally seen as a problem of early to mid-adulthood, is becoming increasingly prevalent among the older adult population (ages ≥65). Diagnosing and treating substance misuse in this vulnerable population is challenging because of multiple pre-existing medical comorbidities as well as polypharmacy. As such, it remains underdiagnosed and underrepresented in the literature. This review provides an overview of the three most commonly misused substances in older adults: alcohol, cannabis, and prescription drugs. It examines epidemiology, societal trends, and treatment options, highlighting the need for targeted research to address the unique challenges faced by older adults. This review also briefly comments on the prevalence and treatment of other illicit drugs in this population.
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Affiliation(s)
- Jiahao Hu
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Neha Kulkarni
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Peter Maliha
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St Louis, MO, USA
| | - George Grossberg
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St Louis, MO, USA
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Vedantam A, Ugiliweneza B, Williamson T, Guest JD, Harrop JS, Tator CH, Aarabi BA, Fehlings MG, Kurpad SN, Neal CJ. Evolving Profile of Acute Spinal Cord Injury Demographics, Outcomes, and Surgical Treatment in North America: Analysis of a Prospective Multi-Center Dataset of 989 Patients. J Neurotrauma 2023; 40:1948-1958. [PMID: 36448585 DOI: 10.1089/neu.2022.0410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Changes in demography and injury patterns have altered the profile and outcome of acute spinal cord injury (SCI) over time. This study sought to describe recent trends in epidemiology and early clinical outcomes using the multi-center North American Clinical Trial Network (NACTN) for Spinal Cord Injury Registry. All participants with blunt acute traumatic SCI (n = 782) were grouped into three five-year time intervals from 2005 to 2019 (2005-2009, 2010-2014, and 2015-2019). Baseline demographics, clinical scores, medical co-morbidities, as well as early clinical outcomes were extracted. Categorical and continuous variables were analyzed to determine between-group differences. Subgroup analysis was performed for participants <50 and ≥50 years of age. Over the duration of the study period, there was an increase in age at presentation (p = 0.0077) as well as a greater incidence of falls as the mechanism of injury. Participants who were ≥50 years of age were more likely to sustain incomplete SCI (<0.0003) and central cord syndrome (< 0.0001). In the most recent period (2015-2019), a greater proportion of NACTN participants underwent surgery within 24 h of injury (63% vs. 41% vs. 41%, p = 0.0001). There was a statistically significant increase in cardiac complications (p < 0.0001) and decrease in pulmonary complications (p < 0.0001) during the study period. Data from the NACTN registry shows that the age of participants with acute SCI is increasing, falls have become the major mechanism of injury, and central cord injury is becoming increasingly prevalent. While early surgical intervention for acute SCI is more common in recent years, cardiac complications are more prevalent while pulmonary complications are less prevalent.
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Affiliation(s)
- Aditya Vedantam
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Theresa Williamson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James D Guest
- The Miami Project to Cure Paralysis, University of Miami, Miami, Florida, USA
| | - James S Harrop
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pensylvania, USA
| | - Charles H Tator
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada, USA
| | - Bizhan A Aarabi
- Department of Neurosurgery, University of Maryland, Baltimore, Maryland, USA
| | - Michael G Fehlings
- Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada, USA
| | - Shekar N Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Chris J Neal
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Cypel YS, DePhilippis D, Davey VJ. Substance Use in U.S. Vietnam War Era Veterans and Nonveterans: Results from the Vietnam Era Health Retrospective Observational Study. Subst Use Misuse 2023; 58:858-870. [PMID: 37096682 DOI: 10.1080/10826084.2023.2188427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Background: Substance use (SU) is associated with physical injury and mental health disorders in older persons, but recent research has scarcely examined SU in U.S. Vietnam-era veterans who are mostly in or near their eighth decade of life. Objectives: We compared the prevalence of self-reported lifetime and current SU and modeled current usage patterns in a nationally representative sample of veterans versus a matched nonveteran cohort. Methods: Cross-sectional, self-reported survey data were analyzed from the 2016-2017 Vietnam Era Health Retrospective Observational Study (VE-HEROeS) (n = 18,866 veterans, n = 4,530 nonveterans). We assessed lifetime and current alcohol and drug use disorders; lifetime and current use of cannabis, opioids, stimulants, sedatives, "other drugs" (psychedelics, prescription or over-the-counter drugs not prescribed/used as intended); and current SU patterns (alcohol-use-only, drug-use-only, dual-SU, no SU). Weighted descriptive, bivariable, and multivariable statistics were calculated. Covariates in multinomial modeling included sociodemographic characteristics, lifetime cigarette smoking, depression, potentially traumatic events (PTEs), and current pain (SF-8TM). Results: Prevalence of lifetime opioid and sedative use (p ≤ .01), drug and alcohol use disorders (p < .001), and current "other drug" use (p < .001) were higher in veterans versus nonveterans. Current use of alcohol and cannabis was high in both cohorts. In veterans, very severe/severe pain, depression, and PTEs were highly associated with drug-use-only (p < .001) and dual-SU (p < .01), but these associations were fewer for nonveterans. Conclusion: This research confirmed existing concerns over substance misuse in older individuals. Vietnam-era veterans may be at particular risk due to service-related experiences and later-life tribulations. Era veterans' unique perceptions toward healthcare assistance for SU may need greater provider focus to maximize self-efficacy and treatment.
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Affiliation(s)
- Yasmin S Cypel
- Epidemiology Program, Health Outcomes Military Exposures (HOME) (12POP5), Office of Patient Care Services, U.S. Department of Veterans Affairs, Washington, District of Columbia, USA
| | - D DePhilippis
- Office of Mental Health and Suicide Prevention, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, District of Columbia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - V J Davey
- Office of Research & Development (14RD), U.S. Department of Veterans Affairs, Washington, District of Columbia, USA
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Pitkälä KH, Immonen S, Öhman H. "Always on vacation": alcohol has become a geriatric problem. Eur Geriatr Med 2023; 14:5-7. [PMID: 36399254 DOI: 10.1007/s41999-022-00718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kaisu H Pitkälä
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Sirpa Immonen
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Öhman
- Clinics of Internal Medicine and Geriatrics, Helsinki University Hospital, Helsinki, Finland
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Kermel-Schiffman I, Afuta M, Zur A, Gavriel-Fried B. Recovery from Alcohol Use Disorder among Older Adults: A Scoping Review. J Appl Gerontol 2023; 42:1137-1150. [PMID: 36609180 DOI: 10.1177/07334648221149284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Alcohol Use Disorder (AUD) among older people is under-diagnosed even though the population of older people is rising. Recovery from AUD among older people is a challenging process. A scoping review of the literature on recovery from AUD among older people was conducted to characterize the main topics in recovery. A systematic search was conducted in five databases: Psycinfo, Medline, CINHAL, WoS, and Embase from January 2000 to May 2021 using the PRISMA-ScR. Twenty-five studies met the inclusion criteria. The concept of recovery was defined in 20 studies, where the most frequent term was "abstinence." 16 studies described treatment programs with different types of interventions. Six studies described specific programs for older people; five reported positive outcomes. Future studies should implement a broader definition of recovery that reflects the dimensions of the concept and refers to different age groups, to enable interdisciplinary professionals to develop holistic interventions.
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Affiliation(s)
| | - May Afuta
- The Bob Shapell School of Social Work, 26745Tel Aviv University, Israel
| | - Amit Zur
- The Bob Shapell School of Social Work, 26745Tel Aviv University, Israel
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Wolde A. Alcohol Use Disorder and Associated Factors Among Elderly in Ethiopia. Subst Abuse 2023; 17:11782218231158031. [PMID: 36875744 PMCID: PMC9983104 DOI: 10.1177/11782218231158031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023]
Abstract
Background The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia. Method Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P-value less than .05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD). Result The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.23-8.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)). Conclusion Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD.
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Affiliation(s)
- Asrat Wolde
- Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia
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McInerney K, Best D, Cross A. Characteristics of people who have received treatment for late-onset problem drinking and alcohol use disorder: A systematic review and narrative synthesis. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 40:100-126. [PMID: 37063815 PMCID: PMC10101163 DOI: 10.1177/14550725221143170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
Aims: The current review investigated the psychosocial characteristics of late-onset problem drinkers, an under-researched area of alcohol harm that accounts for one-third of older problem drinkers. Method: Following the PRISMA model, the protocol and search strategy included a scoping search and main search of nine databases. A total of 1,595 papers were identified; after screening, 26 papers were considered eligible and were included in the review. The review used an investigative framework comprising three categories: standardising age of onset; gender differences; and psychosocial and mental health characteristics. The review also investigated how meaning and purpose in life, and treatment have been reported in relation to this cohort. Findings/Conclusions: The combined onset ages of the reviews’ 26 papers (mean age = 52.69 years) and the participants’ self-reported age at onset (mean age = 56.79 years), suggest that late-onset alcohol use disorder (AUD)/problem drinking is likely to emerge at the age of 55 years and older. Moreover, there is a high prevalence of co-morbid mental health disorders among elderly, late-onset drinkers. Retirement was reported as the most prevalent psychosocial risk factor for late-onset problematic drinking; other late-life events included bereavement, loneliness and social isolation, and boredom. In the context of gender, women are at greater risk of developing late-onset problem drinking than men. Furthermore, late-onset problem drinkers, particularly women, are more treatment compliant than their early-onset counterparts, highlighting the case for bespoke treatments/interventions for late-onset problem drinkers. Finally, the role that meaning and purpose in life plays in late-onset problem drinking has been under-reported and requires further investigation.
