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Alcohol Use in Older Adults: A Systematic Review of Biopsychosocial Factors, Screening Tools, and Treatment Options. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00974-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Social capital and alcohol risks among older adults (50 years and over): analysis from the Drink Wise Age Well Survey. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Although there has been significant research on the relationship between alcohol consumption and demographic and psychological influences, this does not consider the effect of social influence among older drinkers and if these effects differ between men and women. One aspect of social influence is social capital. The aim of this paper is to examine whether relational and cognitive social capital are associated with higher or lower risk of alcohol use among adults aged 50 years or older and to assess the extent to which this relationship differs between men and women. To investigate this, data were collected from a cross-sectional questionnaire survey of adults over the age of 50 in the United Kingdom who were recruited from general practitioners. The sample consisted of 9,984 individuals whose mean age was 63.87 years. From these data, we developed proxy measures of social capital and associate these with the respondent's level of alcohol consumption as measured on the Alcohol Use Disorders Identification Test (AUDIT-10) scale. In the sample, just over 20 per cent reported an increasing risk or dependency on alcohol. Using two expressions of social capital – relational (social relationships) and cognitive (knowledge acquisition and understanding) – we found that greater levels of both are associated with a reduced risk of higher drinking risk. Being female had no significant effect when combined with relational capital but did have a significant effect when combined with cognitive capital. It is argued that interventions to enhance social relations among older people and education to help understand alcohol risks would be helpful to protect older people from the damaging effects of excessive alcohol consumption.
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Bowen MT, George O, Muskiewicz DE, Hall FS. FACTORS CONTRIBUTING TO THE ESCALATION OF ALCOHOL CONSUMPTION. Neurosci Biobehav Rev 2022; 132:730-756. [PMID: 34839930 PMCID: PMC8892842 DOI: 10.1016/j.neubiorev.2021.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/05/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023]
Abstract
Understanding factors that contribute to the escalation of alcohol consumption is key to understanding how an individual transitions from non/social drinking to AUD and to providing better treatment. In this review, we discuss how the way ethanol is consumed as well as individual and environmental factors contribute to the escalation of ethanol consumption from intermittent low levels to consistently high levels. Moreover, we discuss how these factors are modelled in animals. It is clear a vast array of complex, interacting factors influence changes in alcohol consumption. Some of these factors act early in the acquisition of ethanol consumption and initial escalation, while others contribute to escalation of ethanol consumption at a later stage and are involved in the development of alcohol dependence. There is considerable need for more studies examining escalation associated with the formation of dependence and other hallmark features of AUD, especially studies examining mechanisms, as it is of considerable relevance to understanding and treating AUD.
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Affiliation(s)
- Michael T. Bowen
- The University of Sydney, Brain and Mind Centre, Sydney, NSW, 2050, Australia,The University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, 2006, Australia,Corresponding Author: Michael T. Bowen, Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia,
| | - Olivier George
- Department of Psychology, University of California, San Diego, School of Medicine, La Jolla, CA, 92093, USA
| | - Dawn E. Muskiewicz
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
| | - F. Scott Hall
- Department of Pharmacology & Experimental Therapeutics, College of Pharmacology and Pharmacological Science, University of Toledo, OH, USA
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Wilson TD, Barry KL, Maust DT, Blow FC. Association between relationship quality and concurrent alcohol use and sedative-tranquilizer misuse in middle and later life. Aging Ment Health 2021; 25:1110-1114. [PMID: 32090595 PMCID: PMC7442615 DOI: 10.1080/13607863.2020.1727850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Mid-life adults have notably higher rates of alcohol and other substance misuse than older adults and maintain higher levels of use over time. Social isolation has been linked to higher risk use with increasing age. The purpose of this study is to examine the associations between social relationships, drinking, and misuse of sedative-tranquilizers. METHODS The data for this study come from the national Midlife in the United States study wave 2 (MIDUS 2) of adults (N = 3378; 53.3% women) aged 40 and older. Past month alcohol use and past year sedative medication misuse were assessed with social support and strain. Multinomial logistic regressions evaluated the relationship of (a) support and (b) strain to use and co-use of alcohol and sedatives. RESULTS Of the sample, 58.4% used alcohol only, 1.7% only misused sedatives, and 3.5% co-used alcohol/misused sedative-tranquilizers. Support from friends was associated with 1.18 increased risk of co-using compared to not using either substance. Source of strain was associated with co-use for middle-aged and older adults. Familial strain was associated with increased risk of co-using for middle-aged adults. Friend-related strain was associated with increased risk of co-use for older adults. CONCLUSION Evidence suggests that older co-users may differ from those in midlife in terms of social risk factors. As the aging population increases, elucidating the potential mechanisms by which social factors impact concurrent alcohol use and sedative-tranquilizer medication misuse aid the development of targeted interventions and prevention programs in these groups.
