1
|
Zirulnik A, Liu S, Wells M, Alter SM, Engstrom G, Solano JJ, Clayton LM, Reiter M, Hughes PG, Goldstein L, Shih RD. Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients. J Am Coll Emerg Physicians Open 2024; 5:e13245. [PMID: 39086794 PMCID: PMC11289673 DOI: 10.1002/emp2.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/30/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024] Open
Abstract
Objectives Falls are common in adults aged 65 years and older and are the leading cause of traumatic brain injuries in this age group. Alcohol use may increase the risk of falls as well as the severity of resultant injuries. The aim of this study was to examine the association between self-reported alcohol use and the prevalence of intracranial hemorrhage (ICH) in this patient group. Methods This was a secondary analysis of the Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP), a study of older adults with blunt head trauma from a fall. We determined the characteristics of every fall event, including patient demographics and medical history, and clinical signs and symptoms related to head trauma. Self-reported alcohol use was categorized as none, occasionally, weekly, or daily. We defined ICH as any acute ICH detected by computed tomography scan. We evaluated the association between alcohol use frequency and ICH, adjusted for patient factors and head injury risk factors. Results Of 3128 study participants, 18.2% (n = 567) reported alcohol use: 10.3% with occasional use, 1.9% with weekly use, and 6.0% with daily use. ICH was more common in patients who used alcohol (20.5%, 22.0%, and 25.1% for occasional, weekly, and daily alcohol users, respectively, vs. 12.0% for non-users, p < 0.001). The frequency of alcohol use was independently associated with ICH, adjusted for patient and head injury risk factors. The adjusted odds ratios (with 95% confidence intervals) for occasional, weekly, and daily alcohol users increased from 2.0 (1.5‒2.8) to 2.1 (1.1‒4.1) and 2.5 (1.7‒3.6), respectively, and showed the characteristics of dose‒response effect. Conclusions Alcohol use in older adult emergency department patients with head trauma is relatively common. Self-reported alcohol use appears to be associated with a higher risk of ICH in a dose-dependent fashion. Fall prevention strategies may need to consider alcohol mitigation as a modifiable risk factor.
Collapse
Affiliation(s)
| | - Shan Liu
- Harvard Medical SchoolBostonMassachusettsUSA
- Massachusetts General HospitalBostonMassachusettsUSA
| | - Mike Wells
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
| | - Scott M. Alter
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
- Department of Emergency MedicineDelray Medical CenterDelray BeachFloridaUSA
- Department of Emergency MedicineBethesda Hospital EastBoynton BeachFloridaUSA
| | - Gabriella Engstrom
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
| | - Joshua J. Solano
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
- Department of Emergency MedicineDelray Medical CenterDelray BeachFloridaUSA
- Department of Emergency MedicineBethesda Hospital EastBoynton BeachFloridaUSA
| | - Lisa M. Clayton
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
- Department of Emergency MedicineDelray Medical CenterDelray BeachFloridaUSA
- Department of Emergency MedicineBethesda Hospital EastBoynton BeachFloridaUSA
| | - Mark Reiter
- University of Tennessee Health Science CenterNashvilleTennesseeUSA
| | - Patrick G. Hughes
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
- Department of Emergency MedicineDelray Medical CenterDelray BeachFloridaUSA
- Department of Emergency MedicineBethesda Hospital EastBoynton BeachFloridaUSA
| | - Lara Goldstein
- Department of Emergency MedicineMemorial Healthcare SystemHollywoodFloridaUSA
| | - Richard D. Shih
- Department of Emergency MedicineFlorida Atlantic UniversityCharles E. Schmidt College of MedicineBoca RatonFloridaUSA
- Department of Emergency MedicineDelray Medical CenterDelray BeachFloridaUSA
| |
Collapse
|
2
|
