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Critchlow N, Moodie C, Gallopel-Morvan K. Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1155-1167. [PMID: 38787498 DOI: 10.1111/acer.15327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Statutory options for restricting alcohol advertising include limiting it to product-orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). METHODS We conducted a 2 × 2 online between-group experiment with adults (18+) (n = 2421) recruited from a non-probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol-related information and support. The "drink responsibly" control reflected the self-regulatory messages commonly used by alcohol companies. Participants rated the advert on 7-point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. RESULTS Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: -1.57 [makes drinking alcohol seem enjoyable] to -0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: -0.55 [advert attractiveness] to -0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. CONCLUSIONS Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups.
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Affiliation(s)
- Nathan Critchlow
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Karine Gallopel-Morvan
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U1309, Rennes, France
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Zheng JW, Ai SZ, Chang SH, Meng SQ, Shi L, Deng JH, Di TQ, Liu WY, Chang XW, Yue JL, Yang XQ, Zeng N, Bao YP, Sun Y, Lu L, Shi J. Association between alcohol consumption and sleep traits: observational and mendelian randomization studies in the UK biobank. Mol Psychiatry 2024; 29:838-846. [PMID: 38233469 DOI: 10.1038/s41380-023-02375-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
Previous studies have shown that excessive alcohol consumption is associated with poor sleep. However, the health risks of light-to-moderate alcohol consumption in relation to sleep traits (e.g., insomnia, snoring, sleep duration and chronotype) remain undefined, and their causality is still unclear in the general population. To identify the association between alcohol consumption and multiple sleep traits using an observational and Mendelian randomization (MR) design. Observational analyses and one-sample MR (linear and nonlinear) were performed using clinical and individual-level genetic data from the UK Biobank (UKB). Two-sample MR was assessed using summary data from genome-wide association studies from the UKB and other external consortia. Phenotype analyses were externally validated using data from the National Health and Nutrition Examination Survey (2017-2018). Data analysis was conducted from January 2022 to October 2022. The association between alcohol consumption and six self-reported sleep traits (short sleep duration, long sleep duration, chronotype, snoring, waking up in the morning, and insomnia) were analysed. This study included 383,357 UKB participants (mean [SD] age, 57.0 [8.0] years; 46% male) who consumed a mean (SD) of 9.0 (10.0) standard drinks (one standard drink equivalent to 14 g of alcohol) per week. In the observational analyses, alcohol consumption was significantly associated with all sleep traits. Light-moderate-heavy alcohol consumption was linearly linked to snoring and the evening chronotype but nonlinearly associated with insomnia, sleep duration, and napping. In linear MR analyses, a 1-SD (14 g) increase in genetically predicted alcohol consumption was associated with a 1.14-fold (95% CI, 1.07-1.22) higher risk of snoring (P < 0.001), a 1.28-fold (95% CI, 1.20-1.37) higher risk of evening chronotype (P < 0.001) and a 1.24-fold (95% CI, 1.13-1.36) higher risk of difficulty waking up in the morning (P < 0.001). Nonlinear MR analyses did not reveal significant results after Bonferroni adjustment. The results of the two-sample MR analyses were consistent with those of the one-sample MR analyses, but with a slightly attenuated overall estimate. Our findings suggest that even low levels of alcohol consumption may affect sleep health, particularly by increasing the risk of snoring and evening chronotypes. The negative effects of alcohol consumption on sleep should be made clear to the public in order to promote public health.
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Affiliation(s)
- Jun-Wei Zheng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 100191, Beijing, China
| | - Si-Zhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510182, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 511436, China
- Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Su-Hua Chang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Jia-Hui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Tian-Qi Di
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 100191, Beijing, China
| | - Wang-Yue Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 100191, Beijing, China
| | - Xiang-Wen Chang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Jing-Li Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Xiao-Qin Yang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 100191, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
| | - Yan Sun
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China.
- Peking-Tsinghua Center for Life Sciences and International Data Group/McGovern Institute for Brain Research, Peking University, 100191, Beijing, China.
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
- The State Key Laboratory of Natural and Biomimetic Drugs, Peking University, 100191, Beijing, China.
- The Key Laboratory for Neuroscience of the Ministry of Education and Health, Peking University, 100191, Beijing, China.
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Ahola J, Kekäläinen T, Kinnunen ML, Tolvanen A, Pitkänen T, Pulkkinen L, Saajanaho M, Kokko K. Stability in health behavior patterns in middle adulthood: a 19-year follow-up study. Psychol Health 2024:1-21. [PMID: 38389311 DOI: 10.1080/08870446.2024.2316676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Objective: This study investigated subgroups of adults with particular health behavior patterns, their stability over 19 years, and the role of sociodemographic and personality characteristics in these. Methods and Measures: Data on smoking, alcohol consumption, and physical activity were collected at ages 42, 50, and 61 in the Jyväskylä Longitudinal Study of Personality and Social Development (n = 205-302). Latent class, latent transition, and logistic regression analyses were used. Results: Four similar classes of health behaviors were identified at each age. A class named low alcohol consumption (AC)-high physical activity (PA) included individuals with the lowest levels of alcohol consumption and the highest levels of physical activity, and a class named high AC-low PA vice versa. Classes between these extremes of alcohol consumption and physical activity levels were nonsmokers with the lowest proportion of smokers, and smokers vice versa. Although transitions emerged, class memberships were relatively stable. Women, those who were married, held a degree, had higher occupational status, and certain personality traits at age 42 were more likely to belong continuously to healthier classes compared to a stable membership in high AC-low PA. Conclusion: Health behaviors exist in patterns, are relatively stable across adulthood, and associated with sociodemographic and personality characteristics.
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Affiliation(s)
- Johanna Ahola
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja-Liisa Kinnunen
- The Wellbeing Services County of Central Finland, Jyväskylä, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Asko Tolvanen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Lea Pulkkinen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Paunescu AC, Delpierre C, Jacob G, Delrieu L, Pannard M, Préau M, Kvaskoff M. Compliance with public health recommendations of cancer-free female research volunteers: the French Seintinelles study. Cancer Causes Control 2024; 35:293-309. [PMID: 37733136 DOI: 10.1007/s10552-023-01788-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Acting on modifiable risk factors can prevent approximately 40% of cancers. Knowing the factors that lead people to adopt healthy behaviors is crucial for designing effective primary prevention campaigns. Our study attempts to provide knowledge in this direction. METHODS This cross-sectional study was conducted via the Seintinelles collaborative research platform in a community of women without a personal cancer history, and volunteering to take online questionnaires. We collected data on sociodemographic and health factors, knowledge of cancer risk factors, behaviors, and possible behavior changes (tobacco/alcohol use, diet, body weight, and physical activity) in the last 10 years. RESULTS The study involved 1465 women aged between 18 and 84 years. Factors such as young age, living alone, and obesity were associated with some positive or negative behavior changes. Being professionally active and having comorbidities favored certain positive behavior changes, while having dependent children, living in a rural area, and being hospitalized were associated with negative or no change in behaviors. Lack of knowledge about modifiable risk factors for cancer was associated with the non-adoption of various healthy behaviors (consumptions of fruit and vegetables, processed and red meat; physical activity). Only 5.5% of participants currently reported to be compliant with seven public health recommendations (smoking; alcohol, fruit/vegetables, and red/processed meat intakes; body mass index; and physical activity). CONCLUSIONS This study allowed to identify the need to increase the level of knowledge on modifiable risk factors for cancer among the general population and to better clarify the content of prevention messages.