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Affiliation(s)
- Tomorrow D. Wilson
- Department of Psychiatry, University of Michigan, Ann Arbor, United States of America,Tomorrow Wilson, Ph.D., Mailing address: 2800 Plymouth Rd., NCRC Bldg. 16, Ann Arbor, MI 48109, , Phone: 734-232-0296
| | - Kristen L. Barry
- Department of Psychiatry, University of Michigan, Ann Arbor, United States of America
| | - Donovan T. Maust
- Department of Psychiatry, University of Michigan, Ann Arbor, United States of America,Center for Clinical Management Research, VA Ann Arbor, Ann Arbor, United States of America
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, United States of America,Center for Clinical Management Research, VA Ann Arbor, Ann Arbor, United States of America
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Chan G, Kramer JR, Schuckit MA, Hesselbrock V, Bucholz KK, Edenberg HJ, Acion L, Langbehn D, McCutcheon V, Nurnberger JI, Hesselbrock M, Porjesz B, Bierut L, Marenna BC, Cookman A, Kuperman S. A Pilot Follow-Up Study of Older Alcohol-Dependent COGA Adults. Alcohol Clin Exp Res 2019; 43:1759-1768. [PMID: 31141183 PMCID: PMC6685546 DOI: 10.1111/acer.14116] [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: 09/07/2018] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol-related accidents and medical problems. This paper describes a pilot follow-up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation. METHODS The sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM-IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement. RESULTS Of the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age-related past-year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol-related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment. CONCLUSIONS Over a 1-year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow-up.
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Affiliation(s)
| | - John R. Kramer
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | | | | | | | | | - Laura Acion
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Douglas Langbehn
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | | | | | | | | | | | - Bethany C. Marenna
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Angella Cookman
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
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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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Kim S, Spilman SL, Liao DH, Sacco P, Moore AA. Social networks and alcohol use among older adults: a comparison with middle-aged adults. Aging Ment Health 2018; 22:550-557. [PMID: 28006983 PMCID: PMC5523450 DOI: 10.1080/13607863.2016.1268095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study compared the association between social networks and alcohol consumption among middle-aged (MA) and older adults (OA) to better understand the nature of the relationship between those two factors among OA and MA. METHOD We examined Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Current drinkers aged over 50 were subdivided into two age groups: MA (50-64, n = 5214) and OA (65 and older, n = 3070). Each age group was stratified into drinking levels (low-risk vs. at-risk) based on alcohol consumption. The size and diversity of social networks were measured. Logistic regression models were used to examine age differences in the association between the social networks (size and diversity) and the probability of at-risk drinking among two age groups. RESULTS A significant association between the social networks diversity and lower odds of at-risk drinking was found among MA and OA. However, the relationship between the diversity of social networks and the likelihood of at-risk drinking was weaker for OA than for MA. The association between social networks size and at-risk drinking was not significant among MA and OA. CONCLUSION The current study suggests that the association between social networks diversity and alcohol use among OA differs from the association among MA, and few social networks were associated with alcohol use among OA. In the future, research should consider an in-depth exploration of the nature of social networks and alcohol consumption by using longitudinal designs and advanced methods of exploring drinking networks.