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Alcohol Use in Older Adults: A Systematic Review of Biopsychosocial Factors, Screening Tools, and Treatment Options. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00974-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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10
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Listabarth S, Groemer M, Waldhoer T, Vyssoki B, Pruckner N, Vyssoki S, Glahn A, König-Castillo DM, König D. Cognitive decline and alcohol consumption in the aging population-A longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe. Eur Psychiatry 2022; 65:e83. [PMID: 36398412 PMCID: PMC9748981 DOI: 10.1192/j.eurpsy.2022.2344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Prevalence of cognitive decline and dementia is rising globally, with more than 10 million new cases every year. These conditions cause a significant burden for individuals, their caregivers, and health care systems. As no causal treatment for dementia exists, prevention of cognitive decline is of utmost importance. Notably, alcohol is among the most significant modifiable risk factors for cognitive decline. METHODS Longitudinal data across 15 years on 6,967 individuals of the Survey of Health, Ageing and Retirement in Europe were used to analyze the effect of alcohol consumption and further modifiable (i.e., smoking, depression, and educational obtainment) and non-modifiable risk factors (sex and age) on cognitive functioning (i.e., memory and verbal fluency). For this, a generalized estimating equation linear model was estimated for every cognitive test domain assessed. RESULTS Consistent results were revealed in all three regression models: A nonlinear association between alcohol consumption and cognitive decline was found-moderate alcohol intake was associated with overall better global cognitive function than low or elevated alcohol consumption or complete abstinence. Furthermore, female sex and higher educational obtainment were associated with better cognitive function, whereas higher age and depression were associated with a decline in cognitive functioning. No significant association was found for smoking. CONCLUSION Our data indicate that alcohol use is a relevant risk factor for cognitive decline in older adults. Furthermore, evidence-based therapeutic concepts to reduce alcohol consumption exist and should be of primary interest in prevention measures considering the aging European population.
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Affiliation(s)
- Stephan Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Magdalena Groemer
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Alexander Glahn
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical University of Hannover, Hannover, Germany
| | | | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Yang TC, Shoff C, Choi SWE, Sun F. Multiscale dimensions of county-level disparities in opioid use disorder rates among older Medicare beneficiaries. Front Public Health 2022; 10:993507. [PMID: 36225787 PMCID: PMC9548636 DOI: 10.3389/fpubh.2022.993507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/07/2022] [Indexed: 01/26/2023] Open
Abstract
Background Opioid use disorder (OUD) among older adults (age ≥ 65) is a growing yet underexplored public health concern and previous research has mainly assumed that the spatial process underlying geographic patterns of population health outcomes is constant across space. This study is among the first to apply a local modeling perspective to examine the geographic disparity in county-level OUD rates among older Medicare beneficiaries and the spatial non-stationarity in the relationships between determinants and OUD rates. Methods Data are from a variety of national sources including the Centers for Medicare & Medicaid Services beneficiary-level data from 2020 aggregated to the county-level and county-equivalents, and the 2016-2020 American Community Survey (ACS) 5-year estimates for 3,108 contiguous US counties. We use multiscale geographically weighted regression to investigate three dimensions of spatial process, namely "level of influence" (the percentage of older Medicare beneficiaries affected by a certain determinant), "scalability" (the spatial process of a determinant as global, regional, or local), and "specificity" (the determinant that has the strongest association with the OUD rate). Results The results indicate great spatial heterogeneity in the distribution of OUD rates. Beneficiaries' characteristics, including the average age, racial/ethnic composition, and the average hierarchical condition categories (HCC) score, play important roles in shaping OUD rates as they are identified as primary influencers (impacting more than 50% of the population) and the most dominant determinants in US counties. Moreover, the percentage of non-Hispanic white beneficiaries, average number of mental health conditions, and the average HCC score demonstrate spatial non-stationarity in their associations with the OUD rates, suggesting that these variables are more important in some counties than others. Conclusions Our findings highlight the importance of a local perspective in addressing the geographic disparity in OUD rates among older adults. Interventions that aim to reduce OUD rates in US counties may adopt a place-based approach, which could consider the local needs and differential scales of spatial process.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, University at Albany, State University of New York, Albany, NY, United States,*Correspondence: Tse-Chuan Yang
| | - Carla Shoff
- Independent Consultant, Baltimore, MD, United States
| | - Seung-won Emily Choi
- Department of Sociology, Anthropology, and Social Work, Texas Tech University, Lubbock, TX, United States
| | - Feinuo Sun
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, NS, Canada
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Wolde A, Wolancho W, Belay Y, Alemu A, Asefa A, Gebremedhin T. A Community-Based Exploratory Cross-Sectional Study of Elder Abuse Perpetration or Victimization Among Elders in Ethiopia, 2022. Clin Interv Aging 2022; 17:957-969. [PMID: 35730042 PMCID: PMC9206848 DOI: 10.2147/cia.s360548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Elderly abuse and comorbid problematic substance use, disability, and physical and mental illness have been major problems in low-income countries. In most countries, the elderly are the most neglected segment of the population, and there is insufficient information about elderly abuse perpetration or victimization in low-income countries like Ethiopia. Therefore, this study was aimed to assess elderly abuse perpetration or victimization among the elderly in Mizan Aman town, southwest Ethiopia. Methods A community-based cross-sectional study design was conducted among 268 elderly people from May to June, 2021, by using a systematic sampling technique. The elderly abuse and the ASSIST tools were used to assess the elderly abuse and khat, alcohol, cannabis, and tobacco use disorders, respectively. Moreover, multimorbidity and physical disability were also assessed. Data were entered into EpiData version 3.1 and exported to the Statistical Package for Social Science Version 23. A logistic regression model was used to identify independent predictors of elderly abuse. Results The prevalence of elder abuse was 41.8%, and the prevalence of poly substance, alcohol, khat, and tobacco use disorder was 32.5%, 19.4%, 12%, and 4.5%, respectively. Besides, the comorbidity of physical disability and multiple chronic diseases was 8% and 24.6%, respectively. Moreover, physical disability (AOR = 5.652, CI = 1.459, 21.894), multimorbidity (AOR = 3.972, CI = 1.898, 8.314), substance use disorder (AOR = 3.877, CI = 1.814, 8.286), age above 80 years (AOR = 8.452, CI = 2.273, 31.425), and poor social support (AOR = 3.372, CI = 1.043, 10.903) were positively associated with elderly abuse. Conclusion The magnitude of elder abuse and comorbid multimorbidity, physical disability, and substance use disorder was high, and having multiple chronic diseases, physical disability, substance use disorder, advanced age, and poor social support were risk factors for elderly abuse.
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Affiliation(s)
- Asrat Wolde
- Department of Psychiatry, Mizan Tepi University, Mizan Aman, South West Regional State, Ethiopia
| | - Wadu Wolancho
- Department of Nursing, Jimma University, Jimma, Oromia Regional State, Ethiopia
| | - Yeshitila Belay
- Department of Nursing, Jimma University, Jimma, Oromia Regional State, Ethiopia
| | - Asamirew Alemu
- Department of Nursing, Mizan-Tepi University, Mizan Aman, South West Regional State, Ethiopia
| | - Ashenaf Asefa
- Department of Nursing, Mizan-Tepi University, Mizan Aman, South West Regional State, Ethiopia
| | - Tsehaye Gebremedhin
- Department of Nursing, Mizan-Tepi University, Mizan Aman, South West Regional State, Ethiopia
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Florek S, Piegza M, Dębski P, Gorczyca P, Pudlo R. The Influence of Sociodemographic Factors on Symptoms of Anxiety, the Level of Aggression and Alcohol Consumption in the Time of the COVID-19 Pandemic among Polish Respondents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127081. [PMID: 35742329 PMCID: PMC9222902 DOI: 10.3390/ijerph19127081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022]
Abstract
The COVID-19 pandemic has had a significant impact on the mental health of most of the world's population. The authors of this study decided to identify differences in the intensity of anxiety, aggression and alcohol consumption within the study population. The study was conducted via an Internet survey. It uses Polish adaptations of international scales to assess anxiety (GAD-7), aggression (Buss and Perry Aggression Scale) and alcohol consumption (AUDIT test). A total of 538 people were examined. The surveyed group of respondents does not reflect the structure of Polish society. The group of surveyed women scored higher than men in terms of anxiety, as well as anger and hostility. The examined men were characterized by higher results of alcohol consumption and physical aggression. People between 18 and 49 years of age consumed significantly more alcohol than people aged 50 and over. People aged 18-29 obtained statistically significantly higher scores in generalized aggression and hostility. The relationships between the studied parameters do not differ significantly from those presented in other studies. People under the age of 50 are the group most exposed to the harmful effects of alcohol. Women between the ages of 30 and 49 are most vulnerable to the negative mental health effects of the COVID-19 pandemic. There is a need for further research studies in which the studied group will obtain a greater degree of compliance with the structure of Polish society.