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Affiliation(s)
- Alexandra-Cristina Paunescu
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
| | - Cyrille Delpierre
- CERPOP UMR1295 Inserm, Université de Toulouse III, UPS, Toulouse, France
| | - Guillemette Jacob
- Association « Seintinelles. Contre Le Cancer, Tous Volontaires ». 40 Rue Rémy Dumoncel, 75014, Paris, France
| | - Lidia Delrieu
- Association « Seintinelles. Contre Le Cancer, Tous Volontaires ». 40 Rue Rémy Dumoncel, 75014, Paris, France
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris, France
| | - Myriam Pannard
- Institut de Psychologie, UR GRePS, Université Lumière Lyon 2, Bron, France
| | - Marie Préau
- Institut de Psychologie, UR GRePS, Université Lumière Lyon 2, Bron, France
| | - Marina Kvaskoff
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 114 Rue Edouard Vaillant, 94805, Villejuif, France
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Cherpitel CJ, Li L, Kerr WC. The Relationship Between Drinking Patterns and Chronic Health Conditions: New Evidence From Two U.S. National Alcohol Surveys. J Stud Alcohol Drugs 2023; 84:661-669. [PMID: 37306370 PMCID: PMC10600973 DOI: 10.15288/jsad.23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE The association of many chronic disease conditions with alcohol consumption is well established, and research on drinking patterns following diagnosis suggests that those with a chronic condition drink less than their healthy counterparts. However, these studies have not controlled for confounding influences on this relationship. This article reports current drinking patterns of those with one of four chronic disease conditions (hypertension, diabetes, heart disease, cancer) compared to those without, controlling for covariates. METHOD Data were analyzed from a merged sample of the two National Alcohol Surveys of the U.S. adult population (2014-2015 and 2019-2020; n = 9,597). Those reporting any one of the four disease conditions were matched to healthy control respondents on demographic characteristics and history of drinking using propensity score weighting (PSW). RESULTS Those with hypertension and heart disease appeared to drink less than controls during the last year, but after models were adjusted for covariates or PSW, no significant differences were found. For diabetes, only the PSW models showed no significant difference in drinking from controls, whereas both unadjusted and adjusted models for cancer showed no differences from controls. CONCLUSIONS Controlling for covariates and PSW appeared to make cases and their healthy controls more similar in past-year drinking patterns. Observed similarity in drinking patterns of those with and without a chronic disease may serve as an impetus for a greater focus on screening and identification of those with chronic conditions who would benefit from focused harm-reduction messages and implementation of effective alcohol interventions.
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Affiliation(s)
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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Jo Nixon S, Garcia CC, Lewis B. WOMEN'S USE OF ALCOHOL: NEUROBIOBEHAVIORAL CONCOMITANTS AND CONSEQUENCES. Front Neuroendocrinol 2023:101079. [PMID: 37269931 DOI: 10.1016/j.yfrne.2023.101079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/02/2023] [Accepted: 05/27/2023] [Indexed: 06/05/2023]
Abstract
In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.
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Affiliation(s)
- Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Department of Psychology, Gainesville, FL; University of Florida, Department of Neuroscience, Gainesville; University of Florida, Center for Addiction Research & Education, Gainesville, FL.
| | - Christian C Garcia
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Center for Addiction Research & Education, Gainesville, FL
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL; University of Florida, Department of Psychology, Gainesville, FL; University of Florida, Department of Neuroscience, Gainesville; University of Florida, Center for Addiction Research & Education, Gainesville, FL
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7
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Cherpitel CJ, Ye Y, Kerr WC. Association of short-term changes in drinking after onset of a serious health condition and long-term heavy drinking. Drug Alcohol Depend 2022; 241:109691. [PMID: 36371996 PMCID: PMC9772249 DOI: 10.1016/j.drugalcdep.2022.109691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Literature on changes in drinking following diagnosis of chronic health conditions is limited, especially differential response to specific conditions or across demographic subgroups. Methods Data were analyzed from the 2020 National Alcohol Survey of the U.S. adult population (n = 9968). Predictors of change in drinking following first diagnosis of hypertension, heart disease, diabetes, and cancer, and how the short-term post-disease change in drinking was associated with a change in long-term heavy (5 +) drinking from the decade before diagnosis to the decade following diagnosis were analyzed. Results The majority of respondents reported no change in drinking after diagnosis. Men were more likely than women to reduce drinking after hypertension (OR=1.47) but less likely to quit after heart disease (OR=0.46). Black and Hispanic/Latinx drinkers were more likely than white or other drinkers to reduce (OR=2.68, 2.35, respectively) or quit (OR=2.69, 2.34) after hypertension, and more likely to quit after diabetes (OR=3.44, 2.74) and cancer (OR=5.00, 5.27). Black drinkers were more likely to quit after heart disease (OR=3.26). Heavier drinkers were more likely to reduce or quit drinking than lighter drinkers. For all disease types, those who quit drinking after disease onset were less likely to report heavy drinking in the following decade. Conclusions Just cutting down had little effect on subsequent long-term heavy drinking compared to quitting. These data are important for informing efforts aimed at harm reduction in patients diagnosed with a chronic health condition and suggest specific demographic subgroups.
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Affiliation(s)
- Cheryl J Cherpitel
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
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Social, psychological and health characteristics associated with stability and change in adult alcohol consumption. PLoS One 2022; 17:e0277511. [DOI: 10.1371/journal.pone.0277511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Many studies analyzing health effects of alcohol consumption have operationalized alcohol intake from a single baseline measure without further follow-up. Consequently, there is a lack of knowledge about stability and change in alcohol consumption over the life course and the social, psychological, lifestyle, and health characteristics associated with different alcohol consumption trajectories.
Objectives
The aims of the study were to describe the prevalence of different adult-life alcohol consumption trajectories among Danish men and to analyze social, psychological, lifestyle and health characteristics associated with these trajectories.
Methods
For 2510 Danish men, retrospective decade-based information on alcohol consumption during life period 26–60 years was obtained in late midlife and information on individual characteristics was obtained in young adulthood, late midlife and from national hospital registries. The men were allocated to one of six a priori defined alcohol consumption trajectories.
Results
About 65% of Danish men had a stable moderate consumption, drinking 1–21 units weekly while the five other consumption trajectories were comparatively rare: 3% stable abstainers, 4.7% stable high-risk drinkers, 10.9% with increasing and 12.7% with decreasing consumption. Moderate consumption over the adult life-course was associated with the most favorable social, psychological, lifestyle and health characteristics while the other trajectories were generally associated with less favorable characteristics to varying degrees–e. g. this was the case for the stable abstaining trajectory and in particular the trajectory with decreasing consumption.
Conclusion
The findings suggest that the majority of Danish men drink moderately in the life period from young adulthood to late midlife, and deviance from this ‘normal’ moderate consumption trajectory is associated with less favorable social, psychological, lifestyle and health characteristics. Some of these characteristics may influence alcohol consumption patterns, but for some of the trajectories, alcohol consumption may influence health as well as social and psychological functioning.
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Schiller J, Simonsson B, Molarius A. At-risk drinking, loneliness and self-reported diagnosed depression among older people, 70-84 years of age. Aging Ment Health 2022; 27:1037-1044. [PMID: 35866543 DOI: 10.1080/13607863.2022.2098919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES At-risk drinking of alcohol is increasing in the older population and both at-risk drinking and loneliness have been shown to be risk factors for depression. The aim of this study was therefore to investigate the associations between at-risk drinking, loneliness, and self-reported diagnosed depression in the older population. METHODS The study was based on 10,096 persons aged 70-84 years who answered a survey questionnaire sent to a random population sample in Mid-Sweden in 2017. The overall response rate was 77%. The associations between at-risk drinking, loneliness and depression were analysed using multivariate logistic regression, adjusting for age, educational level, country of birth, economic stress, social support, living alone, physical activity, smoking, BMI, and medication use. RESULTS The prevalence of at-risk drinking during the last 12 months was 8% among men and 4% among women. In total, 8% of the men and 14% of the women suffered from loneliness at least weekly. Having a current diagnosed depression was more commonly reported among women (9%) than among men (5%). At-risk drinking was associated with a higher prevalence of diagnosed depression in both men (OR:1.76; 95% CI:1.03-3.01) and women (OR:1.83; 95% CI:1.06-3.18), compared to moderate drinking when adjusting for loneliness and potential confounders. Furthermore, persons who suffered from loneliness every week had a higher prevalence of diagnosed depression (OR:5.95; 95% CI:3.72-9.53 in men and OR:4.80; 95% CI:3.44-6.69 in women) than those who did not suffer from loneliness. CONCLUSION In this population-based study, both at-risk drinking and loneliness were independently associated with self-reported diagnosed depression among men and women aged 70-84 years. These findings are important for prevention of depression among older people.