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Affiliation(s)
- Seungyoun Kim
- UCLA Integrated Substance Abuse Programs, University of California,
Los Angeles, CA, USA
| | - Samantha L. Spilman
- David Geffen School of Medicine, Division of Geriatrics, University
of California, Los Angeles, CA, USA
| | - Diana H. Liao
- David Geffen School of Medicine, Division of Geriatrics, University
of California, Los Angeles, CA, USA
| | - Paul Sacco
- School of Social Work, University of Maryland, Baltimore, MD,
USA
| | - Alison A. Moore
- School of Medicine, Division of Geriatrics, University of
California, San Diego, CA, USA
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Gonçalves PD, Schuckit MA, Smith TL. Drinking Status Between Ages 50 and 55 for Men From the San Diego Prospective Study Who Developed DSM-IV Alcohol Abuse or Dependence in Prior Follow-Ups. J Stud Alcohol Drugs 2018; 78:512-520. [PMID: 28728633 DOI: 10.15288/jsad.2017.78.512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Although alcohol use disorders (AUDs) are prevalent among older individuals, few studies have examined the course and predictors of AUDs from their onset into the person's 50s. This study describes the AUD course from ages 50 to 55 in participants who developed AUDs according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), during the San Diego Prospective Study (SDPS). METHOD Among the 397 university students in the SDPS who were followed about every 5 years from age 20 (before AUD onset), 165 developed AUDs, 156 of whom were interviewed at age 55. Age 50-55 outcomes were compared regarding age 20-50 characteristics. Variables that differed significantly across outcome groups were evaluated using binary logistic regression analyses predicting each outcome type. RESULTS Between ages 50 and 55, 16% had low-risk drinking, 36% had high-risk drinking, 38% met DSM-5 AUD criteria, and 10% were abstinent. Baseline predictors of outcome at ages 50-55 included earlier low levels of response to alcohol predicting DSM-5 AUDs and abstinence, higher drinking frequency predicting DSM-5 diagnoses and lower predicting low-risk drinking, higher participation in treatment and/or self-help groups predicting abstinence and lower predicting DSM-5 AUDs, later ages of AUD onset predicting high-risk drinking, and cannabis use disorders predicting abstinent outcomes. CONCLUSIONS Despite the high functioning of these men, few were abstinent or maintained low-risk drinking during the recent 5 years, and 38% met DSM-5 AUD criteria. The data may be helpful to both clinicians and researchers predicting the future course of AUDs in their older patients and research participants.
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Affiliation(s)
- Priscila Dib Gonçalves
- Department of Psychiatry, University of California, San Diego, La Jolla, California.,Institute of Psychiatry, Psychology and Neuropsychology Service and Institute of Psychiatry, Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), University of São Paulo, São Paulo, Brazil
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Tom L Smith
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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Kuerbis A, Treloar H, Shao S, Houser J, Muench F, Morgenstern J. Comparing daily drivers of problem drinking among older and younger adults: An electronic daily diary study using smartphones. Drug Alcohol Depend 2018; 183:240-246. [PMID: 29306171 PMCID: PMC5803426 DOI: 10.1016/j.drugalcdep.2017.11.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). METHOD Participants (N = 139), ages 20-73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking and focal predictors (mood, loneliness, boredom, stress, poor sleep, social factors, alcohol salience, commitment and confidence not to drink heavily). RESULTS Older adults reported greater alcohol consumption when daily boredom levels were higher. Heavier drinking among younger adults was associated with poorer sleep quality. Greater daily confidence, daily commitment and daily alcohol salience did not impact drinking to the same extent for older adults as for younger adults. Greater person-level commitment predicted reduced drinking equivalently across age, but low person-level commitment predicted greater drinking among older adults compared to their younger counterparts. CONCLUSION Older adults may have unique daily drivers of drinking that are not fully realized in current research and intervention efforts. Addressing the growing substance-use treatment needs among this population will require identifying the unique drivers of drinking among older adults, such as boredom, when compared to younger adults.
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Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at City University of New York, 2180 Third Avenue, New York, NY 10035, United States.
| | - Hayley Treloar
- Brown University, Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, BOX G-S121––, Providence, RI 02912, United States
| | - Sijing Shao
- Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY, 11021, United States.
| | - Jessica Houser
- Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY, 11021, United States.
| | - Fred Muench
- Partnership for Drug Free America/Kids, 352 Park Avenue South, 9th Floor, New York, NY 10010, United States
| | - Jon Morgenstern
- Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY, 11021, United States.
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Gallardo-Peralta LP, Sánchez-Moreno E, De Roda ABL, Astray AA. Ethnicity, Social Support, and Depression Among Elderly Chilean People. THE JOURNAL OF PSYCHOLOGY 2014; 149:601-29. [DOI: 10.1080/00223980.2014.946462] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Sacco P, Bucholz KK, Harrington D. Gender differences in stressful life events, social support, perceived stress, and alcohol use among older adults: results from a National Survey. Subst Use Misuse 2014; 49:456-65. [PMID: 24131262 PMCID: PMC4729187 DOI: 10.3109/10826084.2013.846379] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Stressful life events, perceived stress, and social support relationships with consumption, at-risk drinking, and alcohol use disorder (AUD) were studied in a population-based sample of current drinkers age 60+ in the National Epidemiologic Survey of Alcohol and Related Conditions (Wave 2; 2004-2005; n = 4,360). Stressful life events were associated with AUD among men and women, and crime victimization among men only. However, greater perceived stress was associated with lower consumption among women and greater odds of AUD in men, highlighting differences in the relationship between stress and alcohol use by gender that may be the result of the stress alcohol link.