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Yang TC, Shoff C, Kim S, Shaw BA. County social isolation and opioid use disorder among older adults: A longitudinal analysis of Medicare data, 2013-2018. Soc Sci Med 2022; 301:114971. [PMID: 35430465 DOI: 10.1016/j.socscimed.2022.114971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/12/2022] [Accepted: 04/07/2022] [Indexed: 01/03/2023]
Abstract
This study aims to fill three knowledge gaps: (1) unclear role of ecological factors in shaping older adults' risk of opioid use disorder (OUD), (2) a lack of longitudinal perspective in OUD research among older adults, and (3) underexplored racial/ethnic differences in the determinants of OUD in older populations. This study estimates the effects of county-level social isolation, concentrated disadvantage, and income inequality on older adults' risk of OUD using longitudinal data analysis. We merged the 2013-2018 Medicare population (aged 65+) data to the American Community Survey 5-year county-level estimates to create a person-year dataset (N = 47,291,217 person-years) and used conditional logit fixed-effects modeling to test whether changes in individual- and county-level covariates alter older adults' risk of OUD. Moreover, we conducted race/ethnicity-specific models to compare how these associations vary across racial/ethnic groups. At the county-level, a one-unit increase in social isolation (mean = -0.197, SD = 0.511) increased the risk of OUD by 5.5 percent (OR = 1.055; 95% CI = [1.018, 1.094]) and a one-percentage-point increase in the working population employed in primary industry decreases the risk of OUD by 1 percent (OR = 0.990; 95% CI = [0.985, 0.996]). At the individual-level, increases in the Medicare Hierarchical Condition Categories risk score, physical comorbidity, and mental comorbidity all elevate the risk of OUD. The relationship between county-level social isolation and OUD is driven by non-Hispanic whites, while Hispanic beneficiaries are less sensitive to the changes in county-level factors than any other racial ethnic groups. Between 2013 and 2018, US older adults' risk of OUD was associated with both ecological and individual factors, which carries implications for intervention. Further research is needed to understand why associations of individual factors with OUD are comparable across racial/ethnic groups, but county-level social isolation is only associated with OUD among non-Hispanic white beneficiaries.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
| | | | - Seulki Kim
- Department of Sociology, University at Albany, State University of New York, Albany, NY, USA
| | - Benjamin A Shaw
- Division of Community Health Sciences, University of Illinois Chicago, Chicago, IL, USA
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Klokgieters S, Kok A, Rijnhart J, Visser M, Broese van Groenou M, Verschuren M, Picavet S, Huisman M. Comparative study of two birth cohorts: did the explanatory role of behavioural, social and psychological factors in educational inequalities in mortality change over time? BMJ Open 2022; 12:e052204. [PMID: 35260451 PMCID: PMC8905994 DOI: 10.1136/bmjopen-2021-052204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 02/08/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the contribution of behavioural, social and psychological factors to inequalities in mortality by educational level between birth cohorts. DESIGN Cohort-sequential design. SETTING Two population-based studies in the Netherlands: the Longitudinal Aging Study Amsterdam (LASA) and the Doetinchem Cohort Study (DCS). PARTICIPANTS Data from the LASA included 1990 individuals with birth years 1928-1937 (cohort 1) and 1938-1947 (cohort 2) and, for replication, data from the DCS included 2732 individuals with birth years 1929-1941 (cohort 1) and 1939-1951 (cohort 2). METHODS Years of education, 15-year mortality, lifestyle factors, social factors and psychological factors were modelled using multiple-group accelerated failure time models based on structural equation modelling to compare indirect effects between cohorts. RESULTS Both studies showed similar educational inequalities, with higher mortality among those with lower education. The indirect effects of education via smoking (LASA: difference in survival time ratio (TR)=1.0018, 95% CI 1.0000 to 1.0155, DCS: TR=1.0051, 95% CI 1.0000 to 1.0183), physical activity (LASA: TR=1.0056, 95% CI 1.00009 to 1.0132) and alcohol use (LASA: TR=1.0275, 95% CI 1.0033 to 1.0194) on mortality were stronger in cohort 2 than in cohort 1. In contrast to the other effects, alcohol use was the only factor that was associated positively with education and survival time, which effect increased in the most recent cohort. Emotional support, network size and cognitive functioning showed no difference between cohorts. CONCLUSIONS Smoking, physical activity and alcohol use contributed more to educational inequalities in mortality in recent cohorts. Hence, in addition to tackling fundamental social causes of inequality, policies focusing on intermediary mechanisms such as lifestyle need to adapt their targets to those that prove to be most important within a given time frame.
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Affiliation(s)
- Silvia Klokgieters
- Deparment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, The Netherlands
| | - Almar Kok
- Deparment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands
| | - Judith Rijnhart
- Deparment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marjolein Broese van Groenou
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit, Amsterdam, Noord-Holland, The Netherlands
| | - Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amsterdam, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Susan Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Martijn Huisman
- Deparment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit, Amsterdam, Noord-Holland, The Netherlands
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16
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Stelander LT, Høye A, Bramness JG, Wynn R, Grønli OK. Sex differences in at-risk drinking and associated factors-a cross-sectional study of 8,616 community-dwelling adults 60 years and older: the Tromsø study, 2015-16. BMC Geriatr 2022; 22:170. [PMID: 35232388 PMCID: PMC8886794 DOI: 10.1186/s12877-022-02842-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol consumption among older adults is on the rise, which may be an increasing public health concern. The proportion of older adults who drink above defined low-risk drinking limits, associated characteristics and the sex distribution of at-risk drinking vary across countries. The aims of this study were to (i) estimate the prevalence of at-risk drinking among older adults in Norway, (ii) investigate factors associated with at-risk drinking, and (iii) examine sex differences in alcohol consumption in the context of sociodemographic and selected health characteristics. METHOD A cross-sectional study based on Tromsø 7 (2015-16), an ongoing population-based cohort survey. Data were retrieved from participants aged 60 and older (60-99 years) who answered questions about alcohol consumption (n = 8,616). Sex-stratified logistic regressions were used to assess the association between three at-risk drinking outcome variables, and sociodemographic and selected health characteristics. The outcome variables were operationalized using the Alcohol Use Disorders Identification Test (AUDIT), and Alcohol Consumption Questions (AUDIT-C), i.e. - cut off for at risk drinking, drinking any 6+ in the past year, and any alcohol problems. RESULTS The overall prevalence of at-risk drinking among those aged 60-99 years was equal in women and men; 44% and 46%, respectively. At-risk drinking was strongly associated with a higher level of education, with OR 2.65 (CI 2.28-3.10) in women and OR 1.73 (CI 1.48-2.04) in men. CONCLUSIONS Almost half of older adults in Norway exceeded sex- and older adult-specific at-risk drinking thresholds. Our findings suggest some differences in factors associated with at-risk drinking between women and men. Explicitly, at-risk drinking was associated with very good health, living with a spouse or partner, and having adequate social support in women, while it was associated with the use of sleeping pills in men. Our findings suggest that women exceed at-risk drinking thresholds with better health, while men exceed at-risk drinking thresholds regardless of good or poor health.
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Affiliation(s)
- Line Tegner Stelander
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway.
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Anne Høye
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G Bramness
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Rolf Wynn
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Kristian Grønli
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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17
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Specht S, Schwarzkopf L, Braun-Michl B, Seitz NN, Wildner M, Kraus L. Age, period, and cohort effects on trends in outpatient addiction care utilization in the general Berlin population from 2008 to 2016. BMC Public Health 2022; 22:320. [PMID: 35168578 PMCID: PMC8848644 DOI: 10.1186/s12889-022-12744-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/09/2022] [Indexed: 01/12/2023] Open
Abstract
Background The aim of this study was to decompose independent effects of age, period, and cohort on trends in outpatient addiction care utilization resulting from alcohol (AUD) and illicit substances use disorders (ISUD). Decomposing trends in addiction care utilization into their independent effects by age, period, and cohort may lead to a better understanding of utilization patterns. Methods Individuals seeking help in Berlin outpatient addiction care facilities between 2008 and 2016 with an age range of 18–81 years for AUD (n = 46,706) and 18–70 years for ISUD (n = 51,113) were standardized to the general Berlin population using data from the German Federal Statistical Office. Classification of utilization as AUD- (F10) or ISUD-related (F11, F12, F14, F15, F16, F18, F19) help-seeking was based on primary diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. Age was measured in years and period as year of data collection. Cohort was defined as the mathematical difference between period and age. Age, period, and cohort analyses were conducted using the intrinsic estimator model on AUD- and ISUD-related outpatient addiction care utilization. Results Age effects on AUD-related utilization were highest in 18- to 19-year-old and in 39- to 59-year-old individuals. ISUD-related utilization declined almost continuously with increasing age. Period effects on AUD- and ISUD-related utilization were small. AUD-related utilization was highest in cohorts born from 1951 to 1986. ISUD-related utilization increased in cohorts born between 1954 and 1973 where utilization peaked, followed by a decline of the same order. Conclusions Age and cohort effects were the strongest drivers of trends in AUD- and ISUD-related outpatient addiction care utilization. Onset of help-seeking in earlier phases of AUD development should be enhanced as well as help-seeking for AUD and ISUD in general. The highest cohort-related rates in the baby boomer and following cohorts for AUD and ISUD underline an increased demand for addiction care. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12744-6.
