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Erschienen in: Journal of General Internal Medicine 2/2014

01.02.2014 | Original Research

The Prevalence of Harmful and Hazardous Alcohol Consumption in Older U.S. Adults: Data from the 2005–2008 National Health and Nutrition Examination Survey (NHANES)

verfasst von: Sandra R. Wilson, PhD, Sarah B. Knowles, PhD, MPH, Qiwen Huang, MS, Arlene Fink, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 2/2014

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BACKGROUND

Alcohol consumption and its interaction with disease, medication use, and functional status may result in serious health problems, but little information exists about the national prevalence of alcohol-related health risk in older adults.

OBJECTIVE

To estimate the prevalence of harmful and hazardous alcohol use and the prevalence of consumption in excess of National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommendations, in people aged 65 and older, and by sex and race/ethnicity sub-group.

DESIGN

Cross-sectional, using data from the 2005–2008 National Health and Nutrition Examination Survey of the non-institutionalized U.S. population.

PARTICIPANTS

One thousand and eighty-three respondents aged 65 and older who consume alcohol.

MAIN MEASURES

Participants’ alcohol consumption was classified as Harmful, Hazardous, or Healthwise, in the context of their specific health status, using the Alcohol-Related Problems Survey classification algorithm.

KEY RESULTS

Overall, 14.5 % of older drinkers (95 % CI: 12.1 %, 16.8 %) consumed alcohol above the NIAAA’s recommended limits. However, when health status was taken into account, 37.4 % of older drinkers (95 % CI: 34.9 %, 40.0 %) had Harmful consumption and 53.3 % (95 % CI: 50.1 %, 56.6 %) had either Hazardous or Harmful consumption. Among light/moderate drinkers, the proportions were 17.7 % (95 % CI: 14.7 %, 20.7 %) and 28.0 % (95 % CI: 24.8 %, 31.1 %), respectively. Male drinkers had significantly greater odds of Hazardous/Harmful consumption than female drinkers (OR = 2.14 [95 % CI: 1.77, 2.6]). Black drinkers had worse health status and significantly greater odds of Hazardous/Harmful consumption than white drinkers (OR = 1.49; 95 % CI: 1.02, 2.17), despite having no greater prevalence of drinking in excess of NIAAA-recommended limits.