Tang Y, Caswell E, Mohamed R, Wilson N, Osmanovic E, Smith G, Hartley SD, Bhandari R. A systematic review of validity of US survey measures for assessing substance use and substance use disorders. Syst Rev 2024; 13:166. [PMID: 38937847 PMCID: PMC11210012 DOI: 10.1186/s13643-024-02536-x] [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: 10/12/2023] [Accepted: 04/17/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The steep rise in substance use and substance use disorder (SUD) shows an urgency to assess its prevalence using valid measures. This systematic review summarizes the validity of measures to assess the prevalence of substance use and SUD in the US estimated in population and sub-population-based surveys. METHODS A literature search was performed using nine online databases. Studies were included in the review if they were published in English and tested the validity of substance use and SUD measures among US adults at the general or sub-population level. Independent reviews were conducted by the authors to complete data synthesis and assess the risk of bias. RESULTS Overall, 46 studies validating substance use/SUD (n = 46) measures were included in this review, in which 63% were conducted in clinical settings and 89% assessed the validity of SUD measures. Among the studies that assessed SUD screening measures, 78% examined a generic SUD measure, and the rest screened for specific disorders. Almost every study used a different survey measure. Overall, sensitivity and specificity tests were conducted in over a third of the studies for validation, and 10 studies used receiver operating characteristics curve. CONCLUSION Findings suggest a lack of standardized methods in surveys measuring and reporting prevalence of substance use/SUD among US adults. It highlights a critical need to develop short measures for assessing SUD that do not require lengthy, time-consuming data collection that would be difficult to incorporate into population-based surveys assessing a multitude of health dimensions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022298280.
Collapse
Affiliation(s)
- Yuni Tang
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, 26501, USA
- Highway Safety Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin Caswell
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, 26501, USA
| | - Rowida Mohamed
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
- Biological Sciences Division, University of Chicago, Chicago, USA, IL
| | - Natalie Wilson
- Health Affairs Institute, West Virginia University, Morgantown, WV, USA
| | - Edis Osmanovic
- Health Affairs Institute, West Virginia University, Morgantown, WV, USA
| | - Gordon Smith
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, 26501, USA
| | | | - Ruchi Bhandari
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, 26501, USA.
| |
Collapse
|
3
|
Tevik K, Skråstad RB, Benth JŠ, Selbæk G, Bergh S, Eldholm RS, Krokstad S, Helvik AS. Prevalence and change in alcohol consumption in older adults over time, assessed with self-report and Phosphatidylethanol 16:0/18:1 -The HUNT Study. PLoS One 2024; 19:e0304714. [PMID: 38820445 PMCID: PMC11142565 DOI: 10.1371/journal.pone.0304714] [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: 11/21/2023] [Accepted: 05/16/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Changes in alcohol consumption may affect older adults' health. We examined prevalence and changes in the alcohol consumption of older women and men (≥65 years) in Norway over a 24-year period. METHODS Data from three population-based health surveys (The Trøndelag Health Study-HUNT2 1995-97, HUNT3 2006-08, HUNT4 2017-19) were used. Alcohol consumption was measured using self-reported measures and an objective measure of alcohol consumption (Phosphatidylethanol 16:0/18:1, PEth). Self-reported lifetime abstinence, former drinking, current drinking, frequent drinking (≥4 times/week), and risk drinking (≥8 units/week) were measured. The PEth concentrations were stratified: <0.03 μmol/l (abstinence/very low level of alcohol consumption); >0.06 μmol/l (indicating >1 unit/day); >0.10 μmol/l (indicating >3 units/day), and >0.30 μmol/l (heavy alcohol consumption). RESULTS In HUNT4, the prevalence of self-reported lifetime abstinence, frequent drinking, and risk drinking was 5.2%, 4.4%, and 5.6%, respectively, while prevalence of PEth <0.03 μmol/l was 68.1% and PEth >0.06 μmol/l was 21.2%. Over the course of the three surveys, the prevalence of self-reported lifetime abstinence decreased, while the prevalence of frequent drinking and risk drinking increased. Men were less often abstainers and more often frequent and risky drinkers than women in all three surveys. Gender differences for abstinence and current drinking reduced with time. From HUNT3 to HUNT4, the prevalence of PEth <0.03 μmol/l decreased, while the prevalence of PEth >0.06 μmol/l increased. Men compared to women, had less often PEth <0.03 μmol/l and more often PEth >0.06 and >0.10 μmol/l in HUNT3 and HUNT4. Women and men ≥75 years were just as likely to have PEth >0.30 μmol/l in HUNT4. The gender differences in PEth concentrations were reduced in HUNT4 among those aged 70-74 years or ≥75 years. CONCLUSION Alcohol consumption has increased among Norwegian older adults over a 24-year period, but at a slower pace during the last decade.