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Affiliation(s)
- Sara Specht
- IFT Institut Für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.
| | - Larissa Schwarzkopf
- IFT Institut Für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany
| | - Barbara Braun-Michl
- IFT Institut Für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany
| | - Nicki-Nils Seitz
- IFT Institut Für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany
| | - Manfred Wildner
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany.,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Ludwig Kraus
- IFT Institut Für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Department of Public Health Science, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-106 91, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Izabella utca 46, 1064, Budapest, Hungary
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18
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De Sousa A. Geriatric substance use: Challenges for practice. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_127_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Ballestar-Tarín ML, Ibáñez-del-Valle V, Cauli O, Navarro-Martínez R. Personal and Social Consequences of Psychotropic Substance Use: A Population-Based Internet Survey. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:65. [PMID: 35056373 PMCID: PMC8777796 DOI: 10.3390/medicina58010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 11/17/2022]
Abstract
Background and objectives: Drug abuse has become a major worldwide health concern among all age groups. The present study analyses substance misuse and its social and personal consequences using a population-based internet survey in Spain. Materials and Methods: Screening for drug abuse (of alcohol, marijuana/hashish and psychostimulants) and its related risks and problems was performed using the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) score. Socio-demographic factors, depressive, anxiety and stress symptoms as well as health habits were also evaluated. We used Linear regression methods to compare each variable's individual contribution so as to determine which one best explains the results. Results: In this population-based study, 1224 people completed and returned the online survey. Of all participants, 57% reported consuming at least one substance based on the CRAFFT scale. While increasing age reduces the probability of personal and social consequences of consumption, people who smoke receive up to three times more (OR = 3.370) recommendations from family and friends to reduce their consumption. As for the type of substance, the consumption of marijuana increases the risk of forgetting (OR = 2.33) and the consumption of other psychostimulant substances almost triples the risk of consuming alone (OR = 2.965). Combining substances can increase the rate of driving a vehicle after consumption by 3.4 times. Conclusions: Although age, smoking and the type of substances used increase the risk of suffering from social and personal consequences of the use or abuse of substances, future studies are needed to determine the influence of new variables as a potential tool for treating and minimizing the adverse consequences of drug abuse.
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Affiliation(s)
- María Luisa Ballestar-Tarín
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
| | - Vanessa Ibáñez-del-Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| | - Rut Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
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Yang TC, Shoff C, Kim S. Social isolation, residential stability, and opioid use disorder among older Medicare beneficiaries: Metropolitan and non-metropolitan county comparison. Soc Sci Med 2022; 292:114605. [PMID: 34861571 PMCID: PMC8748391 DOI: 10.1016/j.socscimed.2021.114605] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/01/2021] [Accepted: 11/23/2021] [Indexed: 01/03/2023]
Abstract
Research has shown that the prevalence of opioid use disorder (OUD) may rise substantially as society ages, but this issue receives the least attention in the literature. To address this gap, this study utilizes county-level data from multiple data sources (1) to investigate whether social isolation is associated with OUD prevalence among older Medicare beneficiaries, (2) to examine whether and how residential stability moderates the association between social isolation and OUD prevalence in US counties, and (3) to determine if there are any differences in these associations between metropolitan and non-metropolitan counties. The results show that social isolation is a significant factor for county-level OUD prevalence, regardless of metropolitan status. In addition, counties with high residential stability have low prevalence of OUD among older adults and this association is stronger in metropolitan than in non-metropolitan counties. Nonetheless, high levels of residential stability reinforce the positive relationship between social isolation and OUD prevalence. As a result, when developing policies and interventions aimed at reducing OUD among older adults, place of residence must be taken into account.
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Affiliation(s)
- Tse-Chuan Yang
- University at Albany, 1400 Washington Ave., Arts & Sciences 351, Albany, NY 12222
| | - Carla Shoff
- Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244
| | - Seulki Kim
- University at Albany, 1400 Washington Ave., Arts & Sciences 356, Albany, NY 12222
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21
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Abstract
Older adults continue to drink as they age. Aging changes alcohol kinetics just as with any other drug. Older adults have increased sensitivity to acute alcohol intake that accounts for the increased risk of falls, traffic accidents, and other injury. The Annual Medicare Wellness Exam is an excellent opportunity to introduce screening for unsafe drinking along with accumulated risks and deficits of aging. Older adults have responded well to brief interventions for unhealthy drinking. In the presence of alcohol use disorder or serious comorbidity including psychiatric illness, referral to specialized multidisciplinary care can be lifesaving.
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22
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Stelander LT, Høye A, Bramness JG, Selbæk G, Lunde LH, Wynn R, Grønli OK. The changing alcohol drinking patterns among older adults show that women are closing the gender gap in more frequent drinking: the Tromsø study, 1994-2016. Subst Abuse Treat Prev Policy 2021; 16:45. [PMID: 34039389 PMCID: PMC8152329 DOI: 10.1186/s13011-021-00376-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As the population of older adults continues to grow, changes in alcohol consumption are important to monitor because an increase may have public health consequences. Rates of alcohol use vary with geographical location. The aim of this study was to examine trends in alcohol consumption among older adults in a geographically defined area in Norway, especially changing sex differences in drinking patterns over a 22-year period. METHODS Repeated cross-sectional survey (in 1994-95, 2007-08, and 2015-16) of a general population of older adults. Eligible for this study were 20,939 participants (aged 60-99 years). The data were analysed using generalized estimating equations, stratified by age and sex. Alcohol consumption and drinking patterns were assessed, using an adaptation of the AUDIT-C. RESULTS Between 1994 and 2016, there has been a significant increase in the proportion of current drinkers among older adults. Furthermore, the probability of frequent drinking (alcohol consumption at least twice weekly) increased significantly between 1994 and 2016, particularly among older women; OR 8.02 (CI 5.97-10.79) and OR 5.87 (CI 4.00-8.63) in the age groups 60-69 and 70+ respectively for women, and OR 4.13 (CI 3.42-4.99) and OR 3.10 (CI 2.41-3.99), in the age groups 60-69 and 70+ respectively for men. The majority of older adults drank small amounts of alcohol on typical drinking days, but there was an increasing probability of drinking three drinks or more on each occasion over the study period, except among women aged 70+ years. CONCLUSIONS Among older adults in Norway, alcohol consumption in terms of frequency and quantity on typical drinking days has increased considerably from 1996 to 2016. This change is in the opposite direction of what has been reported among younger adults. The gap between women and men in frequent drinking has been markedly narrowed, which indicate that women's drinking patterns are approaching those of men. This may involve a need to change alcohol policy in Norway to more targeted interventions aimed at older people.
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Affiliation(s)
- Line Tegner Stelander
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway.
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Anne Høye
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G Bramness
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Rolf Wynn
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Kristian Grønli
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Postboks 6124, 9291, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Prev Med 2021; 145:106422. [PMID: 33422577 PMCID: PMC9063034 DOI: 10.1016/j.ypmed.2021.106422] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 01/16/2023]
Abstract
The COVID-19 pandemic has triggered a public health crisis of unprecedented scale. Increased alcohol use has been extensively documented during other crises, particularly among persons with anxiety and depression. Despite COVID-19's differential impact by age, the association of age, mental health and alcohol use during the pandemic has not been explored. This study aimed to examine whether age modified the association of anxiety and depressive symptoms with alcohol use during the COVID-19 pandemic. Two online surveys were administered to U.S. adult social media users in March and April 2020. Generalized linear models were conducted in 2020 among 5850 respondents (52.9% female; 22.0% aged 18-39 years, 47.0% aged 40-59 years, and 31.0% aged ≥60 years) to examine if age modified the association of anxiety and depression symptomatology and alcohol use. Overall, 29% of respondents reported increased alcohol use. Adjusted odds ratios of reporting increased alcohol use were 1.41 (95% CI = 1.20-1.66) among respondents with anxiety symptoms and 1.64 (95% CI = 1.21-2.23) among those with depressive symptoms compared to those without such symptoms. Whereas respondents aged 18-39 years had the highest probability of reporting increased alcohol use, the probability of older persons (40-59 and ≥60 years) reporting increased drinking was much greater among those with symptoms of anxiety and depression, compared to those without symptoms. These findings warrant age-differentiated public health messaging on the risks of excessive alcohol use and scale-up of substance use services for middle-aged and older adults with symptoms of depression and anxiety.
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Specht S, Braun-Michl B, Schwarzkopf L, Piontek D, Seitz NN, Wildner M, Kraus L. Substance use disorder and the baby boom generation: Does Berlin outpatient addiction care face a sustained change? Drug Alcohol Rev 2021; 40:979-988. [PMID: 33508892 PMCID: PMC8451895 DOI: 10.1111/dar.13245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/27/2020] [Accepted: 12/13/2020] [Indexed: 01/10/2023]
Abstract
Introduction The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two‐level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts. Results Compared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction. Discussion and Conclusions Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under‐represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.