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Affiliation(s)
- Paul Sacco
- 1School of Social Work, University of Maryland, Baltimore, Maryland, USA
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Ilomäki J, Gnjidic D, Le Couteur DG, Bell JS, Blyth FM, Handelsman DJ, Cumming RG, Seibel MJ, Waite LM, Naganathan V, Hilmer SN. Alcohol consumption and tobacco smoking among community-dwelling older Australian men: the Concord Health and Ageing in Men Project. Australas J Ageing 2014; 33:185-92. [PMID: 24521471 DOI: 10.1111/ajag.12048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To describe the prevalence and correlates of alcohol consumption and tobacco smoking among older Australian men. METHOD Self-reported alcohol and tobacco use was assessed among a random sample of community-dwelling men aged ≥70 years living in Sydney (n = 1705) from 2005 to 2007. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with alcohol and tobacco use. RESULTS The prevalence of heavy/excessive drinking was 19.2%, daily drinking 33.7%, and binge drinking 14.1%. Daily drinking was associated with chronic pain (OR = 1.38, 95% CI: 1.07-1.78). Binge drinking was associated with anxiety (OR = 1.93, 95% CI: 1.05-3.54) and being widowed (OR = 1.74, 95% CI: 1.11-2.73). Six per cent of men were current smokers and 56.7% were former smokers. Former smoking was associated with polypharmacy (OR = 1.47, 95% CI: 1.14-1.91) and each additional comorbid condition (OR = 1.11, 95% CI: 1.03-1.19). CONCLUSIONS Nearly one-fifth of older men drank heavily or excessively. This highlights the need for public health initiatives to reduce alcohol consumption in older people.
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Affiliation(s)
- Jenni Ilomäki
- Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
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A qualitative study of alcohol, health and identities among UK adults in later life. PLoS One 2013; 8:e71792. [PMID: 23940787 PMCID: PMC3737127 DOI: 10.1371/journal.pone.0071792] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 07/03/2013] [Indexed: 11/24/2022] Open
Abstract
Increasing alcohol consumption among older individuals is a public health concern. Lay understandings of health risks and stigma around alcohol problems may explain why public health messages have not reduced rates of heavy drinking in this sector. A qualitative study aimed to elucidate older people's reasoning about drinking in later life and how this interacted with health concerns, in order to inform future, targeted, prevention in this group. In 2010 a diverse sample of older adults in North East England (ages 50–95) participated in interviews (n = 24, 12 male, 12 female) and three focus groups (participants n = 27, 6 male, 21 female). Data were analysed using grounded theory and discursive psychology methods. When talking about alcohol use older people oriented strongly towards opposed identities of normal or problematic drinker, defined by propriety rather than health considerations. Each of these identities could be applied in older people's accounts of either moderate or heavy drinking. Older adults portrayed drinking less alcohol as an appropriate response if one experienced impaired health. However continued heavy drinking was also presented as normal behaviour for someone experiencing relative wellbeing in later life, or if ill health was construed as unrelated to alcohol consumption. Older people displayed scepticism about health advice on alcohol when avoiding stigmatised identity as a drinker. Drinking patterns did not appear to be strongly defined by gender, although some gendered expectations of drinking were described. Identities offer a useful theoretical concept to explain the rises in heavy drinking among older populations, and can inform preventive approaches to tackle this. Interventions should engage and foster positive identities to sustain healthier drinking and encourage at the community level the identification of heavy drinking as neither healthy nor synonymous with dependence. Future research should test and assess such approaches.
