Drinking In Older Adults Research Articles

Binge drinking and progression of white matter hyperintensities of presumed vascular origin in older men

BackgroundInformation on trajectories of diffuse subcortical brain damage of vascular origin associated with binge drinking in older adults is limited. We sought to evaluate the impact of this drinking pattern on the progression of white matter hyperintensities (WMH) of presumed vascular origin in individuals aged ≥60 years taken from the community. MethodsFollowing a longitudinal prospective design, participants of the Atahualpa Project Cohort received interviews to assess patterns of alcohol intake as well as baseline and follow-up brain MRIs. Only men were included because alcohol consumption in women is negligible and tend not to engage in binge drinking in our studied population. Poisson regression models were fitted to assess the incidence rate ratio of WMH progression by patterns of alcohol use (binge drinking or not), after adjusting for demographics, level of education and cardiovascular risk factors. ResultsThe study included 114 men aged ≥60 years (mean age: 65.1±5.4 years). Thirty-seven participants (32%) reported binge drinking for more than 30 years. Follow-up MRIs revealed WMH progression in 45 participants (39%) after a median of 7.2 years. In unadjusted analysis, the risk of WMH progression among individuals with binge drinking was 2.08 (95% C.I.: 1.16–3.73). After adjustment for age, education level and vascular risk factors, participants with this drinking pattern were 2.75 times (95% C.I.: 1.42–5.30) more likely to have WMH progression than those who did not. ConclusionsStudy results show an independent association between binge drinking and WMH progression in community-dwelling older men.

The Relationship Between Alcohol Consumption and Frailty Among Older Adults in China: Results From the Chinese Longitudinal Healthy Longevity Survey.

Alcohol consumption has an impact on the frailty, but current research in China lacks a detailed classification of alcohol use. This study aimed to explore the relationship between different drinking patterns and frailty in older adults. The data came from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) study, which included older adults (aged ≧ 60). Their demographic data, drinking status, and frailty index were collected in CLHLS. Through logistic regression models to analyze the correlation between alcohol consumption and frailty. A total of 14,931 participants were included in the analysis. The prevalence of frailty was 29.1%, 35.2%, and 14.9% among risk-free, past risky, and now risky drinkers, respectively. After adjusting for covariates, past risky drinking was a risk factor for frailty (p = .003). High-risk alcohol consumption is positively correlated with frailty. Prevention and reduction of risky drinking in older adults may help protect them from developing frailty.

Validation of the AUDIT and AUDIT-C for Hazardous Drinking in Community-Dwelling Older Adults.

Background: One of the best-known tools in screening for hazardous drinking is the Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated form, the AUDIT-C. The aim of the present study is to determine the cut-offs of both instruments in identifying hazardous drinking in older adults. Method: A sample of 1577 older adults completed a questionnaire regarding alcohol behavior. Hazardous drinking was defined as drinking >10 units/week. Receiver operating characteristics (ROC) curves of AUDIT and AUDIT-C were calculated and cut-off scores were derived. Results: Respectively 27.3% and 12.3% of older men and women drank >10 units/week. For the AUDIT the best trade-off between sensitivity and specificity was using a cut-off of ≥5 for men and ≥4 for women, which yielded in men sensitivity and specificity values respectively of 80.7% and 81.3% and in women 100% and 71.7%, respectively. We found the AUDIT-C to perform well with an optimal cut-off of ≥5 for men and ≥4 for women, which generated in men sensitivity and specificity values respectively of 76.5% and 85.3% and in women 100% and 74.1%, respectively. Conclusion: The AUDIT-C is accurate and sufficient in screening for hazardous drinking in community-dwelling older adults if the cut-offs are tailored by gender.

Prevalence and sociodemographic factors of risky drinking in Australian older adults.