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Affiliation(s)
- Sara Specht
- IFT Institut für Therapieforschung, Munich, Germany
| | | | - Larissa Schwarzkopf
- IFT Institut für Therapieforschung, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University, Munich, Germany
| | | | | | - Manfred Wildner
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, Munich, Germany.,Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany.,Department of Public Health Science, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Listabarth S, Vyssoki B, Waldhoer T, Gmeiner A, Vyssoki S, Wippel A, Blüml V, Gruber M, König D. Hazardous alcohol consumption among older adults: A comprehensive and multi-national analysis of predictive factors in 13,351 individuals. Eur Psychiatry 2020; 64:e4. [PMID: 33342458 PMCID: PMC8057428 DOI: 10.1192/j.eurpsy.2020.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Older adults exhibit heightened vulnerability for alcohol-related health impairments. Increases in the proportion of older adults within the European Union’s total population and prevalence rates of alcohol use disorders in this age group are being observed. This large scale international study was conducted to identify those older adults with an increased risk to engage in hazardous drinking behaviour. Methods Socio-demographic, socio-economic, personality characteristics (Big Five Inventory, BFI-10), and alcohol consumption patterns of 13,351 individuals from 12 different European countries, collected by the Survey of Health, Aging, and Retirement in Europe, were analyzed using regression models. Results Age, nationality, years of education, as well as personality traits, were significantly associated with alcohol intake. For males, extraversion predicted increased alcohol intake (RR = 1.11, CI = 1.07–1.16), whereas conscientiousness (RR = 0.93, CI = 0.89–0.97), and agreeableness (RR = 0.94, CI = 0.90–0.99), were associated with a reduction. For females, openness to new experiences (RR = 1.11, CI = 1.04–1.18) predicted increased alcohol intake. Concerning excessive drinking, personality traits, nationality, and age-predicted consumption patterns for both sexes: Extraversion was identified as a risk factor for excessive drinking (OR = 1.15; CI = 1.09–1.21), whereas conscientiousness was identified as a protective factor (OR = 0.87; CI = 0.823–0.93). Conclusion Hazardous alcohol consumption in the elderly was associated with specific personality characteristics. Preventative measures, crucial in reducing deleterious health consequences, should focus on translating the knowledge of the association of certain personality traits and alcohol consumption into improved prevention and treatment.
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Affiliation(s)
- Stephan Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhoer
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Andrea Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Andreas Wippel
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Victor Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Maria Gruber
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Raninen J, Agahi N. Trends in older people’s drinking habits, Sweden 2004–2017. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:459-469. [PMID: 35310773 PMCID: PMC8899064 DOI: 10.1177/1455072520954336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022] Open
Abstract
Aims: To examine if and how the drinking habits of older people aged 60–79 years in
Sweden have changed during 2004–2017, with a specific focus on age groups
and gender. Data and measures: A Swedish, nationally representative, repeated cross-sectional telephone
survey covering the years 2004–2017 (n = 225,134) was used.
Four aspects of alcohol consumption were investigated: proportion of alcohol
consumers, frequency of drinking, amount per drinking occasion, and
prevalence of heavy episodic drinking. Results: Three of the four measures investigated showed increases in alcohol
consumption in the older age groups, particularly among women. Proportion of
alcohol consumers, frequency of drinking and prevalence of heavy episodic
drinking during the past month increased in most older age groups among both
women and men, while the average amount per drinking occasion remained
stable. Thus, total consumption in older age groups has increased over time,
since the proportion of drinkers and the frequency of drinking has
increased. Increases were particularly marked among women and in the age
groups 70–74 and 75–79 years. In age groups below 60 years, these measures
showed either declines or stability. Conclusions: There has been a steady increase in alcohol consumption across all the older
age groups studied, which implies that the changing drinking habits are not
isolated only to certain birth cohorts. Instead there seems to be a
continuous shift in older people’s drinking habits which can be expected to
continue. However, these increases are from very low levels, and older
people’s drinking is still at modest levels. Public health implications must
be studied further.
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Affiliation(s)
- Jonas Raninen
- CAN (Swedish Council for Information on Alcohol and Other Drugs), Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; School of Social Sciences, Unit of Social Work, Södertörn University, Huddinge, Sweden; and Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Neda Agahi
- Karolinska Institutet, Stockholm, Sweden
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Helvik AS, Engedal K, Johannessen A. Elevated alcohol consumption among geriatric psychiatric in-patients. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:400-410. [PMID: 35310925 PMCID: PMC8899249 DOI: 10.1177/1455072520936813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 06/02/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction: Although a clear relationship has been established between elevated alcohol consumption and psychiatric problems in old age, there are few descriptions of the prevalence of elevated alcohol consumption in older adults who have been referred to geriatric psychiatric treatment. Aim: To describe the prevalence of self-reported elevated alcohol consumption in men and women referred to geriatric psychiatry wards in Norway, and to explore factors associated with elevated alcohol consumption. Method: This cross-sectional study includes data from a registry of geriatric psychiatry patients aged ≥ 65 years from December 2016 until December 2018. The outcome measure was reported elevated alcohol consumption assessed with the short version of the Alcohol Use Disorders Identification Test (AUDIT-C). The analyses used demographic data as well as a measure of cognitive function, psychiatric diagnosis and use of psychotropic drugs. Results: In total, 367 patients (131, 35.7% men) with a mean (SD) age of 74.7 (7.6) years were included. Of these patients, 27% scored above the pre-set cut-off for elevated alcohol consumption according to AUDIT-C (≥ 3 and 4 for women and men, respectively). The prevalence of elevated alcohol did not differ by gender. In adjusted logistic regression analysis, older age, living with someone and use of antidepressants were associated with reduced odds for reporting elevated alcohol consumption (OR 0.93, 95% CI 0.89–0.96; OR 0.54, 95% CI 0.31–0.97; and 0.54, 95% CI 0.32–0.92, respectively). Conclusion: A relatively high proportion of psychiatric patients aged 65 years or older reported elevated alcohol consumption, regardless of diagnosis. Older age, living with someone and use of antidepressants were associated with lower odds for elevated alcohol consumption.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim; and Norwegian National advisory unit for aging and health, Vestfold Hospital Trust, Trondheim, Norway
| | - Knut Engedal
- Norwegian National advisory unit for aging and health, Vestfold Hospital Trust, Trondheim, Norway
| | - Aud Johannessen
- Norwegian National advisory unit for aging and health, Vestfold Hospital Trust, Trondheim; and University of South-Eastern Norway, Norway
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Trias-Llimós S, Bosque-Prous M, Obradors-Rial N, Teixidó-Compañó E, Belza MJ, Janssen F, Espelt A. Alcohol and educational inequalities: Hazardous drinking prevalence and all-cause mortality by hazardous drinking group in people aged 50 and older in Europe. Subst Abus 2020; 43:152-160. [PMID: 32543303 DOI: 10.1080/08897077.2020.1773597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: We examined educational inequalities in hazardous drinking prevalence among individuals aged 50 or more in 14 European countries, and explored educational inequalities in mortality in hazardous drinkers in European regions. Methods: We analyzed data from waves 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (SHARE). We estimated age-standardized hazardous drinking prevalence, and prevalence ratios (PR) of hazardous drinking by country and educational level using Poisson regression models with robust variance. We estimated the relative index of inequality (RII) for all-cause mortality among hazardous drinkers and non-hazardous drinkers using Cox proportional hazards regression models and for each region (North, South, East and West). Results: In men, educational inequalities in hazardous drinking were not observed (PRmedium = 1.09 [95%CI: 0.98-1.21] and PRhigh = 0.99 [95%CI: 0.88-1.10], ref. low), while in they were observed in women, having the highest hazardous drinking prevalence in the highest educational levels (PRmedium = 1.28 [95%CI: 1.15-1.42] and PRhigh = 1.53 [95%CI: 1.36-1.72]). Overall, the Relative Index of Inequality (RII) in all-cause mortality among hazardous drinkers was 1.12 [95%CI: 1.03-1.22] among men and 1.10 [95%CI: 0.97-1.25] among women. Educational inequalities among hazardous drinkers were observed in Eastern Europe for both men (RIIhazardous = 1.21 [95%CI: 1.01-1.45]) and women (RIIhazardous = 1.46 [95%CI: 1.13-1.87]). Educational inequalities in mortality among non-hazardous drinkers were observed in Southern, Western and Eastern Europe among men, and in Eastern Europe among women. Conclusions: Higher educational attainment is positively associated with hazardous drinking prevalence among women, but not among men in most of the analyzed European countries. Clear educational inequalities in mortality among hazardous drinkers were only observed in Eastern Europe. Further research on the associations between alcohol use and inequalities in all-cause mortality in different regions is needed.
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Affiliation(s)
- Sergi Trias-Llimós
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Nuria Obradors-Rial
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Ester Teixidó-Compañó
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Maria José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fanny Janssen
- Netherlands Interdisciplinary Demographic Institute - KNAW/University of Groningen, The Hague, The Netherlands.,Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
| | - Albert Espelt
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
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Huhn AS, Hobelmann JG, Ramirez A, Strain EC, Oyler GA. Trends in first-time treatment admissions for older adults with alcohol use disorder: Availability of medical and specialty clinical services in hospital, residential, and outpatient facilities. Drug Alcohol Depend 2019; 205:107694. [PMID: 31704379 DOI: 10.1016/j.drugalcdep.2019.107694] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a growing problem among older adults. The aim of this study was to quantify trends in first-time treatment admissions for older adults with AUD in the U.S., and examine the medical and specialty clinical services offered by treatment facility type. METHODS Patient level data were collected from the Treatment Episode Data Set for Admissions between 2004-2017. Joinpoint regression was used to identify unique trends in first-time treatment admissions for older adults with AUD. Provider level data were collected from the National Survey of Substance Abuse Treatment Services (N-SSATS) for the most recent year, 2017. N-SSATS data were grouped by facility type (inpatient/hospital, residential, and outpatient treatment) to examine differences in medications and clinical services. RESULTS Among all persons seeking first-time treatment for AUD with alcohol as their primary drug of choice (n = 3,606,948), there was a significant increase in the proportion of older adults seeking treatment from 2004 to 2017 (p-trend<0.001), with an average annual percent change of 6.8% (95% confidence intervals: 6.2%-7.4%). The majority of older adults with AUD sought treatment in outpatient and residential facilities, which compared to hospital-based facilities had lower odds of offering supervised detoxification, acamprosate, naltrexone, psychiatric medications, or mental health services (all p-values<0.001). Fewer than 25% of hospital-based and 20% of residential or outpatient facilities offered specialty services for older adults. CONCLUSIONS U.S. substance abuse treatment providers are not compensating for the changing nature of admissions by older adults, and are not providing state of the art services for this population.