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Affiliation(s)
- Jim Schiller
- Unit for Public Health, Region Västmanland, Västerås, Sweden
| | - Bo Simonsson
- Unit for Public Health, Region Västmanland, Västerås, Sweden
| | - Anu Molarius
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden.,Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
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Villarreal Rizzo AF, Downer B. The Association between Late-Life Alcohol Consumption and Incident Dementia among Mexican Americans Aged 75 and Older. Gerontol Geriatr Med 2022; 8:23337214221109823. [PMID: 35966639 PMCID: PMC9373159 DOI: 10.1177/23337214221109823] [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: 04/10/2022] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Evidence for late-life alcohol consumption being
associated with reduced dementia risk is largely based on cohort studies of
predominately non-Hispanic white older adults. Our objective was to investigate
the relationship between late-life alcohol consumption and dementia risk among
Mexican-America adults aged 75 and older. Methods: This study was a
retrospective analysis of waves 5 (2004/05) to 8 (2012/13) of the Hispanic
Established Populations for the Epidemiologic Study of the Elderly. The final
sample included 1,255 participants. Late-life alcohol consumption status was
classified as life-long abstainer, former drinker, and current drinker. Dementia
was defined as a score of 18 points or lower on the Mini-Mental Status
Examination or a proxy-reported diagnosis of dementia. Results:
41.8% of participants were life-long abstainers, 42.0% were former drinkers, and
16.3% were current drinkers. Current alcohol consumers had significantly lower
dementia risk compared to life-long abstainers (HR=0.63, 95% CI = 0.44–0.89).
Dementia risk for former alcohol consumers compared to life-long abstainers was
not statistically significant (HR = 0.85, 95% CI = 0.67–1.09).
Conclusions: Current alcohol consumption was associated with
lower dementia risk for Mexican Americans aged 75 and older. Continued research
is needed to identify pathways for the protective association between late life
alcohol consumption and dementia risk.
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Affiliation(s)
| | - Brian Downer
- Department of Nutrition, Metabolism & Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
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Pangaribuan SM, Lin YK, Lin MF, Chang HJ. Mediating Effects of Coping Strategies on the Relationship Between Mental Health and Quality of Life Among Indonesian Female Migrant Workers in Taiwan. J Transcult Nurs 2021; 33:178-189. [PMID: 34784809 DOI: 10.1177/10436596211057289] [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: 11/16/2022] Open
Abstract
INTRODUCTION Mental health is a major concern among migrant workers worldwide. More than 200,846 female migrant workers in Taiwan are from Indonesia. The study's purpose was to investigate mediating effects of coping strategies on the relationship between mental health problems and the quality of life (QoL). METHOD This cross-sectional study was conducted in Taiwan. In total, 500 Indonesian female migrant workers completed four questionnaires. A mediation test was conducted to estimate direct and indirect effects. RESULTS Coping strategies, namely substance use, behavioral disengagement, denial, and religious dedication, partially mediated the relationship between mental health problems (depression, anxiety, and stress) and QoL among Indonesian female migrant workers in Taiwan. DISCUSSION Health promotion programs should be developed for Indonesian female migrant workers in Taiwan to help them detect and overcome their mental health problems. Interventions that facilitate effective coping strategies should be administered to improve their QoL.
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Affiliation(s)
| | - Yen-Kuang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Hsiu-Ju Chang
- College of Nursing, Department of Nursing, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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12
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The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults. Br J Nutr 2021; 126:1380-1388. [PMID: 33441197 DOI: 10.1017/s0007114521000088] [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: 11/05/2022]
Abstract
Given the dynamic characteristic of an individual's drinking behaviours, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥ 40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5·3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the third visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2·9 mmHg, P = 0·032) and -adjusted models (3·6 mmHg, P = 0·001), and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3·9 mmHg, P = 0·003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption rather than the trajectory may be significantly related to raised SBP, and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP is adjusted in men.
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13
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Adherence to Drinking Guidelines and Reasons for Alcohol Consumption Cessation in the Southern Cone of Latin America - Findings from the CESCAS Study. Glob Heart 2021; 16:2. [PMID: 33598382 PMCID: PMC7792452 DOI: 10.5334/gh.840] [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] [Indexed: 11/20/2022] Open
Abstract
Introduction Alcohol consumption is a risk factor for morbidity and mortality globally. Consumption levels in Southern Latin America are among the highest in the world. Objectives To describe consumption patterns and adherence to guidelines in the general adult population of Southern Latin America, as well as exploration of reasons for alcohol cessation and the advising role of the health worker in this decision. Methods In 7,520 participants from the Centro de Excelencia en Salud Cardiovascular para el America del Sur (CESCAS) cohort, consumption patterns were described and the proportion excessive drinkers (i.e. >7 units/week for women and >14 for men or binge drinking: >4 (women) or >5 (men) units at a single occasion) was calculated. Former drinkers were asked if they had quit alcohol consumption on the advice of a health worker and/or because of health reasons. Furthermore, among former drinkers, multivariable logistic regression analysis was performed to assess which participant characteristics were independently associated with the chance of quitting consumption on a health worker's advice. Results Mean age was 54.8 years (SD = 10.8), 42% was male. Current drinking was reported by 44.6%, excessive drinking by 8.5% of the population. In former drinkers, 23% had quit alcohol consumption because of health reasons, half of them had additionally quit on the advice of a health worker. The majority of former drinkers however had other, unknown, reasons. When alcohol cessation was based on a health worker's advice, sex, country of residence, educational status and frequency of visiting a physician were independent predictors. Conclusion In this Southern American population-based sample, most participants adhered to the alcohol consumption guidelines. The advising role of the health worker in quitting alcohol consumption was only modest and the motivation for the majority of former drinkers remains unknown. A more detailed assessment of actual advice rates and exploration of additional reasons for alcohol cessation might be valuable for alcohol policy making.
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14
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Love SAM, North KE, Zeng D, Petruski-Ivleva N, Kucharska-Newton A, Palta P, Graff M, Loehr L, Jones SB, Heiss G. Nine-Year Ethanol Intake Trajectories and Their Association With 15-Year Cognitive Decline Among Black and White Adults. Am J Epidemiol 2020; 189:788-800. [PMID: 31971233 PMCID: PMC7407608 DOI: 10.1093/aje/kwaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/14/2022] Open
Abstract
Faster rates of age-related cognitive decline might result in early onset of cognitive impairment and dementia. The relationship between ethanol intake and cognitive decline, although studied extensively, remains poorly understood. Previous studies used single measurements of ethanol, and few were conducted in diverse populations. We assessed the association of 9-year trajectories of ethanol intake (1987-1998) with 15-year rate of decline in cognitive performance from mid- to late life (1996-2013) among 2,169 Black and 8,707 White participants of the US Atherosclerosis Risk in Communities study using multivariable linear regression models. We hypothesized that stable, low to moderate drinking would be associated with lesser 15-year cognitive decline, and stable, heavy drinking with greater 15-year cognitive decline. Stable, low to moderate drinking (for Blacks, adjusted mean difference (MD) = 0.03 (95% confidence interval (CI): -0.13, 0.19); for Whites, adjusted MD = 0.02 (95% CI: -0.05, 0.08)) and stable, heavy drinking (for Blacks, adjusted MD = 0.08 (95% CI: -0.34, 0.50); for Whites, adjusted MD = -0.03 (95% CI: -0.18, 0.11)) in midlife compared with stable never-drinking were not associated with 15-year decline in general cognitive function from mid- to late life. No association was observed for the stable former and "mostly" drinking trajectories with 15-year cognitive decline. Stable low, low to moderate, and stable heavy drinking in midlife are not associated with lesser and greater cognitive decline, respectively, from mid- to late life among Black and White adults.