This study describes the prevalence of risky drinking in older adults (aged 60+ years) in Australia and explores the socioeconomic and lifestyle factors associated with this. The negative consequences of drinking behaviours in older adults were also explored. Cross-sectional design, with data obtained from the Australian 2016 National Drug Strategy Household Survey, yielding a sample size of 7976 participants. Multivariable logistic regression was used to assess the correlates of risky drinking. Approximately 17% of older Australians reported risky drinking and their most popular drinking location was in the home (93%). Respondents who were male [odds ratio 3.78, 95% confidence interval (3.22, 4.43)], of younger age group (60-69 years) [2.96, (2.25, 3.89)], in a higher socioeconomic status [1.76, (1.41, 2.21)], had no dependents [1.51, (1.10, 2.07)], were unemployed [1.64, (1.10, 2.44)] and were either current or ex-smokers [2.32, (1.90, 2.83) or 3.55, (2.95, 4.29)], were more likely to report risky drinking. Approximately 54% of risky drinkers experienced a negative outcome as a result of their drinking in the last year. Risky drinking in older adults is a key public health issue, with a concerning rate of risky drinking and associated negative outcomes seen in the current study. Interventions aimed at older drinkers thus need to focus beyond socio-economically disadvantaged groups, while self-moderation on risky drinking, controlling accessibility to take-away alcohol and increasing the awareness of harms of risky drinking may help to reduce risky drinking among older people.

Perceived social capital and binge drinking in older adults: The Health and Retirement Study, US data from 2006–2014

ObjectiveSocial capital has been described as having both positive influences as well as negative influences (“the dark side”) on health behaviors. We sought to test the association of perceived social capital on the risk of binge drinking among older adults, using a longitudinal design. MethodsWe used HRS (Health and Retirement Study) data, a nationally representative sample of US adults aged ≥50 years evaluated every two years (from 2006 to 2014). We investigated the relationship between perceived social capital (neighborhood social cohesion and neighborhood physical disorder, positive social support and negative social support) and binge drinking over time, with a multilevel structural equation modelling (MSEM) approach, modelling number of binge-drinking days as hurdle negative binomial. We used MSEM estimating the associations at person level (overall) and within waves. ResultsThe sample included 19,140 individuals. At baseline mean age was 66.8 (SD 10.3). Over time, the number of binge drinking days decreased. Negative social support increased the average number of binge drinking days among those who drink, where one unit increase was associated with an increase of 37 % in the expected number of days binge drinking in the same wave. The association of positive social support on the number of binge drinking days was stronger for females (-0.59 (SE = 0.12)), while neighborhood social cohesion was significantly associated with binge drinking in females (-0.05 (SE = 0.01)), but not in males. ConclusionsNegative social support favored binge drinking. Positive social support and neighborhood social cohesion are protective factors for binge drinking, especially for women.

The Role of Psychological Distress in the Relationship between Drinking Motives and Hazardous Drinking in Older Adults

Introduction: Drinking motives seem to be the most proximal predictors of alcohol outcomes. Consequently, these are an essential factor to consider as they may influence the extent to which alcohol is used in a risky way, even in older adults. Objective: We studied the moderating effect of distress on the relationship between drinking motives and drinking behaviour in a community-dwelling older adult sample. Method: In a retrospective cross-sectional research study, participants were community-dwelling older adults aged 65 years and older. All respondents completed a questionnaire covering the Drinking Motives Questionnaire (DMQ), the Alcohol Use Disorders Identification Test (AUDIT), and the General Severity Index (GSI) of the Brief Symptom Inventory (BSI). Results: In this sample of 1,148 older adults, drinking motives and hazardous alcohol use were associated (enhancement motives r = 0.478, p < 0.001; coping motives r = 0.367, p < 0.001; and social motives r = 0.235, p < 0.001). Furthermore, moderation analysis showed that older adults drinking predominantly for enhancement or coping motives (respectively, β = 0.433, CI [95%] = 2.557–3.222 and β = 0.327, CI [95%] = 1.077–1.491, p < 0.001), and older adults who had higher levels of psychological distress (β = 2.518, CI [95%] = 2.017–3.019, p < 0.001) were more likely to report higher degree of hazardous alcohol use. Conclusion: The relations between coping drinking motives and enhancement drinking motives on hazardous drinking depended on the level of distress. The associations between drinking for coping and drinking for enhancement were stronger in high levels of distress. Although causality cannot be interpreted from cross-sectional data, tackling psychological distress and drinking to cope with negative affect or to enhance positive affect might have strong effects on reducing hazardous drinking behaviour among older adults.

Factors associated with high-risk drinking in older adults: Evidence from a national survey in Japan.