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Affiliation(s)
- Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Ashley Addiction Treatment, Havre de Grace, MD, USA.
| | - J Gregory Hobelmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Ashley Addiction Treatment, Havre de Grace, MD, USA
| | | | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - George A Oyler
- Ashley Addiction Treatment, Havre de Grace, MD, USA; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
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Menecier P, Fernandez L, Galiano AR, Ploton L. Attitudes et croyances de soignants hospitaliers envers le mésusage d’alcool de sujets âgés : étude par entretiens de recherche. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2017.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Uhlmann A, Bandelow B, Stein DJ, Bloch S, Engel KR, Havemann-Reinecke U, Wedekind D. Grey matter structural differences in alcohol-dependent individuals with and without comorbid depression/anxiety-an MRI study. Eur Arch Psychiatry Clin Neurosci 2019; 269:285-294. [PMID: 29372325 DOI: 10.1007/s00406-018-0870-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022]
Abstract
Although depression and anxiety disorders are common comorbid conditions in alcohol dependence, few structural brain imaging studies have compared alcohol-dependent subjects with and without such comorbidity. In the current study, brain scans of 35 alcohol-dependent with and 40 individuals without diagnosis of a comorbid ICD-10 depressive or anxiety disorder receiving detoxification inpatient treatment were evaluated. Thickness and volumes of automatically segmented neuroanatomical structures were measured in FreeSurfer. Furthermore, associations of brain structure with biological markers and clinical severity markers of alcohol dependence were assessed. Despite comparable addiction severity, the non-comorbid group had evidence of higher cytotoxic effects of alcohol use on hepatic and haematological markers, and showed significantly smaller volumes of total cerebral, and cerebellar grey matter. Similarly, they showed unexpected smaller hippocampal and nucleus accumbens volumes, and thinner frontal, temporal and occipital cortices. Smaller brain volumes correlated with increased markers of hepatic and haematological dysfunction, and with longer duration of alcohol dependence in the non-comorbid group. Evidence of higher biomarkers of alcohol use may be indicative of more severe alcohol dependence or higher vulnerability to ethanol toxicity in this group. Furthermore, psychopathology-related drug treatment, which occurred in 53% of the comorbid group over the recent years, or tissue inflammation may have a moderate effect on the grade of cerebral atrophy in alcohol-dependent patients. Longitudinal studies are needed to investigate this issue more fully.
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Affiliation(s)
- A Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - B Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Centre, University of Goettingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - S Bloch
- Department of Psychiatry and Psychotherapy, University Medical Centre, University of Goettingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany
| | - K R Engel
- Department of Psychiatry and Psychotherapy, University Medical Centre, University of Goettingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany
| | - U Havemann-Reinecke
- Department of Psychiatry and Psychotherapy, University Medical Centre, University of Goettingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany.,Centre of Nanomicroscopy and Molecular Biology of the Brain, CNMPB, Goettingen University Medical Centre, Goettingen, Germany
| | - Dirk Wedekind
- Department of Psychiatry and Psychotherapy, University Medical Centre, University of Goettingen, von-Siebold-Strasse 5, 37075, Göttingen, Germany.
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Agahi N, Dahlberg L, Lennartsson C. Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample. Drug Alcohol Depend 2019; 196:40-45. [PMID: 30660938 DOI: 10.1016/j.drugalcdep.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Today's older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people's drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men. METHODS Longitudinal nationally representative data of older Swedish women and men aged over 65 - the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) - from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. RESULTS Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group. CONCLUSIONS Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
| | - Lena Dahlberg
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden; Dalarna University, School of Education, Health and Social Studies, 791 88, Falun, Sweden.
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
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Guimarães MSF, Tavares DMDS. PREVALENCE AND FACTORS ASSOCIATED WITH ABUSE AND LIKELY DEPENDENCE OF ALCOHOL AMONG ELDERLY. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-2018-0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: verify the prevalence of abuse and probable alcohol dependence in the elderly; describe sociodemographic and clinical characteristics of the elderly; and verify the factors associated with alcohol abuse and probable dependence in the elderly. Method: cross-sectional study, observational, domiciliary survey type, conducted with 614 elderly people living in the urban area of the city of Uberaba, Brazil. The Mini Mental State Examination, sociodemographic instrument, Older Americans Resources and Services Questionnaire, Geriatric Depression Scale and Michigan Alcoholism Screening Test - Geriatric Version were used. Statistical analysis was performed in the Statiscal Package for Social Sciences. Results: the prevalence of abuse and probable alcohol dependence was 26.5%. Among the elderly with abuse and probable dependence on alcohol, there was predominance of males, 60 |- 70 years old, who lived with a spouse or partner, had 1 |- 5 years of schooling, individual monthly income from 1 -| 3 minimum wages, five or more morbidities and no indication of depressive symptoms. Abuse and probable alcohol dependence were associated with males and the presence of depressive symptoms. Conclusion: the study reinforces the need to identify early abuse and probable alcohol dependence in the elderly and to invest in health action strategies for the purpose of health promotion, disease prevention and rehabilitation of the elderly.
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Substance Use Issues Among the Underserved. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kazemi F, Motalebi SA, Mirzadeh M, Mohammadi F. Predisposing factors for substance abuse among elderly people referring to Qazvin addiction treatment centers, Iran (2017). THE JOURNAL OF QAZVIN UNIVERSITY OF MEDICAL SCIENCES 2018. [DOI: 10.29252/qums.22.5.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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A hidden aspect of the U.S. opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder. Drug Alcohol Depend 2018; 193:142-147. [PMID: 30384321 PMCID: PMC6242338 DOI: 10.1016/j.drugalcdep.2018.10.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/11/2018] [Accepted: 10/16/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Older adults with opioid use disorder (OUD) are a medically complex population. The current study evaluated trends in older adults seeking treatment for OUD, with a focus on primary heroin versus prescription opioid use. This study also compared older adults with OUD to the younger OUD population on demographics and drug use behaviors. METHODS Publicly available data from state-certified addiction treatment centers were collected via the Treatment Episode Data Set - Admissions (TEDS-A) between 2004-2015. This study utilized Joinpoint Regression to conduct a cross-sectional, longitudinal analysis of trends in first-time treatment admissions for OUD in adults 55 and older (older adults; n = 400,421) versus adults under the age of 55 (n = 7,795,839). Given the rapid increase in older adults seeking treatment for OUD between 2013-2015, secondary outcomes include changes in demographics and drug use between 2012 (as a baseline year) and 2015. RESULTS The proportion of older adults seeking treatment for OUD rose steadily between 2004-2013 (41.2% increase; p-trend = 0.046), then rapidly between 2013-2015 (53.5% increase; p-trend = 0.009). The proportion of older adults with primary heroin use more than doubled between 2012-2015 (p < 0.001); these individuals were increasingly male (p < 0.001), African American (p < 0.001), and using via the intranasal route of administration (p < 0.001). CONCLUSIONS There has been a recent surge in older adults seeking treatment for OUD, particularly those with primary heroin use. Specialized treatment options for this population are critically needed, and capacity for tailored elder care OUD treatments will need to increase if these trends continue.
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Ahlner F, Sigström R, Rydberg Sterner T, Mellqvist Fässberg M, Kern S, Östling S, Waern M, Skoog I. Increased Alcohol Consumption Among Swedish 70-Year-Olds 1976 to 2016: Analysis of Data from The Gothenburg H70 Birth Cohort Studies, Sweden. Alcohol Clin Exp Res 2018; 42:2403-2412. [PMID: 30422305 DOI: 10.1111/acer.13893] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 09/13/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The older adult population is increasing worldwide, as is the number of older adults who consume alcohol. Although there is a growing body of research on alcohol consumption among older people, few studies focus on changes in at-risk consumption over time across well-defined birth cohorts of older adults. METHODS This study used a serial cross-sectional design in order to compare alcohol consumption patterns among birth cohorts of Swedish 70-year-olds (total n = 2,268) examined in 1976 to 1977 (n = 393), 1992 to 1993 (n = 248), 2000 to 2002 (n = 458), and 2014 to 2016 (n = 1,169). Participants took part in a multidisciplinary study on health and aging. Face-to-face interviews were conducted by healthcare professionals. Protocols regarding alcohol consumption were similar for all cohorts. The volume of weekly alcohol consumption was estimated during the past month. At-risk consumption was defined as ≥100 g alcohol/wk corresponding roughly to the National Institute on Alcohol Abuse and Alcoholism definition of heavy consumption. RESULTS The proportion of at-risk consumers among men increased from 16.1% in 1976 to 1977 to 29.9% in 2000 to 2002 (p = 0.001) and 45.3% in 2014 to 2016 (p < 0.001). In women, proportions were low in 1976 to 1977 (0.5%) and 1992 to 1993 (2.0%; p = 0.134), but increased to 9.5% in 2000 to 2002 (p < 0.001) and 24.3% in 2014 to 2016 (p < 0.001). The male:female ratio regarding consumption of ≥100 g/wk decreased from 32.2:1 in 1976 to 1977 to 3.1:1 in 2000 to 2002 to 1.9:1 in 2014 to 2016. Spirit consumption decreased dramatically among men during the study period, while women reported very low spirit consumption at all examinations. Wine consumption increased in both sexes between 2000 to 2002 and 2014 to 2016. Beer consumption increased among men between 2000 to 2002 and 2014 to 2016. CONCLUSIONS Recent cohorts of 70-year-olds in Sweden report significantly higher levels of alcohol consumption than previous cohorts. There was a dramatic increase in at-risk consumption among 70-year-olds from the 1970s to the mid-2010s, and this was particularly pronounced among women.