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Affiliation(s)
- Shelly-Ann M Love
- Correspondence to Dr. Shelly-Ann M. Love, Department of Epidemiology, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27516 (e-mail: )
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15
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Rosansky JA, Rosenberg H. A systematic review of reasons for abstinence from alcohol reported by lifelong abstainers, current abstainers and former problem‐drinkers. Drug Alcohol Rev 2020; 39:960-974. [DOI: 10.1111/dar.13119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Joseph A. Rosansky
- Department of Psychology Bowling Green State University Bowling Green USA
| | - Harold Rosenberg
- Department of Psychology Bowling Green State University Bowling Green USA
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16
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The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep 2020; 10:5275. [PMID: 32210292 PMCID: PMC7093458 DOI: 10.1038/s41598-020-62227-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 03/02/2020] [Indexed: 11/11/2022] Open
Abstract
The relationship between alcohol consumption and sleep disturbance is complex. The association of alcohol dependence with insomnia is likely to be bidirectional in nature. Alcohol use is common among older people in many societies and the prevalence of insomnia tends to increase with age, therefore this group warrants particular consideration. We explored the cross sectional and long term (30 years) associations between alcohol drinking (volume and hazardous drinking) and sleep duration and insomnia in a general population study of older adults (6,117 male and female civil servants followed for 30 years). For men, drinking more than 21 units (approximately 168 grams) of alcohol per week, compared with not drinking, was associated with waking several times a night (odds ratio 1.30, confidence intervals 1.02–1.66). Men who maintained a heavy volume of drinking over the three decades of observation, or who had an unstable consumption pattern, tended to have worse sleep profiles in terms of waking tired and waking several times. Sustained male hazardous drinking (as measured by the AUDIT-C scale) was also associated with worse sleep profiles. Findings for women were not so clear. In this population based setting, drinking high volumes of alcohol may contribute to the prevalence of sleep problems in older age, particularly for men. People in this age group should be discouraged from using alcohol as a sleep aid.
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Zanjani F, Schoenberg N, Martin C, Clayton R. Reducing Medication Risks in Older Adult Drinkers. Gerontol Geriatr Med 2020; 6:2333721420910936. [PMID: 32166107 PMCID: PMC7052447 DOI: 10.1177/2333721420910936] [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: 08/08/2019] [Revised: 12/03/2019] [Accepted: 02/11/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives: Prevalent concomitant alcohol and medication use among older
adults is placing this group at risk for adverse health events. Given limited existing
interventions to address concomitant alcohol and medication risk (AMR), a brief
educational intervention was demonstrated. The purpose of the current study was to examine
change in AMR behaviors 3 months post-education among older adult drinkers.
Methods: A convenience sample of 58 older adult drinkers (mean age = 72)
was recruited and followed (n = 40; 70% at follow-up), from four
pharmacies in rural Virginia. Results: Findings indicated decreased alcohol
consumption in high-risk drinkers. Conclusion: Future research should explore
methods to sustain reduced AMR.
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Affiliation(s)
| | | | | | - Richard Clayton
- University of Kentucky College of Public Health, Lexington, USA
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18
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Dare J, Wilkinson C, Traumer L, Kusk KH, McDermott ML, Uridge L, Grønkjaer M. "Women of my age tend to drink": the social construction of alcohol use by Australian and Danish women aged 50-70 years. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:35-49. [PMID: 31538364 DOI: 10.1111/1467-9566.12991] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In Australia and Denmark, women aged 50-70 years are more likely than younger women to consume alcohol at levels that exceed national low risk drinking guidelines. To explore and possibly help explain this sociocultural shift in patterns of alcohol use, this research investigated the social construction of alcohol use amongst 49 women (25 in Northern Denmark, 24 in Western Australia) aged 50-69 years. The women viewed drinking as normal and acceptable. While some women reported reducing their drinking due to health concerns, others neutralised alcohol-related health risks through compensatory behaviours including exercise. Such constructions arguably serve to sustain at-risk drinking amongst some women. Our research highlights that interventions to minimise alcohol-related health risks amongst middle-aged and young-old women should acknowledge that women's social construction of their drinking practices may prioritise subjective experiences of "being in control" while drinking, over biomedical understandings of the health impacts of alcohol.
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Affiliation(s)
- Julie Dare
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Celia Wilkinson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Curtin University, Bentley, WA, Australia
| | - Line Traumer
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Kathrine H Kusk
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | | | - Lynsey Uridge
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Mette Grønkjaer
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Chapman J, Harrison N, Kostadinov V, Skinner N, Roche A. Older Australians' perceptions of alcohol-related harms and low-risk alcohol guidelines. Drug Alcohol Rev 2019; 39:44-54. [PMID: 31829473 DOI: 10.1111/dar.13022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/21/2019] [Accepted: 11/24/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND AIMS Australia has an ageing population. Given the concomitant increase in the numbers and proportion of risky drinkers among older adults, research examining contributory factors is a priority. The current study examined older adults' estimates of the NHMRC low-risk drinking guidelines, consumption patterns and associated harms and self-identification of drinking type. DESIGN AND METHODS Data from respondents aged 50+ years (N = 11 886) in the 2016 National Drug Strategy Household Survey were subjected to secondary analyses. Estimates of low-risk drinking levels, perceived level of harm from current drinking, self-identification of drinking type and awareness of standard drinks and labelling were included. Data were examined for those aged 50-59 years and 60+. RESULTS Seventeen percent of older Australians drank at both long-term and short-term risk levels. Approximately 39% of males and 11% of females overestimated the long-term low-risk levels and 54% of males and 20% of females overestimated the short-term low-risk levels. Overestimation was highest among risky drinkers. Most older risky drinkers were aware of standard drinks and labelling; however, less than half perceived their drinking as harmful, instead identifying as social drinkers. DISCUSSION AND CONCLUSIONS Although substantial gaps are evident in older respondents' estimates of low-risk drinking, additional public awareness campaigns are likely to be of limited use. Older peoples' engagement with the public health system presents 'windows of opportunity' to provide targeted, age-appropriate harm reduction strategies. Appropriate intervention and policy responses are required to direct resources to this emerging area of concern.
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Affiliation(s)
- Janine Chapman
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Nathan Harrison
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Victoria Kostadinov
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Natalie Skinner
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
| | - Ann Roche
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, Australia
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Nixon SJ, Lewis B. Clarifying the neurobehavioral sequelae of moderate drinking lifestyles and acute alcohol effects with aging. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:39-78. [PMID: 31733667 DOI: 10.1016/bs.irn.2019.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Epidemiological estimates indicate not only an increase in the proportion of older adults, but also an increase in those who continue moderate alcohol consumption. Substantial literatures have attempted to characterize health benefits/risks of moderate drinking lifestyles. Not uncommonly, reports address outcomes in a single outcome, such as cardiovascular function or cognitive decline, rather than providing a broader overview of systems. In this narrative review, retaining focus on neurobiological considerations, we summarize key findings regarding moderate drinking and three health domains, cardiovascular health, Type 2 diabetes (T2D), and cognition. Interestingly, few investigators have studied bouts of low/moderate doses of alcohol consumption, a pattern consistent with moderate drinking lifestyles. Here, we address both moderate drinking as a lifestyle and as an acute event. Review of health-related correlates illustrates continuing inconsistencies. Although substantive reductions in risk for cardiovascular and T2D events are reported, robust conclusions remain elusive. Similarly, whereas moderate drinking is often associated with enhanced cognition and lower dementia risk, few benefits are noted in rates of decline or alterations in brain structure. The effect of sex/gender varies across health domains and by consumption levels. For example, women appear to differentially benefit from alcohol use in terms of T2D, but experience greater risk when considering aspects of cardiovascular function. Finally, we observe that socially relevant alcohol doses do not consistently impair performance in older adults. Rather, older drinkers demonstrate divergent, but not necessarily detrimental, patterns in neural activation and some behavioral measures relative to younger drinkers. Taken together, the epidemiological and laboratory studies reinforce the need for greater attention to key individual differences and for the conduct of systematic studies sensitive to age-related shifts in neurobiological systems.