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Kuerbis A, Sacco P. A review of existing treatments for substance abuse among the elderly and recommendations for future directions. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2013; 7:13-37. [PMID: 23471422 PMCID: PMC3583444 DOI: 10.4137/sart.s7865] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background With population aging, there is widespread recognition that the healthcare system must be prepared to serve the unique needs of substance using older adults (OA) in the decades ahead. As such, there is an increasingly urgent need to identify efficient and effective substance abuse treatments (SAT) for OA. Despite this need, there remains a surprising dearth of research on treatment for OA. Aims of review This review describes and evaluates studies on SAT applied to and specifically designed for OA over the last 30 years with an emphasis on methodologies used and the knowledge gained. Methods Using three research databases, 25 studies published in the last 30 years which investigated the impact of SAT on OA and met specific selection criteria were reviewed. Results A majority of the studies were methodologically limited in that they were pre-to-post or post-test only studies. Of the randomized controlled trials, many were limited by sample sizes of 15 individuals or less per group, making main effects difficult to detect. Thus, with caution, the literature suggests that among treatment seeking OA, treatment, whether age-specific or mixed-age, generally works yielding rates of abstinence comparable to general populations and younger cohorts. It also appears that with greater treatment exposure (higher dosage), regardless of level of care, OA do better. Finally, based on only two studies, age-specific treatment appears to potentiate treatment effects for OA. Like younger adults, OA appear to have a heterogeneous response to treatments, and preliminary evidence suggests a possibility of treatment matching for OA. Conclusions Expansion of research on SAT for OA is urgently needed for maximum effectiveness and efficiency of the healthcare system serving these individuals. Future research needs to include laboratory and community based randomized controlled trials with high internal validity of previously vetted evidenced-based practices, including Motivational Interviewing, cognitive behavioral therapy, and medications such as naltrexone, to determine the best fit for OA.
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Affiliation(s)
- Alexis Kuerbis
- Research Foundation for Mental Hygiene, Inc, and Columbia University Medical Center
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Kuipers MAG, van Poppel MNM, van den Brink W, Wingen M, Kunst AE. The association between neighborhood disorder, social cohesion and hazardous alcohol use: a national multilevel study. Drug Alcohol Depend 2012; 126:27-34. [PMID: 22572208 DOI: 10.1016/j.drugalcdep.2012.04.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/06/2012] [Accepted: 04/14/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Evidence on associations of alcohol use with neighborhood disorder and social cohesion is limited. The aim of this study was to further investigate these associations. METHODS Individual data of 14,258 Dutch adults, living in 1546 neighborhoods across The Netherlands, were obtained from the 2006 to 2009 national health survey (POLS). Data on neighborhood disorder and social cohesion were derived from the 2006 Netherlands Housing Research (WoON). Hazardous drinking was measured as: ≥14, ≥21, and ≥28 drinks/week for women, and ≥21, ≥28, and ≥35 for men. Multilevel logistic regression models were adjusted for age, gender, ethnicity, marital status, education, income, wealth, predominant neighborhood religion, and population density. Potential mediation of psychological distress (depression and anxiety) and general mental health (MHI-5 score) was tested. RESULTS High neighborhood disorder was associated with more hazardous alcohol use for women (OR cut-off 3: 3.72 [2.03-6.83]), but not for men (OR cut-off 3: 1.08 [0.72-1.62]). There was no mediation by psychological distress, and modest mediation by general mental health. Social cohesion had no linear association with hazardous alcohol use, but for males moderate social cohesion was associated with more hazardous alcohol use (OR cut-off 1: 1.29 [1.08-1.53]). In predominantly Protestant neighborhoods this association seemed weaker. CONCLUSIONS Hazardous alcohol use seems to have a stronger and more consistent relationship with neighborhood disorder than with social cohesion. This suggests that negative aspects of the social environment have more impact on the prevalence of hazardous alcohol use than positive factors related to sociability and support.
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Affiliation(s)
- Mirte A G Kuipers
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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McCarty F, DePadilla L, Elifson K, Sterk C. Excessive drinking among African American men: individual and contextual correlates. J Ethn Subst Abuse 2012; 11:113-29. [PMID: 22679893 DOI: 10.1080/15332640.2012.675227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In this article, the authors explored associations of multiple domains with regular drinking and getting drunk among adult African American men. Questionnaire-based, computer-assisted interviews were conducted with 484 men in Atlanta, Georgia. Data analysis involved multivariate logistic regression analyses. Findings show that being older increased the odds of both drinking behaviors. Sensation seeking increased the odds of regular drinking, and having experienced childhood sexual and physical abuse increased the odds of getting drunk. Having health insurance reduced the odds of both outcomes. Insurance coverage and the heterogeneity among adult African American men must be considered in risk reduction efforts.
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