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Affiliation(s)
- Felicia Ahlner
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Robert Sigström
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Svante Östling
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry (FA, RS, TRS, MMF, SK, SÖ, MW, IS), Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Dauber H, Pogarell O, Kraus L, Braun B. Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:40. [PMID: 30400930 PMCID: PMC6220462 DOI: 10.1186/s13011-018-0176-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/22/2018] [Indexed: 11/25/2022]
Abstract
Background In western countries demographic changes are leading to an ageing society. Consequently, the number of older adults with alcohol use disorders (AUDs) will rise and the demand of treatment is likely to increase. However, thus far not many older adults with an AUD are seeking treatment and little is known about the efficacy of treatment for older adults. The present study aimed at determining the proportion of older adults with an AUD in addiction treatment, particular characteristics and treatment outcomes of this clientele. Methods Using data of 10,860 patients with an AUD aged 60 and over that are documented within the national German addiction care system we conducted exploratory analyses with regard to prevalence, sociodemographic, disorder- and treatment-related variables. Results Overall, we found a low proportion of older patients in treatment due to AUDs, but highly positive treatment outcomes. With regard to sociodemographic and disorder-related characteristics, older females and late-onset patients in particular constitute a unique clientele. Conclusions The low service utilisation on the one hand but good treatment prognosis on the other emphasise the need to promote treatment seeking among older adults with AUDs. In this context, the special characteristics we found among older patients may contribute to better reach this population and to improve provisions of targeted treatment approaches.
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Affiliation(s)
- Hanna Dauber
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany. .,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Nußbaumstr. 7, 80336, Munich, Germany.
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Nußbaumstr. 7, 80336, Munich, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany.,Department of Public Health Sciences, Stockholm University, 10691, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös-Loránd-University, Budapest, 1053, Hungary
| | - Barbara Braun
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany
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Ouellette L, TenBrink W, Gier C, Shepherd S, Mitten S, Steinberger M, Riley B, Sutliffe C, Jones J. Alcoholism in elderly patients: Characteristics of patients and impact on the emergency department. Am J Emerg Med 2018; 37:776-777. [PMID: 30170930 DOI: 10.1016/j.ajem.2018.08.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lindsey Ouellette
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - William TenBrink
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Chad Gier
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Spencer Shepherd
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Sadie Mitten
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Matthew Steinberger
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Brad Riley
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States; Spectrum Health Hospitals, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Chad Sutliffe
- Grand Valley State University, Department of Allied Health Sciences, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States
| | - Jeffrey Jones
- Department of Emergency Medicine, Michigan State University College of Human Medicine, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States; Spectrum Health Hospitals, 15 Michigan St NE 736B, Grand Rapids, MI 49503, United States.
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Le A, Palamar JJ. Oral health implications of increased cannabis use among older adults: Another public health concern? JOURNAL OF SUBSTANCE USE 2018; 24:61-65. [PMID: 30524195 PMCID: PMC6277025 DOI: 10.1080/14659891.2018.1508518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/29/2018] [Indexed: 12/29/2022]
Abstract
Prevalence of cannabis use among older Americans (aged ≥ 65) appears to be rising, and emerging evidence associates cannabis use with several oral diseases. The burden of oral diseases among older Americans is great, but literature discussing potential implications of increasing rates of cannabis use and the oral health of older persons is lacking. This paper explores the latest trends in prevalence of cannabis use among older Americans and summarizes the literature on the oral health status of older adults and oral effects of cannabis use, and considers broad implications for oral health and public health policy and future research. Further studies on the effects cannabis use on the oral health of older adults are needed. Future research should investigate older subjects' susceptibility to cannabis-related oral diseases, as well as the proportions that develop disease. Policymakers may wish to tackle barriers to access of dental services for the older population, or target subsets of the population that suffer from comparably higher rates of oral diseases, while dental professionals may require training on managing underlying substance use behaviors in addition to clinical oral manifestations.
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Affiliation(s)
- Austin Le
- Department of Population Health, New York University Langone Medical Center, New York, USA
- New York University College of Dentistry, New York, USA
| | - Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
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Gale SC, Peters J, Murry JS, Crystal JS, Dombrovskiy VY. Injury patterns and outcomes in late middle age (55-65): The intersecting comorbidity with high-risk activity - A retrospective cohort study. Ann Med Surg (Lond) 2018; 27:22-25. [PMID: 29511538 PMCID: PMC5832647 DOI: 10.1016/j.amsu.2018.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/16/2018] [Accepted: 01/21/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Late middle age (LMA), is a watershed between youth and old age, with unique physical and social changes and declines in vitality, but a desire to remain active despite increasing comorbidity. While post-injury outcomes in the elderly are well studied, little is known regarding LMA patients. We analyzed the injured LMA population admitted to a rural, regional Level 1 Trauma Center relative to outcomes for both younger and older patients. MATERIALS AND METHODS Our registry was queried retrospectively for patients admitted 7/2008- 12/2015; they were divided into three cohorts: 18-54, 55-65, and >65 years. Demographics, injury details, comorbidities, and outcomes were compiled and compared using ANOVA and Chi-square; p < 0.05 was significant. RESULTS During the study period, 10,543 were admitted; 1419 (14%) were LMA who experienced overall injury mechanisms, severities and patterns that mirrored the younger cohort. However comorbidity rates were high (56.4%) and comparable to the elderly. LMA patients had the highest rates of alcohol abuse, morbid obesity, and psychiatric illness (p < 0.0001) and suffered the poorest outcomes: highest complications and hospital charges, and longest ICU and hospital LOS. LMA mortality (4.1%) was 41% higher than younger patients (2.9%; p < 0.02) and similar to the older cohort (4.7%; p = 0.32). CONCLUSIONS The LMA population has similar mechanisms and injury patterns to younger patients, while exhibiting comorbidity rates similar to the elderly. High-energy injuries exact a greater toll in LMA with poorer outcomes and greater resource utilization. Targeted outreach for injury prevention, and future studies, are needed to address high-risk behavior, substance abuse, and societal contributors.
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Affiliation(s)
- Stephen C. Gale
- Department of Surgery, East Texas Medical Center, Tyler, TX, USA
| | - JoAnn Peters
- Department of Surgery, East Texas Medical Center, Tyler, TX, USA
| | - Jason S. Murry
- Department of Surgery, East Texas Medical Center, Tyler, TX, USA
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Use of alcohol and drugs with addiction potential among older women and men in a population-based study. The Nord-Trøndelag Health Study 2006-2008 (HUNT3). PLoS One 2017; 12:e0184428. [PMID: 28886172 PMCID: PMC5590962 DOI: 10.1371/journal.pone.0184428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 08/23/2017] [Indexed: 02/06/2023] Open
Abstract
Background Little is known about the consumption habits of older adults in Norway with respect to alcohol and the use of drugs with addiction potential, such as benzodiazepines, z-hypnotics and opioids, among regular drinkers. We studied the prevalence of self-reported consumption of alcohol on a regular basis in community-living older men and women (≥ 65 years). Furthermore, we investigated the prevalence of dispensed prescribed drugs with addiction potential in older men and women who were regular drinkers. Methods We used data from the Nord-Trøndelag Health Study 2006–2008 (HUNT3). Of 12,361 older adults in the HUNT3 study, 11,545 had answered the alcohol consumption item and were included in our study. Regular drinkers were defined as consuming alcohol one or more days a week. Data on dispensed drugs with addiction potential were drawn from the Norwegian Prescription Database. Addiction potential was defined as at least one prescription for benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years. Results In total 28.2% of older Norwegian adults were regular drinkers. Men in the study were more likely to be regular drinkers than women. Drugs with addiction potential were used by 32.4% of participants, and were more commonly used by women. Nearly 12% of participants used benzodiazepines, 19% z-hypnotics and 12.4% opioids. Among regular drinkers, 29% used drugs with addiction potential, which was also more common among women. Adjusted for age, gender and living situation, use of z-hypnotics was associated with regular alcohol intake, while use of opioids was associated with no regular alcohol intake. Conclusion The prevalence of the use of drugs with addiction potential was high in a Norwegian population of older adults who reported regular consumption of alcohol. Strategies should be developed to reduce or prevent alcohol consumption among older adults who use drugs with addiction potential.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S. Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
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Bosque-Prous M, Brugal MT, Lima KC, Villalbí JR, Bartroli M, Espelt A. Hazardous drinking in people aged 50 years or older: a cross-sectional picture of Europe, 2011-2013. Int J Geriatr Psychiatry 2017; 32:817-828. [PMID: 27388047 DOI: 10.1002/gps.4528] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/12/2016] [Accepted: 05/27/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess gender and age differences in hazardous drinking and to analyse and compare the factors associated with it in men versus women, and in 50 to 64-year-old versus ≥65-year-old people in Europe. METHODS Cross-sectional study with data from 65,955 people aged ≥50 years from 18 countries (SHARE project, 2011-2013). The outcome variable, hazardous drinking, was calculated using an adaptation of the AUDIT-C test. Several individual (sociodemographic, life-style and health factors) and contextual variables (country socioeconomic indicators and alcohol policies) were analysed. The prevalence of hazardous drinking was estimated by each exposure variable. To estimate associations, multilevel Poisson regression models with robust variance were fit, yielding prevalence ratios and their 95% confidence intervals (95%CI). RESULTS Overall, the prevalence of hazardous drinking was 21.5% (95%CI = 21.1-22.0), with substantial differences between countries. The proportion of hazardous drinking was higher in men than in women [26.3%(95%CI = 25.6-27.1); 17.5%(95%CI = 17.0-18.0), respectively], as well as in middle-aged people than in older people [23.6%(95%CI = 23.0-24.3); 19.2%(95%CI = 18.6-19.8), respectively]. At the individual level, associations were found for migrant background, marital status, educational level, tobacco smoking, depression and self-perceived health. At the contextual level, hazardous drinking was associated with gender inequalities in society (only in women) and alcohol advertising regulations (both genders). CONCLUSIONS One in five people aged ≥50 years in the countries studied is a hazardous drinker, with large differences by countries, gender and age group. Interventions and policies aimed at preventing or reducing alcohol use in this population should account for country, gender and age differences, as well as individual characteristics. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Marina Bosque-Prous