CONCLUSION

Most older Americans who drink are light/moderate drinkers, yet substantial proportions of such drinkers drink in a manner that is either harmful or hazardous to their health. Older adults with risky alcohol consumption are unlikely to be identified by health care providers if clinicians rely solely on whether patient consumption exceeds the NIAAA-recommended limits.
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Literatur
1.
Zurück zum Zitat Anderson G. Chronic Care: Making the Case for Ongoing Care. Princeton: Robert Wood Johnson Foundation; 2010. Anderson G. Chronic Care: Making the Case for Ongoing Care. Princeton: Robert Wood Johnson Foundation; 2010.
2.
Zurück zum Zitat Mukamal KJ, Chen CM, Rao SR, Breslow RA. Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardiol. 2010;55:1328–35.PubMedCrossRef Mukamal KJ, Chen CM, Rao SR, Breslow RA. Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002. J Am Coll Cardiol. 2010;55:1328–35.PubMedCrossRef
3.
Zurück zum Zitat Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA. 2003;289:1405–13.PubMedCrossRef Mukamal KJ, Kuller LH, Fitzpatrick AL, Longstreth WT Jr, Mittleman MA, Siscovick DS. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA. 2003;289:1405–13.PubMedCrossRef
4.
Zurück zum Zitat Chermack ST, Blow FC, Hill EM, Mudd SA. The relationship between alcohol symptoms and consumption among older drinkers. Alcohol Clin Exp Res. 1996;20:1153–8.PubMedCrossRef Chermack ST, Blow FC, Hill EM, Mudd SA. The relationship between alcohol symptoms and consumption among older drinkers. Alcohol Clin Exp Res. 1996;20:1153–8.PubMedCrossRef
5.
Zurück zum Zitat Moos RH, Brennan PL, Schutte KK, Moos BS. Older adults’ health and changes in late-life drinking patterns. Aging Ment Health. 2005;9:49–59.PubMedCrossRef Moos RH, Brennan PL, Schutte KK, Moos BS. Older adults’ health and changes in late-life drinking patterns. Aging Ment Health. 2005;9:49–59.PubMedCrossRef
6.
Zurück zum Zitat Moore AA, Whiteman EJ, Ward KT. Risks of combined alcohol/medication use in older adults. Am J Geriatr Phamacother. 2007;5:64–74.CrossRef Moore AA, Whiteman EJ, Ward KT. Risks of combined alcohol/medication use in older adults. Am J Geriatr Phamacother. 2007;5:64–74.CrossRef
7.
Zurück zum Zitat Adams WL. Potential for adverse drug-alcohol interactions among retirement community residents. J Am Geriatr Soc. 1995;43:1021–5.PubMed Adams WL. Potential for adverse drug-alcohol interactions among retirement community residents. J Am Geriatr Soc. 1995;43:1021–5.PubMed
9.
Zurück zum Zitat National Institute on Alcoholism and Alcohol Abuse. Helping patients who drink too much: A clinician’s guide. Bethesda: National Institutes of Health, US Department of Health and Human Services; 2005. National Institute on Alcoholism and Alcohol Abuse. Helping patients who drink too much: A clinician’s guide. Bethesda: National Institutes of Health, US Department of Health and Human Services; 2005.
10.
Zurück zum Zitat Fink A, Elliott MN, Tsai M, Beck JC. An evaluation of an intervention to assist primary care physicians in screening and educating older patients who use alcohol. J Am Geriatr Soc. 2005;53:1937–43.PubMedCrossRef Fink A, Elliott MN, Tsai M, Beck JC. An evaluation of an intervention to assist primary care physicians in screening and educating older patients who use alcohol. J Am Geriatr Soc. 2005;53:1937–43.PubMedCrossRef
11.
Zurück zum Zitat Fink A, Morton SC, Beck JC, Hays RD, Spritzer K, Oishi S, et al. The alcohol-related problems survey: identifying hazardous and harmful drinking in older primary care patients. J Am Geriatr Soc. 2002;50:1717–22.PubMedCrossRef Fink A, Morton SC, Beck JC, Hays RD, Spritzer K, Oishi S, et al. The alcohol-related problems survey: identifying hazardous and harmful drinking in older primary care patients. J Am Geriatr Soc. 2002;50:1717–22.PubMedCrossRef
12.
Zurück zum Zitat Adams WL, Yuan Z, Barboriak JJ, Rimm AA. Alcohol-related hospitalizations of elderly people. Prevalence and geographic variation in the United States. JAMA. 1993;270:1222–5.PubMedCrossRef Adams WL, Yuan Z, Barboriak JJ, Rimm AA. Alcohol-related hospitalizations of elderly people. Prevalence and geographic variation in the United States. JAMA. 1993;270:1222–5.PubMedCrossRef
13.
Zurück zum Zitat Tobias CR, Lippmann S, Pary R, Oropilla T, Embry CK. Alcoholism in the elderly. How to spot and treat a problem the patient wants to hide. Postgrad Med. 1989;86(67–70):5–9. Tobias CR, Lippmann S, Pary R, Oropilla T, Embry CK. Alcoholism in the elderly. How to spot and treat a problem the patient wants to hide. Postgrad Med. 1989;86(67–70):5–9.
15.
Zurück zum Zitat Blow FC, Barry KL. Alcohol and substance misuse in older adults. Curr Psychiatry Rep. 2012;14:310–9.PubMedCrossRef Blow FC, Barry KL. Alcohol and substance misuse in older adults. Curr Psychiatry Rep. 2012;14:310–9.PubMedCrossRef
16.
Zurück zum Zitat Blow FC, Barry KL. Use and misuse of alcohol among older women. Alcohol Res Health. 2002;26:308–15.PubMed Blow FC, Barry KL. Use and misuse of alcohol among older women. Alcohol Res Health. 2002;26:308–15.PubMed
17.
Zurück zum Zitat Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–14.PubMedCrossRef Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–14.PubMedCrossRef
18.
Zurück zum Zitat Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;45:529–38.PubMedCrossRef Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;45:529–38.PubMedCrossRef
19.
Zurück zum Zitat Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.PubMedCrossRef Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.PubMedCrossRef