Collapse
Affiliation(s)
- Kjerstin Tevik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sverre Bergh
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Geriatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-Sofie Helvik
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
4
|
Berhe NM, Hassen HY, Van Geertruyden JP, Ndejjo R, Musinguzi G, Bastiaens H, Abrams S. Types and Effectiveness of Community-Based Cardiovascular Disease Preventive Interventions in Reducing Alcohol Consumption: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e61323. [PMID: 38947657 PMCID: PMC11212836 DOI: 10.7759/cureus.61323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 07/02/2024] Open
Abstract
Cardiovascular disease (CVD) poses a global health challenge, with modifiable risk factors, notably alcohol consumption, impacting its onset and progression. This review synthesizes evidence on the types and effectiveness of community-based interventions (CBIs) aimed at reducing alcohol consumption for CVD prevention. Electronic databases were systematically searched until October 31, 2019, with updates until February 28, 2023. Given the heterogeneity in outcome measures, we narratively synthesized the effectiveness of CBIs, adhering to the synthesis without meta-analysis (SWiM) guidelines for transparent reporting. For selected homogenous studies, a random-effects meta-analysis was utilized to estimate the effects of CBIs on alcohol consumption. Twenty-two eligible studies were included, with 16 demonstrating that CBIs reduced alcohol consumption compared to controls. Meta-analysis findings revealed reductions in above moderate-level alcohol consumption (pooled odds ratio (OR)=0.50, 95% confidence interval (CI): 0.37, 0.68), number of alcohol drinks per week (standardized mean difference=-0.08, 95% CI: -0.14, -0.03), and increased odds of low-risk drinking (pooled OR=1.99, 95% CI: 1.04, 3.81) compared to the control groups. Multi-component interventions (particularly those combining health education, awareness, and promotion activities) and those interventions with a duration of 12 months or more were notably effective. The beneficial effects of CBIs focusing on achieving a reduction in alcohol consumption showed promising outcomes. Implementing such interventions, especially multicomponent interventions, could play a significant role in mitigating the increasing burden of CVDs. Future studies should also consider employing standardized and validated tools to measure alcohol consumption outcomes to enhance the consistency and comparability of findings.
Collapse
Affiliation(s)
- Neamin M Berhe
- Department of Primary & Integrated Care, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
- Department of Health Sciences, Société Générale de Surveillance (SGS) Life Sciences, Mechelen, BEL
| | - Hamid Y Hassen
- Department of Primary & Integrated Care, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UGA
| | - Geofrey Musinguzi
- Department of Primary & Integrated Care, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UGA
| | - Hilde Bastiaens
- Department of Primary & Integrated Care, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
- Global Health Institute, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
| | - Steven Abrams
- Global Health Institute, Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BEL
- Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, BEL
| |
Collapse
|
5
|
Booth L, Miller M, Pettigrew S. The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review. Drug Alcohol Rev 2024; 43:141-155. [PMID: 37934620 DOI: 10.1111/dar.13769] [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: 02/27/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
ISSUES Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. APPROACH A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. KEY FINDINGS The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. IMPLICATIONS AND CONCLUSION Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.