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Affiliation(s)
- Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States.
| | - Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida Center for Addiction Research & Education, Gainesville, FL, United States
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Szabó Á, Towers A, Sheridan J, Newcombe D. Ten-Year Trajectories of Alcohol Consumption in Older Adult New Zealanders. J Gerontol B Psychol Sci Soc Sci 2019; 76:496-506. [PMID: 31680155 DOI: 10.1093/geronb/gbz143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Older adults are often treated as a homogeneous drinking group, but research suggests that they engage with alcohol in various ways, ranging from abstention to heavy drinking. The study aimed to (i) identify subgroups of older adults based on changes in frequency and quantity of alcohol use over 10 years and (ii) examine co-occurring changes in mental and physical health. METHOD Data were collected biennially between 2006 and 2016 from 2,632 New Zealanders (55-70 years old at baseline). Latent class growth analysis was performed to identify trajectories of alcohol use. Co-occurring changes in physical and mental health were examined using latent growth curve analysis. RESULTS Five drinking profiles emerged: (i) infrequent, low-quantity consumers; (ii) highly frequent, low-quantity consumers; (iii) moderately frequent, high-quantity consumers; (iv) moderately frequent, low-quantity consumers; and (v) highly frequent, high-quantity consumers. Drinking trajectories demonstrated no change or slight declines in frequency and quantity over time. Frequent and moderately frequent, high-quantity drinking was more prevalent among men, younger participants, and active smokers. Moderately frequent, heavy drinkers were in very poor health. Frequent and moderately frequent, low-quantity drinking was associated with better health and economic well-being. Infrequent, low-quantity consumers were more likely to be women and in poor health. DISCUSSION The five drinking profiles indicate that older adults engage with alcohol in diverse ways. Two of these patterns indicated potentially hazardous use, which highlights the need for screening and intervention in this age group.
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Affiliation(s)
- Ágnes Szabó
- School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Andy Towers
- School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Janie Sheridan
- Centre for Addiction Research, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand
| | - David Newcombe
- Centre for Addiction Research, Faculty of Medical and Health Sciences, the University of Auckland, New Zealand
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Holton A, Boland F, Gallagher P, Fahey T, Moriarty F, Kenny RA, Cousins G. Potentially serious alcohol-medication interactions and falls in community-dwelling older adults: a prospective cohort study. Age Ageing 2019; 48:824-831. [PMID: 31579905 PMCID: PMC6814088 DOI: 10.1093/ageing/afz112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To investigate the association between potentially serious alcohol-medication interactions (POSAMINO criteria), hypothesised to increase the risk of falls in older adults, and falls in community-dwelling older adults at two and 4 years follow-up. DESIGN A prospective cohort study. SETTING The Irish Longitudinal Study on Ageing. SUBJECTS A total of 1,457 community-dwelling older adults aged ≥65 years, with a complete alcohol and regular medication data to allow for the application of the POSAMINO criteria. OUTCOMES Self-reported falls at 2 and 4 years follow-up, any falls (yes/no), injurious falls (yes/no) and number of falls (count variable). RESULTS The number of participants who reported falling since their baseline interview at 2 and 4 years were 357 (24%) and 608 (41.8%), respectively; 145 (10%) reported an injurious fall at 2 years and 268 (18%) at 4 years. Median (IQR) number of falls was 1 (1-2) at 2 years and 2 (1-3) at 4 years. Exposure to CNS POSAMINO criteria, hypothesised to increase the risk of falls due primarily to increased sedation, was associated with a significantly increased risk for falling (adjusted relative risk (RR) 1.50, 95% confidence interval (CI) 1.21-1.88) and for injurious falls (adjusted RR 1.62, 95% CI: 1.03-2.55) at 4 years. These equate to an absolute risk of 19% for falling (95% CI: 5-33%) and 8% for injurious falls (95% CI, 4-20%) at 4 years. CONCLUSIONS Assessment and management strategies to prevent falls in community-dwelling older adults should consider patients' alcohol consumption alongside their assessment of patient medications, particularly among those receiving CNS agents.
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Affiliation(s)
- Alice Holton
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland
| | - Fiona Boland
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul Gallagher
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland
| | - Tom Fahey
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Frank Moriarty
- HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Gráinne Cousins
- School of Pharmacy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland
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Changes in Alcohol Consumption and Associated Variables among Older Adults in Spain: A population-based cohort study. Sci Rep 2019; 9:10401. [PMID: 31320663 PMCID: PMC6639301 DOI: 10.1038/s41598-019-46591-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 06/27/2019] [Indexed: 12/29/2022] Open
Abstract
We examined prospective changes in drinking patterns and their associations with socio-behavioral and health status variables in older adults in Spain using data from a prospective cohort of 2,505 individuals (53.3% women) representative of the non-institutionalized population aged >60 years in Spain. Alcohol consumption was assessed at baseline (2008–10) and at follow-up (2012) with a validated diet history. At risk drinking was defined as consuming >14 g of alcohol/day on average or any binge drinking in the last 30 days; lower amounts were considered light drinking. A total of 26.5% of study participants changed their intake during follow-up. Most participants reduced alcohol intake, but 23.3% of men and 8.9% of women went from light to at risk drinking during the study period. Low social connectivity at baseline was linked to at risk drinking for both sexes. However, the observed associations between changes in social connectivity, morbidity, BMI, or dietary habits and changes in drinking patterns differed by sex. We concluded that since about a quarter of older adults in Spain consume more alcohol than recommended, identifying socio-behavioral factors associated with this behavior is key for designing health campaigns targeting excessive alcohol consumption in this vulnerable population.
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Beck KH, Zanjani F, Allen HK. Social context of drinking among older adults: Relationship to alcohol and traffic risk behaviors. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2019; 64:161-170. [PMID: 33162781 PMCID: PMC7643866 DOI: 10.1016/j.trf.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Alcohol use among older adults is a major public health concern given potentially negative effects to health and functioning in this population. Little is known about context in which alcohol use among older adults occurs, or how context of use is associated with risk behaviors. METHOD Invitation letters were mailed to licensed drivers 65 years and older in Maryland. A total of 825 participants completed an online survey that assessed demographic characteristics, alcohol use, social context of drinking, and driving behaviors. RESULTS The analytic sample consisted of 604 older adult current drinkers (55% male). A factor analysis revealed three separate contexts of drinking: social facilitation, emotional comfort, and relaxation. Drinking in the context of social facilitation was associated with driving after drinking. Drinking in the context of emotional comfort was associated with getting drunk, driving after drinking, and running a stop sign or red light. Drinking in the context of relaxation was associated with traffic risk behaviors, including running a stop sign or red light and getting in a near crash or collision. CONCLUSIONS Understanding the social context of alcohol use among older adults may be useful for targeting and attempting to modify risky alcohol use and driving behaviors.