This study aimed to clarify the association between high-risk drinking and health outcomes (e.g. physical and psychosocial factors, including help-seeking behavior) among older Japanese adults. Data were obtained from the 2013 Comprehensive Survey of Living Conditions in Japan, which surveyed 295 367 households. We restricted analyses to 55 147 current drinkers. Multinomial logistic regression models were used to examine associations between alcohol consumption and various factors. Overall, 35.3% of participants were in the low-risk group, 13.1% were in the at-risk group and 1.0% were in the high-risk group. Those in the at-risk and high-risk groups were more likely to be younger, male, employed and tobacco users. They were also more likely to report sleeping ≥9 h per night, and they were more likely to report unhealthy eating habits. Being in the high-risk drinking group was significantly associated with being divorced (OR 1.51, 95% CI 1.11-2.05) and having poor mental health (OR 1.57, 95% CI 1.13-1.68). The high-risk drinking group was more likely to include those who endorsed experiencing challenges without seeking aid (OR 1.87, 95% CI 1.39-2.53) or felt no need to seek aid (OR 1.39, 95% CI 1.15-1.68). Being at high-risk for drinking is associated with poorer help-seeking behavior, suggesting a need for more aggressive outreach. Geriatr Gerontol Int 2019; 19: 1260-1267.

The "Health Benefits" of Moderate Drinking in Older Adults may be Better Explained by Socioeconomic Status.

To assess whether a relationship between alcohol use and health exists for older adults before and after controlling for proxy and full indicators of socioeconomic status (SES). Secondary analysis of data from 2,908 participants in the New Zealand Longitudinal Study of Ageing (2012) completing measures of alcohol use, health, SES proxies (income, education) and SES. Sample mean age was 65, 52% were female, more than 80% were drinkers, and more than 75% had educational qualifications. Moderate drinkers had better health and SES than heavier or nondrinkers. The positive influence of moderate alcohol consumption on health was observed for men and women when controlling for SES proxies, but was substantially reduced in women and completely disappeared for men when controlling for full SES. SES plays a key role in presumed "heath benefits" of moderate alcohol consumption for older adults. It accounts for any alcohol-health relationship in a sample of men of whom 45% consume at least one drink daily, and substantially attenuates the association between alcohol and health in a sample of women who are not frequent drinkers. Prior research may have missed the influence of SES on this alcohol-health relationship due to the use of incomplete SES measures.

Acute Behavioral and Long-Term Health Effects of Moderate Alcohol Use in Older Adults

This review addresses current literature regarding health consequences associated with of a lifestyle or pattern of moderate drinking and the neurobehavioral effects of moderate drinking episodes in older adults. Discussed studies include both large-scale epidemiological investigations of the effect of moderate alcohol use on multiple health-related domains (e.g., cancer and cardiovascular disease risk) in older adults and laboratory investigations of moderate alcohol’s acute neurobehavioral effects. Numerous studies provide evidence that a pattern of moderate drinking is associated with both potential health benefits and risks for older adults, including evidence for reduced risk of cardiovascular disease and cognitive decline but elevated risk for some cancers, including of the oral cavity, esophagus, and breast. Furthermore, laboratory administration studies indicate that older adults may be more susceptible to neurobehavioral alteration as a result of acute moderate alcohol intake than their younger counterparts. It is clear from the extant literature that even relatively low BACs resulting from the practice of a moderate drinking lifestyle are not without risk. This risk should be balanced against potential benefits at the level of the individual drinker. Additional studies regarding moderate drinking in older adults are needed to address limitations of the literature, including consideration of potential sex effects, inclusion of less rarified samples in acute studies, and the use of longitudinal, prospective designs.

Screening for Intimate Partner Violence: The Time Is Now

Screening for Intimate Partner Violence: The Time Is Now

Drinking Patterns Linked to Cognitive Impairment in Older Adults

VANCOUVER, B.C. – Certain patterns of alcohol consumption appear detrimental to older adults’ cognitive health, according to a pair of longitudinal cohort studies. In a study of older women, moderate drinking at a mean age of 81 years and initiation of drinking after a mean age of 68 years increased the odds of cognitive impairment. In a study of older men and women, those consuming large amounts of alcohol in a single sitting, socalled binge drinking, were more likely to be in the top decile of cognitive decline over time. These new fi ndings call into question what constitutes risky drinking in older adults and conventional practices of risk assessment, investigators reported at the Alzheimer’s Association International Conference 2012.

Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial

To examine whether a multi-faceted intervention among older at-risk drinking primary care patients reduced at-risk drinking and alcohol consumption at 3 and 12 months. Randomized controlled trial. Three primary care sites in southern California. Six hundred and thirty-one adults aged ≥ 55 years who were at-risk drinkers identified by the Comorbidity Alcohol Risk Evaluation Tool (CARET) were assigned randomly between October 2004 and April 2007 during an office visit to receive a booklet on healthy behaviors or an intervention including a personalized report, booklet on alcohol and aging, drinking diary, advice from the primary care provider and telephone counseling from a health educator at 2, 4 and 8 weeks. The primary outcome was the proportion of participants meeting at-risk criteria, and secondary outcomes were number of drinks in past 7 days, heavy drinking (four or more drinks in a day) in the past 7 days and risk score. At 3 months, relative to controls, fewer intervention group participants were at-risk drinkers [odds ratio (OR) 0.41; 95% confidence interval (CI) 0.22-0.75]; they reported drinking fewer drinks in the past 7 days [rate ratio (RR) 0.79; 95% CI 0.70-0.90], less heavy drinking (OR 0.46; 95% CI 0.22-0.99) and had lower risk scores (RR 0.77 95% CI 0.63-0.94). At 12 months, only the difference in number of drinks remained statistically significant (RR 0.87; 95% CI 0.76-0.99). A multi-faceted intervention among older at-risk drinkers in primary care does not reduce the proportions of at-risk or heavy drinkers, but does reduce amount of drinking at 12 months.

Health-Related Behaviors in Older Adults: Relationships with Socioeconomic Status

There is limited information about the clustering of health behaviors in older people. This study aims to examine clustering of smoking, low levels of physical activity, and risky drinking in older adults and the relationship of these behaviors with measures of SES. Data on health behaviors were analyzed from 11,214 individuals aged > or =50 years (mean age=65.2 years) who participated in the 2002 wave of the English Longitudinal Study of Ageing. Clustering was examined by studying the ratio of observed to expected prevalence of each combination of health behavior. Logistic regressions tested the relationship between socioeconomic measures (education, wealth, and subjective social status) and health behaviors. Data were collected between March 2002 and March 2003, and analyses were conducted in 2008. Only a small proportion of participants reported all three health-risk behaviors, although this was higher than that expected on the basis of prevalence of individual behaviors. Combinations of two health-risk behaviors were common. Multiple health-risk behaviors were less common among individuals of a higher SES. Total accumulated wealth and subjective social status were more consistently related to health-risk behaviors than education in this population. This study provides evidence of clustering of health-risk behaviors in older adults and suggests that interventions aimed at multiple risk factors could usefully target less affluent groups.

Alcohol Use, Comorbidity, and Mortality

To examine the combined influence of alcohol use and comorbidity on 20-year mortality in older adults (average age 66 at the time of the baseline survey). Longitudinal analysis of a national probability sample-based cohort study. Data sources were the National Health and Nutrition Examination Survey I (NHANES I), 1971-1974, and the NHANES Epidemiologic Followup Survey, 1992. Four thousand six hundred ninety-one adults aged 60 and older who provided data on alcohol use. The prevalence of at-risk drinking in older adults in the United States and the 20-year all-cause mortality risk associated with it. At-risk drinking status was determined from amount of alcohol consumed and comorbidities, using a previously validated method. The prevalence of at-risk drinking in the United States between 1971 and 1974 in older adults was 10% (18% of men, 5% of women). The majority of at-risk drinkers were identified as such because of their use of alcohol in amounts deemed risky in the presence of relevant comorbidities (69%) (e.g., drinking 2-3 drinks per day and having gout or anxiety or taking a medication for pain). In men, at-risk drinking was associated with higher mortality rates than not-at-risk drinking (hazard ratio=1.20, 95% confidence interval=1.01-1.41); abstinence was not associated with greater mortality. In women, neither abstinence nor at-risk drinking was associated with greater mortality rates. In this first, large population-based study of older adults examining the mortality risks of alcohol use and comorbidity, at-risk drinking was associated with greater mortality rates in men. These findings suggest that a lower threshold of alcohol use should be recommended for older adults with specific comorbidities to reduce mortality risks.

The alcohol-related problems survey: identifying hazardous and harmful drinking in older primary care patients.