Collapse
Affiliation(s)
- Leon Booth
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Mia Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
6
|
Chaudhary S, Chen Y, Zhornitsky S, Le TM, Zhang S, Chao HH, Dominguez JC, Li CSR. The effects of age on the severity of problem drinking: Mediating effects of positive alcohol expectancy and neural correlates. Addict Biol 2023; 28:e13278. [PMID: 37252876 DOI: 10.1111/adb.13278] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/24/2023] [Accepted: 03/20/2023] [Indexed: 06/01/2023]
Abstract
Aging is associated with reduction in the severity of alcohol misuse. However, the psychological and neural mechanisms underlying the age-related changes remain unclear. Here, we tested the hypothesis that age-related diminution of positive alcohol expectancy (AE) mediated the effects of age on problem drinking and investigated the neural correlates of the mediating effects. Ninety-six drinkers 21-85 years of age, including social drinkers and those with mild/moderate alcohol use disorder (AUD), were assessed for global positive (GP) AE and problem drinking, each with the Alcohol Expectancy Questionnaire and Alcohol Use Disorders Identification Test (AUDIT), and with brain imaging during alcohol cue exposure. We processed imaging data with published routines; identified the correlates shared between whole-brain regression against age, GP and AUDIT scores; and performed mediation and path analyses to explore the interrelationships between the clinical and neural variables. The results showed that age was negatively correlated with both GP and AUDIT scores, with GP score completely mediating the correlation between age and AUDIT score. Lower age and higher GP correlated with shared cue responses in bilateral parahippocampal gyrus and left middle occipital cortex (PHG/OC). Further, higher GP and AUDIT scores were associated with shared cue responses in bilateral rostral anterior cingulate cortex and caudate head (ACC/caudate). Path analyses demonstrated models with significant statistical fit and PHG/OC and ACC/caudate each interrelating age to GP and GP to AUDIT scores. These findings confirmed change in positive AE as a psychological mechanism mitigating alcohol misuse as individuals age and highlighted the neural processes of cue-reactivity interrelating age and alcohol use severity.
Collapse
Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Thang M Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Herta H Chao
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | | | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| |
Collapse
|
7
|
Lee S, Kim J, Kim JS. Current Status of Korean Alcohol Drinking in Accordance with the Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing. Korean J Fam Med 2023; 44:129-142. [PMID: 37225438 DOI: 10.4082/kjfm.23.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023] Open
Abstract
Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans' alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.
Collapse
Affiliation(s)
- Sami Lee
- Department of Family Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Jihan Kim
- Department of Family Medicine, Sejong Trinium Woman's Hospital, Sejong, Korea
- Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jong Sung Kim
- Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| |
Collapse
|
8
|
Ramsoomar L, Gibbs A, Chirwa ED, Machisa MT, Alangea DO, Addo-Lartey AA, Dunkle K, Jewkes R. Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South. BMJ Open 2023; 13:e063730. [PMID: 36921941 PMCID: PMC10030569 DOI: 10.1136/bmjopen-2022-063730] [Citation(s) in RCA: 1] [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] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES To describe associations between men's poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women's mental health and their experiences of IPV and NPSV in five settings in the Global South. DESIGN A pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations. SETTING Three sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories. PARTICIPANTS 7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys. MAIN OUTCOME MEASURES All studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women's health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women. FINDINGS Overall men's poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not. CONCLUSIONS Interventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women's experience.
Collapse
Affiliation(s)
- Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Psychology, University of Exeter, Exeter, Devon, UK
| | - Esnat D Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercilene T Machisa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Deda Ogum Alangea
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Adolphina Addoley Addo-Lartey
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
| |
Collapse
|
9
|
Alcohol and aging - An area of increasing concern. Alcohol 2023; 107:19-27. [PMID: 35940508 DOI: 10.1016/j.alcohol.2022.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/18/2022]
Abstract
Alcohol use is increasing among adults 65 and older and the size of this population is expanding rapidly. Aging is associated with systemic inflammation, sleep disturbances, cancers, cognitive decline, and increased risk of injury and death from falls and other accidents. Alcohol misuse exacerbates and accelerates these age-related changes. Older drinkers are more sensitive to acute alcohol-induced impairments in memory, coordination, reaction time, and driving performance. Oxidative stress and DNA damage resulting from chronic heavy alcohol consumption contribute to an increased risk of cancer, liver disease, and cardiovascular disease. Medication use increases with age and many medications prescribed to older adults can interact negatively with alcohol. The rapid expansion of the population aged 65 and older, combined with higher levels of alcohol use and AUD in the Baby Boomer cohort than the preceding generation, could significantly increase the burden of alcohol on the healthcare system resulting from AUD and alcohol-related injuries and diseases. Screening and brief intervention for hazardous alcohol use among older patients along with education regarding potential interactions between alcohol and medications could substantially reduce the risk of harms from alcohol but currently is underutilized.