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Affiliation(s)
- Kenneth H. Beck
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Faika Zanjani
- Virginia Commonwealth University, College of Health Professions, 1200 E. Broad Street, Box 980233, Richmond, VA 23298, USA
| | - Hannah K. Allen
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
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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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Deak T, Savage LM. Preface: Setting the stage for understanding alcohol effects in late aging: A special issue including both human and rodent studies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:xiii-xxv. [PMID: 31733669 PMCID: PMC6998208 DOI: 10.1016/s0074-7742(19)30116-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
It is widely recognized that people worldwide are living longer than in previous decades, with formidable projections regarding the expansion of elderly age groups in the decades to come. Older individuals are also sustaining higher levels of alcohol consumption later in life, and binge drinking remains a prevalent pastime in a significant proportion of aged individuals. Older people are more sensitive to neurobehavioral effects of alcohol, and as individuals age, the cumulative impact of lifetime alcohol intake begins to emerge. This brief review provides a perspective on the emerging field of how alcohol interacts with the aging brain and sets the stage for understanding the relationship between alcohol and overall brain health. In doing so, we introduce a set of articles collected in this book series (all chapters available on PubMed) which spans human epidemiology and clinical outcomes, along with a series of neurobehavioral studies in preclinical (rodent) models. Because both natural aging as well as alcohol use and abuse include tell-tale signs of neuroinflammation (heightened expression of neuroimmune genes, activation of inflammatory signaling pathways, and signs of glial activation), particular emphasis is placed on the role of neuroinflammation in both aging- and alcohol-related alterations in neurobehavioral function, with special emphasis on the spectrum of cognitive dysfunction ranging from mild cognitive impairment to Alzheimer's associated brain pathology.
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Affiliation(s)
- Terrence Deak
- Behavioral Neuroscience Program, Department of Psychology, Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States.
| | - Lisa M Savage
- Behavioral Neuroscience Program, Department of Psychology, Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
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Pennay A, Callinan S, Livingston M, Lubman DI, Holmes J, MacLean S, Herring R, Dietze P. Patterns in Reduction or Cessation of Drinking in Australia (2001-2013) and Motivation for Change. Alcohol Alcohol 2019; 54:79-86. [PMID: 30346513 PMCID: PMC7614938 DOI: 10.1093/alcalc/agy072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 10/14/2018] [Indexed: 11/14/2022] Open
Abstract
AIMS This paper examines: (a) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. SHORT SUMMARY Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons; older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. METHODS Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. RESULTS Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. CONCLUSION Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people.
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Affiliation(s)
- Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Daniel I. Lubman
- Turning Point, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - John Holmes
- School of Health and Related Research, University of Sheffield, UK
| | - Sarah MacLean
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Rachel Herring
- Drug and Alcohol Research Centre, Department of Mental Health, Social Work and Integrative Medicine, School of Health Education, Middlesex University, London, UK
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Zanjani F, Allen HK, Schoenberg N, Martin C, Clayton R. Immediate effects of a brief intervention to prevent alcohol and medication interactions among older adults. HEALTH EDUCATION RESEARCH 2018; 33:261-270. [PMID: 29982394 PMCID: PMC6049010 DOI: 10.1093/her/cyy021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
Risk of experiencing alcohol and medication interactions (AMI) is significant among older adults due to the substantial prevalence of alcohol and medication use in this segment of the population. Given the lack of community-level AMI prevention interventions for older adults, this study aimed to examine the immediate effects of a brief, pharmacy-based intervention to prevent AMI among older adults, as well as assess differential effects by past-month drinking status. A convenience sample of 134 adults aged 59 and older was recruited from four pharmacies in rural Virginia. Participants were assessed on their AMI awareness, intentions and importance prior to and immediately after exposure to intervention materials. Findings support immediate, positive intervention effects on AMI awareness, intentions and perceived importance of AMI messaging. Changes from pre to post-test did not differ by drinking status, but participants who consumed alcohol were less likely than non-drinkers to recognize the potential consequential severity of alcohol and medication interactions at both time points. Recommendations and future research to prevent AMI are discussed.
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Affiliation(s)
- Faika Zanjani
- Department of Gerontology, School of Allied Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Hannah K Allen
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Nancy Schoenberg
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Catherine Martin
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Richard Clayton
- Department of Health, Behavior, and Society, College of Public Health, University of Kentucky, Lexington, KY, USA
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Holton A, Boland F, Gallagher P, Fahey T, Kenny R, Cousins G. Life Course Transitions and Changes in Alcohol Consumption Among Older Irish Adults: Results From The Irish Longitudinal Study on Ageing (TILDA). J Aging Health 2018; 31:1568-1588. [PMID: 29947553 DOI: 10.1177/0898264318783080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The objective of this study was to determine whether trajectories of older adults' alcohol consumption are influenced by the following life course transitions, relationship status, employment status, and self-rated health. Method: Volume and frequency of drinking were harmonized across first three waves of The Irish Longitudinal Study on Ageing (TILDA; N = 4,295). Multilevel regression models were used to model frequency, average weekly consumption, and heavy episodic drinking. Results: Men and women drank more frequently over time, with frequency decreasing with age for women. Average weekly consumption decreased over time and with increasing age. Transitions in self-rated health, particularly those reflecting poorer health, were associated with lower frequency and weekly consumption. Heavy episodic drinking decreased with age. Men who were retired across all waves were more likely to engage in heavy episodic drinking at baseline. Discussion: Despite the decline in average weekly consumption and heavy episodic drinking, the observed quantities consumed and the increase in frequency of consumption suggest that older Irish adults remain vulnerable to alcohol-related harms.
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Affiliation(s)
- Alice Holton
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Fiona Boland
- 2 HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Paul Gallagher
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Tom Fahey
- 2 HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Roseanne Kenny
- 3 The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Gráinne Cousins
- 1 School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Karriker-Jaffe KJ, Greenfield TK, Mulia N, Zemore SE. Ten-Year Trend in Women's Reasons for Abstaining or Limiting Drinking: The 2000 and 2010 United States National Alcohol Surveys. J Womens Health (Larchmt) 2018; 27:665-675. [PMID: 29634451 PMCID: PMC5962333 DOI: 10.1089/jwh.2017.6613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Data on individual and cultural factors contributing to drinking can inform screening and brief intervention in clinical practice. Our aims were to examine 10-year trends in women's reasons for abstaining/limiting drinking and to document changes in associations with drinking status for population subgroups defined by race/ethnicity and age. MATERIALS AND METHODS Using repeated cross-sectional data from White, Black and Hispanic women in the 2000 and 2010 United States National Alcohol Surveys (combined N = 5501), population-weighted multiple linear and multinomial logistic regression models assessed changes in three reasons for abstaining or limiting drinking (health concerns, religious prohibition, and upsetting family or friends) and drinking status (past-year abstainer, low-risk drinker, or at-risk drinker), and their associations over time. RESULTS Adjusting for key demographics, reasons for limiting alcohol consumption declined in importance over time, with reductions in both health concerns and religious prohibition particularly noteworthy for older women of all three racial/ethnic backgrounds. Despite these reductions in importance, both health concerns and religious prohibition were most consistently associated with increased abstinence relative to low-risk drinking; these reasons were not strongly associated with at-risk drinking, however. CONCLUSIONS It is essential for healthcare providers and others to disseminate accurate information about the risks of drinking to counter cultural shifts that suggest greater acceptance of moderate-to-heavy drinking by women aged 40 and older.
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Affiliation(s)
| | | | - Nina Mulia
- Alcohol Research Group, Public Health Institute , Emeryville, California
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute , Emeryville, California
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Knott CS, Britton A, Bell S. Trajectories of alcohol consumption prior to the diagnosis of type 2 diabetes: a longitudinal case-cohort study. Int J Epidemiol 2018; 47:953-965. [PMID: 29342257 PMCID: PMC6005149 DOI: 10.1093/ije/dyx274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/03/2017] [Accepted: 12/18/2017] [Indexed: 12/22/2022] Open
Abstract
Background Non-linear associations have been reported between baseline measures of alcohol consumption and type 2 diabetes (T2DM). However, given that drinking varies over the adult life course, we investigated whether differences existed in the longitudinal trajectory of alcohol consumption according to T2DM status. Methods For a case–cohort (916 incident cases; 7376 controls) of British civil servants nested within the Whitehall II cohort, the self-reported weekly volume of alcohol consumption was traced backwards from the date of diagnosis or censoring to the beginning of the study, covering a period of up to 28 years. Mean trajectories of alcohol intake were estimated separately by diagnosis status using random-effects models. Results Drinking increased linearly among male cases before diagnosis, but declined among male non-cases prior to censoring. At the time of diagnosis or censoring, consumption among those who developed T2DM was 33.4 g/week greater on average. These patterns were not apparent among women. Here, alcohol intake among female cases was consistently below that of non-cases, with the difference in consumption most pronounced around 15 years prior to diagnosis or censoring, at ∼28.0 g/week. Disparities by diagnosis status were attenuated following adjustment for potential confounders, including the frequency of consumption and metabolic factors. Drinking among male and female cases declined following diagnosis. Conclusions Differences in the weekly volume of alcohol consumption are reported in the years leading up to diagnosis or censoring. Although male and female cases predominantly consumed alcohol at volumes lower than or equal to those who were not diagnosed, these disparities appear to be largely explained by a range of socio-demographic and lifestyle factors. Where disparities are observed between cases and non-cases, adjusted absolute differences are small in magnitude. The decision to drink alcohol should not be motivated by a perceived benefit to T2DM risk.