Older adults can incur problems at low levels of alcohol consumption because of age-related physiological changes, declining health and functional status, and medication use. We have developed and tested a screening measure specifically for older people, the Alcohol-Related Problems Survey (ARPS), to identify older adults with these risks. Survey. Academic and community primary care clinics. Five hundred forty-nine current drinkers aged 65 and older, mostly white with high school or more education. Alcohol use was classified as harmful, hazardous, or nonhazardous depending upon consumption alone or combined with selected comorbidities and medication use. Harmful drinking (including alcohol abuse or dependence) means the presence of problems (e.g., hypertension, adverse drug events, legal problems) due to drinking. Hazardous drinking means risks for problems are likely. Nonhazardous drinking poses no known risks for problems. Eleven percent of subjects were harmful drinkers and 35% were hazardous drinkers. Harmful drinking was more common in men than women and in persons younger than 75 than those aged 75 and older. Similar proportions of men and women and younger and older age groups were hazardous drinkers. Most harmful drinkers were identified by their use of alcohol with their comorbidity, whereas most hazardous drinkers were identified by their use of alcohol with medications. Test-retest reliability was substantial (kappa = 0.65). Physicians are urged to screen for alcohol-related problems in older persons. The ARPS reliably identifies harmful, hazardous, and nonhazardous drinking in older adults resulting most often from the interaction between alcohol and disease and medication use.

Relapse prevention and maintaining abstinence in older adults with alcohol-use disorders.

Although older adults are sometimes believed to have the lowest rates of alcohol abuse as an age cohort, the prevalence of alcohol use and abuse in this group is clearly underestimated. The under-diagnosis of alcohol abuse is due, in part, to the facts that the effects of alcohol use among older adults tend to be less clearly visible than among other age groups and that older adults are less likely to seek treatment than younger age groups. An additional challenge to diagnosis may be a lack of previous alcohol abuse by the patient, as approximately one-third of older adults with alcohol-use problems first develop their drinking problem after the age of 60 years. With a demographic shift that is expected to increase the number of older adults with alcohol problems, the awareness and understanding of this problem becomes increasingly important. Under-diagnosis of problem drinking in older adults is particularly unfortunate because the risks associated with alcohol abuse and relapse for the elderly are significant. Relapse, or the return to drinking following abstinence, may follow situations that are of particularly high risk for older adults. These include situations related to anxiety, interpersonal conflict, depression, loneliness, loss or social isolation. By helping patients to monitor these high-risk situations, to identify strategies that have been successful in promoting abstinence in the past, and to become engaged in treatment, relapse may be avoided and abstinence maintained. Treatments such as cognitive-behavioural therapy, group and family therapies and self-help groups are just as effective for older adults as they are for other age groups. In fact, group and family therapies and self-help groups may be of particular benefit to older adults because of the emphasis on social support. Medicinal adjuncts are also equally effective in the elderly, but strict compliance and careful monitoring of adverse effects are especially important in patients who take multiple medications. Because of their benign adverse effect profiles, naltrexone and acamprosate are particularly good pharmacological agents for relapse prevention in older adults.

Features of excessive alcohol drinking in older adults distinctively captured by behavioral and biological screening instruments: An epidemiological study

The entire ⩾65-year-old population living in a small Italian town, where alcohol use is almost ubiquitous, was assessed with a frequency–quantity questionnaire for alcohol intake and with two screening instruments for alcohol problems, the CAGE questionnaire and the MCV-γGT test. Aim of the study was to assess whether these instruments identify different subsets of subjects with alcohol problems. Of the 649 participants, 19.1% were at-risk drinkers (average intake >40 g/day in men and >20 g/day in women). Both the screening instruments were positive in only a minority of participants. Of the 377 drinkers, 53 gave ⩾1 affirmative response to the CAGE questionnaire, whereas 24 had a positive MCV-γGT test. The concordance between positive CAGE questionnaire and MCV-γGT test was limited to seven subjects (kappa = 0.10), and these tests identified subjects who differed for several health and psychosocial characteristics. Participants aged ⩾75 years drank less, but had similar prevalence of CAGE and MCV-γGT positive markers as compared to younger participants. In conclusion, excessive drinking is common in the elderly. Screening tests based on behavioral and biological markers identify two different sets of subjects with possible alcohol problems. This might indicate the opportunity to use these instruments in conjunction.

Brief physician advice reduced drinking in older adults

Brief physician advice reduced drinking in older adults

Brief physician advice reduced drinking in older adults

Fleming MF, Manwell LB, Barry KL , et al. Brief physician advice for alcohol problems in older adults: a randomized community-based trial. J Fam Pract1999 May; 48 : 378 –84...

Brief physician advice reduced drinking in older adults

Brief physician advice reduced drinking in older adults