Collapse
|
10
|
Belay GM, Lam KKW, Liu Q, Wu CST, Mak YW, Ho KY. Magnitude and determinants of alcohol use disorder among adult population in East Asian countries: A systematic review and meta-analysis. Front Public Health 2023; 11:1144012. [PMID: 36926176 PMCID: PMC10011711 DOI: 10.3389/fpubh.2023.1144012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol use despite adverse health outcomes. Despite several studies that have analyzed the prevalence and determinants, their results have been equivocal, and the reasons for the differences in prevalence rates and determinants of AUD across nationalities are unknown. Hence, this study estimated the pooled prevalence of alcohol use disorder and its determinant among adults in East Asian countries. Methods Articles were searched from PubMed, Web of Science, EMBASE, PsycINFO, and Scopus. All observational study designs that fulfilled the predefined criteria were included in the study. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The quality and heterogeneity of articles were assessed using the new castle-Ottawa scale (NOS) and I2, respectively. Additionally, publication bias was checked through funnel plot and Egger's regression test. Results A total of 14 articles with 93, 161 study participants were considered in the study. Of which 9 studies were included in the meta-analysis of the 1-year prevalence of alcohol use disorder, 6 in the lifetime, 9 in alcohol abuse, and 8 in alcohol dependency. Consequently, the overall pooled prevalence of one-year alcohol use disorder was 8.88% (95% CI: 6.32, 11.44), lifetime 13.41% (95%CI: 8.48, 18.34), alcohol abuse 5.4% (95% CI: 2.66, 8.13), and alcohol dependency 4.47% (95% CI: 2.66, 6.27). In the subgroup analysis by country, the highest 1-year and lifetime pooled prevalence of alcohol use disorder was observed in Korea at 9.78% (95% CI:4.40, 15.15) and 16.73% (95% CI: 15.31, 18.16), respectively. Besides, smoking (OR: 3.99; 95% CI: 1.65, 6.33) and male gender (OR: 5.9; 95% CI: 3.3, 8.51) were significant determinants of alcohol use disorder. Conclusions The magnitude of alcohol use disorder was high among adults in East Asian countries. Smoking and male gender were the key determinants of alcohol use disorders.
Collapse
Affiliation(s)
| | | | | | | | | | - Ka Yan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
11
|
Pitkälä KH, Immonen S, Öhman H. "Always on vacation": alcohol has become a geriatric problem. Eur Geriatr Med 2023; 14:5-7. [PMID: 36399254 DOI: 10.1007/s41999-022-00718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kaisu H Pitkälä
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Sirpa Immonen
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Öhman
- Clinics of Internal Medicine and Geriatrics, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
12
|
Johannessen A, Tevik K, Engedal K, Tjelta T, Helvik AS. Family' members experiences of their older relative's alcohol and substance misuse. Int J Qual Stud Health Well-being 2022; 17:2094059. [PMID: 35786387 PMCID: PMC9255228 DOI: 10.1080/17482631.2022.2094059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services. AIM To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems. METHOD In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis. FINDINGS Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse. CONCLUSION The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation.
Collapse
Affiliation(s)
- Aud Johannessen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway
| | - Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Knut Engedal
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Thomas Tjelta
- Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway
| | - Anne-Sofie Helvik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
13
|
Owens JM. Recognition of Unhealthy Alcohol Use in Older Adults. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|