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Affiliation(s)
- Craig S Knott
- Research Department of Epidemiology and Public Health, University College London, London, UK.,MRC Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK and
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Steven Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK.,Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK
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Knott CS, Bell S, Britton A. The stability of baseline-defined categories of alcohol consumption during the adult life-course: a 28-year prospective cohort study. Addiction 2018; 113:34-43. [PMID: 28734088 PMCID: PMC5725237 DOI: 10.1111/add.13949] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/10/2017] [Accepted: 07/14/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS Studies that report the relationship between alcohol consumption and disease risk have predominantly operationalized drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption during the adult life-course according to baseline categories of drinking. DESIGN A prospective observational study. SETTING United Kingdom. PARTICIPANTS A cohort of British civil servants totalling 6838 men and 3372 women aged 34-55 years at baseline, followed for a mean 19.1 (standard deviation = 9.5) years. MEASUREMENTS The volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1-50.0 g/week, 50.1-100.0 g/week, 100.1-150.0 g/week, 150.1-250.0 g/week and >250.0 g/week. For women, the highest category was defined as > 100.0 g/week. Baseline frequency was derived as 'daily or almost daily' and 'not daily or almost daily'. Trajectories were estimated within baseline categories using growth curve models. FINDINGS Trajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men: > 250.0 g/week; women: > 100.0 g/week), declining by 47.0 [95% confidence interval (CI) = 40.7, 53.2] and 16.8 g/week (95% CI = 12.6, 21.0), respectively, per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes. CONCLUSION Among UK civil servants, consumption within baseline drinking categories is generally stable during the life-course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear to be driven by transitions to non-drinking. Cohorts of older people may be at particular risk of misclassifying former heavy drinkers as moderate consumers of alcohol.
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Affiliation(s)
- Craig S. Knott
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK,MRC Epidemiology Unit and Centre for Diet and Activity Research (CEDAR)University of Cambridge School of Clinical MedicineCambridgeUK
| | - Steven Bell
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK,Department of Public Health and Primary Care, Strangeways Research LaboratoryUniversity of CambridgeCambridgeUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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33
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Motivations for reducing alcohol consumption: An international survey exploring experiences that may lead to a change in drinking habits. Addict Behav 2017; 75:40-46. [PMID: 28692953 DOI: 10.1016/j.addbeh.2017.06.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 06/20/2017] [Accepted: 06/29/2017] [Indexed: 02/02/2023]
Abstract
AIMS Brief interventions delivered by doctors and other healthcare practitioners might be meaningfully enhanced by understanding what individual experiences might lead patients to cut down. The aim of the current paper was to explore the experiences that might lead people to reduce their alcohol consumption and to compare these findings between respondents from 21 different countries. METHODS Global Drug Survey is an online cross sectional, opportunistic anonymous survey. This paper includes 72,209 respondents from 21 counties with over 250 respondents (60.8% male). RESULTS Almost a third (32.9%) of participants reported that they would like to drink less alcohol over the next 12months, and a third thought their GP would tell them to cut down if they were honest about their drinking. The primary experiences that were rated as most likely to lead to a change in behaviour were related to physical health, sexual assault and having to seek emergency medical treatment. Respondents from Germany were more likely to select embarrassment as a motivation to reduce drinking than those from other counties. Females were more likely to report indicate motivations related to sexual regret, sexual assault or seeking treatment. Older participants and those in the low risk audit category were more likely to report embarrassment or forgetfulness as potential motivation for change. CONCLUSION Understanding the different motivations that may lead individuals to change their drinking behaviours can be used to inform targeted brief interventions and targeted public health guidance.
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Del Pino-Gutiérrez A, Fernández-Aranda F, Granero R, Tárrega S, Valdepérez A, Agüera Z, Håkansson A, Sauvaget A, Aymamí N, Gómez-Peña M, Moragas L, Baño M, Honrubia M, Menchón JM, Jiménez-Murcia S. Impact of alcohol consumption on clinical aspects of gambling disorder. Int J Ment Health Nurs 2017; 26:121-128. [PMID: 26952336 DOI: 10.1111/inm.12221] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/26/2015] [Accepted: 01/03/2016] [Indexed: 11/27/2022]
Abstract
Similarities between gambling disorder and substance use disorders have been extensively described. To date, however, few studies using large clinical samples have been carried out that reliably assess the relationship between different levels of alcohol consumption and gambling disorders. The present study aimed to assess the impact of baseline alcohol consumption levels on the clinical profile in a large sample of treatment-seeking individuals. Nine hundred and fifty-one consecutive outpatients diagnosed with gambling disorder according to DSM-IV criteria were compared after being included in three alcohol consumption groups (low risk, abuse and risk of dependence) based on their total raw scores on the AUDIT questionnaire. Results showed a high prevalence of risk of alcohol dependence in GD patients who were immigrants, unemployed, and had a low level of education. A positive linear trend was also found between alcohol consumption level and the prevalence of other current and life-time comorbid mental disorders, and for the presence of drug abuse. Statistically significant differences were found between the three alcohol consumption groups in terms of the evolution and severity of the gambling disorder, self-directedness personality trait, and levels of general psychopathology, hostility and paranoid ideation. In conclusion, the results showed an association between increased alcohol consumption and greater dysfunction.