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M Teresa Brugal
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Kenio C Lima
- Department of Dentistry, Postgraduate Public Health Program (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Joan R Villalbí
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Montse Bartroli
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Albert Espelt
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Psicobiologia i Metodologia en Ciències de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
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Choi NG, DiNitto DM, Marti CN. Older adults who use or have used marijuana: Help-seeking for marijuana and other substance use problems. J Subst Abuse Treat 2017; 77:185-192. [DOI: 10.1016/j.jsat.2017.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 02/09/2017] [Accepted: 02/10/2017] [Indexed: 01/28/2023]
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Boule LA, Kovacs EJ. Alcohol, aging, and innate immunity. J Leukoc Biol 2017; 102:41-55. [PMID: 28522597 DOI: 10.1189/jlb.4ru1016-450r] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/24/2017] [Accepted: 04/13/2017] [Indexed: 12/15/2022] Open
Abstract
The global population is aging: in 2010, 8% of the population was older than 65 y, and that is expected to double to 16% by 2050. With advanced age comes a heightened prevalence of chronic diseases. Moreover, elderly humans fair worse after acute diseases, namely infection, leading to higher rates of infection-mediated mortality. Advanced age alters many aspects of both the innate and adaptive immune systems, leading to impaired responses to primary infection and poor development of immunologic memory. An often overlooked, yet increasingly common, behavior in older individuals is alcohol consumption. In fact, it has been estimated that >40% of older adults consume alcohol, and evidence reveals that >10% of this group is drinking more than the recommended limit by the National Institute on Alcohol Abuse and Alcoholism. Alcohol consumption, at any level, alters host immune responses, including changes in the number, phenotype, and function of innate and adaptive immune cells. Thus, understanding the effect of alcohol ingestion on the immune system of older individuals, who are already less capable of combating infection, merits further study. However, there is currently almost nothing known about how drinking alters innate immunity in older subjects, despite innate immune cells being critical for host defense, resolution of inflammation, and maintenance of immune homeostasis. Here, we review the effects of aging and alcohol consumption on innate immune cells independently and highlight the few studies that have examined the effects of alcohol ingestion in aged individuals.
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Affiliation(s)
- Lisbeth A Boule
- Department of Surgery, Division of GI, Trauma, and Endocrine Surgery (GITES), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; .,The Mucosal Inflammation Program (MIP), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.,The Investigations in Metabolism, Aging, Gender and Exercise (IMAGE) Research Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; and
| | - Elizabeth J Kovacs
- Department of Surgery, Division of GI, Trauma, and Endocrine Surgery (GITES), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; .,The Mucosal Inflammation Program (MIP), University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.,The Investigations in Metabolism, Aging, Gender and Exercise (IMAGE) Research Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; and.,The Immunology Graduate Program, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA
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Abstract
BACKGROUND We aimed to determine the prevalence of alcohol use among older Jamaicans as well as to explore among this population the relationships between alcohol use and: age, sex, depressive symptoms, and life satisfaction. Although the nature of these relationships among the proposed study population were uncertain, in other settings alcohol use has tended to decline with increasing age, occur more commonly among men than women, and show non-linear relationships with depressive symptoms and life satisfaction. METHODS Data gathered by two-stage cluster sampling for a nationally representative health and lifestyle survey of 2,943 community-dwelling older Jamaicans, aged 60 to 103 years, were subjected to secondary analysis using the Student's t-test and χ 2 test as appropriate. RESULTS Current alcohol use was reported by 21.4% of the participants. It steadily declined with age and was six times more prevalent among men (37.6%) than women (6.2%). These findings were statistically significant as were associations of current alcohol use with comparatively lower levels of depressive symptoms. Current alcohol use was also more prevalent among persons who were either highly satisfied or highly dissatisfied with their lives, compared to others who had levels of life satisfaction between these two extremes. CONCLUSIONS Current alcohol use among older Jamaicans occurs primarily among men, declines with increasing age, and is associated with a relatively low likelihood of depression. It is also associated with very high and very low levels of life satisfaction.
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European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol 2017; 34:192-214. [DOI: 10.1097/eja.0000000000000594] [Citation(s) in RCA: 491] [Impact Index Per Article: 70.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kowalchuk AA, Gonzalez SJ, Zoorob RJ. Substance Use Issues Among the Underserved: United States and International Perspectives. Prim Care 2017; 44:113-125. [PMID: 28164811 DOI: 10.1016/j.pop.2016.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Substance use affects people of all ages, cultures, and socioeconomic levels. Most underserved populations have lower rates of substance use than the general population in a given society, excluding tobacco use. The impact of substance use is more severe, however, in the underserved, with higher rates of incarceration, job loss, morbidity, and mortality. Innovative solutions are being developed to address these differences. Working together, underserved patients with substance use problems can be helped on their journeys toward health and wholeness.
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Affiliation(s)
- Alicia Ann Kowalchuk
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA.
| | - Sandra J Gonzalez
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
| | - Roger J Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
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Hayes V, Demirkol A, Ridley N, Withall A, Draper B. Alcohol-related cognitive impairment: current trends and future perspectives. Neurodegener Dis Manag 2016; 6:509-523. [DOI: 10.2217/nmt-2016-0030] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Excessive alcohol use is associated with a wide range of physical, psychological and social consequences, and is responsible for a significant proportion of the burden of disease globally. An area which has received increasing interest is alcohol-related brain damage, not just because of the cost to the individual and society through resource utilization, but also because of the potential for prevention and reversibility. This paper aims to review the current literature on this subject and seeks to explore issues around diagnosis and treatment of alcohol-related brain damage.
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Affiliation(s)
- Victoria Hayes
- Drug & Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia
- School of Public Health & Community Medicine, Faculty of Medicine, UNSW, Sydney, Australia
| | - Apo Demirkol
- Drug & Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia
- School of Public Health & Community Medicine, Faculty of Medicine, UNSW, Sydney, Australia
| | - Nicole Ridley
- Drug & Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia
| | - Adrienne Withall
- School of Public Health & Community Medicine, Faculty of Medicine, UNSW, Sydney, Australia
| | - Brian Draper
- School of Psychiatry, UNSW, Sydney, Australia
- Academic Department of Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia
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Du Y, Wolf IK, Knopf H. Psychotropic drug use and alcohol consumption among older adults in Germany: results of the German Health Interview and Examination Survey for Adults 2008-2011. BMJ Open 2016; 6:e012182. [PMID: 27855095 PMCID: PMC5073532 DOI: 10.1136/bmjopen-2016-012182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The use and combined use of psychotropic drugs and alcohol among older adults is a growing public health concern and should be constantly monitored. Relevant studies are scarce in Germany. Using data of the most recent national health survey, we analyse prevalence and correlates of psychotropic drug and alcohol use among this population. METHODS Study participants were people aged 60-79 years (N=2508) of the German Health Interview and Examination Survey for Adults 2008-2011. Medicines used during the last 7 days were documented. Psychotropic drugs were defined as medicines acting on the nervous system (ATC code N00) excluding anaesthetics (N01), analgesics/antipyretics (N02B), but including opiate codeines used as antitussives (R05D). Alcohol consumption in the preceding 12 months was measured by frequency (drinking any alcohol-containing beverages at least once a week/a day) and quantity (alcohol consumed in grams/day; cut-offs: 10/20 g/day for women/men defining moderate and risky drinking). SPSS complex sample module was used for analysis. RESULTS 21.4% of study participants use psychotropic medications, 66.9% consume alcohol moderately and 17.0% riskily, 51.0% drink alcohol at least once a week and 18.4% daily, 2.8% use psychotropic drugs combined with daily alcohol drinking. Among psychotropic drug users, 62.7% consume alcohol moderately, 14.2% riskily. The most frequently used psychotropic medications are antidepressants (7.9%) and antidementia (4.2%). Factors associated with a higher rate of psychotropic drug use are female sex, worse health status, certified disability and polypharmacy. Risky alcohol consumption is positively associated with male sex, smoking, upper social class, better health status, having no disability and not living alone. CONCLUSIONS Despite the high risk of synergetic effects of psychotropic drugs and alcohol, a substantial part of older psychotropic drug users consume alcohol riskily and daily. Health professionals should talk about the additional health risks of alcohol consumption when prescribing psychotropic drugs to older adults.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Ingrid-Katharina Wolf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- YD and I-KW contributed equally
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