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Affiliation(s)
- Amparo Del Pino-Gutiérrez
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, The Nursing School of the University of Barcelona, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Roser Granero
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Spain
| | - Salomé Tárrega
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Spain
| | - Ana Valdepérez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain
| | - Anders Håkansson
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anne Sauvaget
- Addictology and Psychiatry Department, Nantes University Hospital, France
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Honrubia
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, The Nursing School of the University of Barcelona, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain.,CIBER Mental Health (CIBERSAM), Institute of Health Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Spain
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Kerr WC, Ye Y, Greenfield TK, Williams E, Lui CK, Li L, Lown EA. Changes in heavy drinking following onset of health problems in a U.S. general population sample. Prev Med 2017; 95:47-51. [PMID: 27939261 PMCID: PMC5269508 DOI: 10.1016/j.ypmed.2016.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 01/12/2023]
Abstract
Heavy episodic drinking is a well-established risk factor for heart disease, diabetes, certain cancers, stroke, hypertension and injuries, however, little is known about whether health problems precipitate changes in subsequent drinking patterns. Retrospective cohort analyses of heavy drinking by decade were conducted using data from the 2010 U.S. National Alcohol Survey (n=5240). Generalized estimating equations models were used to predict any, monthly, and weekly heavy (5+) drinking occasions across decades of life following a diagnosis of hypertension, heart problems, diabetes, stroke, cancer, or serious injury. Experiencing heart problems was associated with higher odds of reduced weekly heavy drinking (adjusted odds ratio (ORadj)=3.5; 95% confidence interval (CI); 1.7-7.4). The onset of diabetes was also associated with higher odds of reducing any heavy drinking over the decade (ORadj=1.7; 95% CI; 1.1-2.6). Cancer survivors were less likely to report no heavy drinking (ORadj=0.5; 95% CI; 0.3-0.8) or no weekly heavy drinking (ORadj=0.3; 95% CI; 0.2-0.7). Hypertension, stroke and injury were not found to have any significant associations. Reduced heavy drinking was more likely to be reported by Black drinkers following heart problems and Whites following a diabetes diagnosis. Increased heavy drinking following a cancer diagnosis was significant among women and Whites. Future studies on alcohol's heath and mortality risks should take into consideration effects of health problems on drinking patterns. Additionally, study results support increased prevention efforts targeting heavy drinking among cancer survivors, especially White women, and individuals with or being treated for hypertension.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Edwina Williams
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Camillia K Lui
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - E Anne Lown
- Department of Social and Behavioral Sciences, 3333 California Street, University of California, San Francisco, San Francisco, CA 94118, USA
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36
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Bell S, Mehta G, Moore K, Britton A. Ten-year alcohol consumption typologies and trajectories of C-reactive protein, interleukin-6 and interleukin-1 receptor antagonist over the following 12 years: a prospective cohort study. J Intern Med 2017; 281:75-85. [PMID: 27485145 PMCID: PMC5173424 DOI: 10.1111/joim.12544] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Moderate alcohol consumption is thought to confer cardiometabolic protective effects. Inflammatory pathways are hypothesized to partly underlie this association. OBJECTIVES The aim of this study was to examine the association between typologies of alcohol consumption and markers of inflammation, and their rate of change over time. METHODS Data were collected from 8209 participants [69% men; mean age, 50 years (SD 6.1)] of the British Whitehall II study. Alcohol consumption typologies were defined using up to three measures during an approximately 10-year period spanning from 1985 to 1994 as (i) stable nondrinkers, (ii) stable moderate drinkers (referent), (iii) stable heavy drinkers, (iv) nonstable drinkers and (v) former drinkers. C-reactive protein (CRP), interleukin (IL)-6 and IL-1 receptor antagonist (IL-1 RA) were measured up to three times in the following 12 years. RESULTS Stable moderate drinkers had lower levels of CRP than stable nondrinkers, stable heavy drinkers, former drinkers and nonstable drinkers, but there were no differences in the rate of change in CRP over time between groups. Stable nondrinkers had higher levels of IL-6 as did stable heavy drinkers; rates of change in IL-6 over time were also increased in the latter group. Stable nondrinkers also had higher levels of IL-1 RA. These associations were robust to adjustment for confounding factors. CONCLUSION Our novel investigation of 10-year drinking typologies shows that stable moderate alcohol consumption is associated with a long-term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease.
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Affiliation(s)
- S Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - G Mehta
- UCL Institute of Liver and Digestive Health, Royal Free Campus, University College London, London, UK
| | - K Moore
- UCL Institute of Liver and Digestive Health, Royal Free Campus, University College London, London, UK
| | - A Britton
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Kuiper JS, Zuidersma M, Zuidema SU, Burgerhof JG, Stolk RP, Oude Voshaar RC, Smidt N. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol 2016; 45:1169-1206. [PMID: 27272181 DOI: 10.1093/ije/dyw089] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline. METHODS MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these. RESULTS We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies. CONCLUSIONS Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies.
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Affiliation(s)
- Jisca S Kuiper
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes Gm Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands .,Department of Geriatrics, University Medical Center Groningen, Groningen, The Netherlands
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Gowin JL, Vatsalya V, Westman JG, Schwandt ML, Bartlett S, Heilig M, Momenan R, Ramchandani VA. The Effect of Varenicline on the Neural Processing of Fearful Faces and the Subjective Effects of Alcohol in Heavy Drinkers. Alcohol Clin Exp Res 2016; 40:979-87. [PMID: 27062270 DOI: 10.1111/acer.13046] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 02/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pharmacotherapies for alcohol use disorder have been shown to reduce hazardous drinking and improve overall health. The effect sizes for the effectiveness of these medications, however, are small, underscoring the need to expand the range of therapeutics and develop personalized treatment approaches. Recent studies have suggested that varenicline, an α4β2-nicotinic partial agonist widely used for smoking cessation, can help alcoholics reduce drinking, but the neurocognitive underpinnings of its effectiveness remain largely unexplored. METHODS In this double-blind study, 32 heavy drinkers were randomized to receive varenicline (2 mg/d) or placebo. After 2 weeks of dosing, participants underwent functional MRI scans, during which they viewed images of faces with either neutral or fearful expressions at baseline and following an intravenous alcohol infusion to a target breath alcohol concentration of 80 mg%. Blood oxygen level-dependent (BOLD) response was analyzed with Analysis of Functional Neuroimaging software. Linear mixed-effects models were used to examine the effects of facial expression (fearful vs. neutral) and medication (placebo vs. varenicline) on BOLD response. The effect of medication on measures of subjective response to alcohol was also examined. RESULTS Results indicated a significant facial expression-by-medication interaction in the left amygdala. The groups showed equivalent activation to neutral faces, but, whereas the placebo group showed increased activation to fearful faces, the varenicline group showed no change in activation. Amygdala activation to fearful faces correlated with number of drinks in the previous 90 days and Obsessive Compulsive Drinking Scale scores. There was no effect of varenicline on subjective response to alcohol. CONCLUSIONS Our results indicate that varenicline may disrupt amygdala response to fearful faces in heavy drinkers. Further, amygdala activation correlated with alcohol consumption, suggesting that the effects of varenicline may be related to aspects of drinking behavior. These results suggest that amygdala response to fearful faces may be developed as a biomarker of the effectiveness of medications being developed for the treatment of alcohol use disorder.
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Affiliation(s)
| | - Vatsalya Vatsalya
- Section on Human Psychopharmacology, Bethesda, Maryland.,University of Louisville and Robley Rex VAMC, Louisville, Kentucky
| | | | | | - Selena Bartlett
- Translational Research Institute, Institute for Health and Biomedial Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Reza Momenan
- Clinical Neuroimaging Research Core, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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Holdsworth C, Mendonça M, Pikhart H, Frisher M, de Oliveira C, Shelton N. Is regular drinking in later life an indicator of good health? Evidence from the English Longitudinal Study of Ageing. J Epidemiol Community Health 2016; 70:764-70. [PMID: 26797821 PMCID: PMC4975801 DOI: 10.1136/jech-2015-206949] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/01/2016] [Indexed: 02/02/2023]
Abstract
Background Older people who drink have been shown to have better health than those who do not. This might suggest that moderate drinking is beneficial for health, or, as considered here, that older people modify their drinking as their health deteriorates. The relationship between how often older adults drink and their health is considered for two heath states: self-rated health (SRH) and depressive symptoms. Methods Data were analysed from the English Longitudinal Study of Ageing (ELSA), a prospective cohort study of older adults, using multilevel ordered logit analysis. The analysis involved 4741 participants present at wave 0, (1998/1999 and 2001), wave 4 (2008/2009) and wave 5 (2010/2011). The outcome measure was frequency of drinking in last year recorded at all three time points. Results Older adults with fair/poor SRH at the onset of the study drank less frequently compared with adults with good SRH (p<0.05). Drinking frequency declined over time for all health statuses, though respondents with both continual fair/poor SRH and declining SRH experienced a sharper reduction in the frequency of their drinking over time compared with older adults who remained in good SRH or whose health improved. The findings were similar for depression, though the association between depressive symptoms and drinking frequency at the baseline was not significant after adjusting for confounding variables. Conclusions The frequency of older adults’ drinking responds to changes in health status and drinking frequency in later life may be an indicator, rather than a cause, of health status.
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Affiliation(s)
- Clare Holdsworth
- School of Physical and Geographical Sciences, Keele University, Keele, UK
| | - Marina Mendonça
- School of Physical and Geographical Sciences, Keele University, Keele, UK
| | - Hynek Pikhart
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Nicola Shelton
- Department of Epidemiology & Public Health, University College London, London, UK
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