20.
Zurück zum Zitat National Center for Health Statistics. National Health and Nutrition Examination Survey. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2012 [cited 2010]; Available from: http://www.cdc.gov/nchs/nhanes.htm. National Center for Health Statistics. National Health and Nutrition Examination Survey. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2012 [cited 2010]; Available from: http://​www.​cdc.​gov/​nchs/​nhanes.​htm.
21.
Zurück zum Zitat National Center for Health Statistics. Analytic and Reporting Guidelines: The National Health and Nutrition Examination Survey (NHANES). In: US Department of Health and Human Services, editor. Hyattsville, MD: Centers for Disease Control and Prevention; 2006. National Center for Health Statistics. Analytic and Reporting Guidelines: The National Health and Nutrition Examination Survey (NHANES). In: US Department of Health and Human Services, editor. Hyattsville, MD: Centers for Disease Control and Prevention; 2006.
22.
Zurück zum Zitat Moore AA, Beck JC, Babor TF, Hays RD, Reuben DB. Beyond alcoholism: identifying older, at-risk drinkers in primary care. J Stud Alcohol. 2002;63:316–24.PubMed Moore AA, Beck JC, Babor TF, Hays RD, Reuben DB. Beyond alcoholism: identifying older, at-risk drinkers in primary care. J Stud Alcohol. 2002;63:316–24.PubMed
23.
Zurück zum Zitat Moore AA, Hays RD, Reuben DB, Beck JC. Using a criterion standard to validate the Alcohol-Related Problems Survey (ARPS): a screening measure to identify harmful and hazardous drinking in older persons. Aging (Milano). 2000;12:221–7. Moore AA, Hays RD, Reuben DB, Beck JC. Using a criterion standard to validate the Alcohol-Related Problems Survey (ARPS): a screening measure to identify harmful and hazardous drinking in older persons. Aging (Milano). 2000;12:221–7.
24.
Zurück zum Zitat Fink A, Tsai MC, Hays RD, Moore AA, Morton SC, Spritzer K, et al. Comparing the alcohol-related problems survey (ARPS) to traditional alcohol screening measures in elderly outpatients. Arch Gerontol Geriatr. 2002;34:55–78.PubMedCrossRef Fink A, Tsai MC, Hays RD, Moore AA, Morton SC, Spritzer K, et al. Comparing the alcohol-related problems survey (ARPS) to traditional alcohol screening measures in elderly outpatients. Arch Gerontol Geriatr. 2002;34:55–78.PubMedCrossRef
25.
Zurück zum Zitat Wilson SR, Fink A, Verghese S, Beck JC, Nguyen K, Lavori P. Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences. J Am Geriatr Soc. 2007;55:445–50.PubMedCrossRef Wilson SR, Fink A, Verghese S, Beck JC, Nguyen K, Lavori P. Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences. J Am Geriatr Soc. 2007;55:445–50.PubMedCrossRef
26.
Zurück zum Zitat Moore AA, Morton SC, Beck JC, Hays RD, Oishi SM, Partridge JM, et al. A new paradigm for alcohol use in older persons. Med Care. 1999;37:165–79.PubMedCrossRef Moore AA, Morton SC, Beck JC, Hays RD, Oishi SM, Partridge JM, et al. A new paradigm for alcohol use in older persons. Med Care. 1999;37:165–79.PubMedCrossRef
27.
Zurück zum Zitat Kranzler HR, Tennen H, Babor TF, Kadden RM, Rounsaville BJ. Validity of the longitudinal, expert, all data procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. Drug Alcohol Depend. 1997;45:93–104.PubMedCrossRef Kranzler HR, Tennen H, Babor TF, Kadden RM, Rounsaville BJ. Validity of the longitudinal, expert, all data procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. Drug Alcohol Depend. 1997;45:93–104.PubMedCrossRef
28.
Zurück zum Zitat Saunders JB, Aasland OG. World Health Organization collaborative project on the identification and treatment of persons with harmful alcohol consumption: report on Phase I development of a screening instrument. Geneva, Switzerland, 1987. Saunders JB, Aasland OG. World Health Organization collaborative project on the identification and treatment of persons with harmful alcohol consumption: report on Phase I development of a screening instrument. Geneva, Switzerland, 1987.
29.
Zurück zum Zitat Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II. Addiction. 1993;88:791–804.PubMedCrossRef Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II. Addiction. 1993;88:791–804.PubMedCrossRef
30.
Zurück zum Zitat National Center for Health Statistics. Analytic Note Regarding 2007–2010 Survey Design Changes and Combining Data Across other Survey Cycles. In: US Department of Health and Human Services, editor. Hyattsville, MD: Centers for Disease Control and Prevention; 2010. National Center for Health Statistics. Analytic Note Regarding 2007–2010 Survey Design Changes and Combining Data Across other Survey Cycles. In: US Department of Health and Human Services, editor. Hyattsville, MD: Centers for Disease Control and Prevention; 2010.
31.
Zurück zum Zitat D'Amico EJ, Paddock SM, Burnam A, Kung FY. Identification of and guidance for problem drinking by general medical providers: results from a national survey. Med Care. 2005;43:229–36.PubMedCrossRef D'Amico EJ, Paddock SM, Burnam A, Kung FY. Identification of and guidance for problem drinking by general medical providers: results from a national survey. Med Care. 2005;43:229–36.PubMedCrossRef
32.
Zurück zum Zitat Moore AA, Blow FC, Hoffing M, Welgreen S, Davis JW, Lin JC, et al. Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial. Addiction. 2011;106:111–20.PubMedCentralPubMedCrossRef Moore AA, Blow FC, Hoffing M, Welgreen S, Davis JW, Lin JC, et al. Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial. Addiction. 2011;106:111–20.PubMedCentralPubMedCrossRef
33.
Zurück zum Zitat Friedmann PD, McCullough D, Chin MH, Saitz R. Screening and intervention for alcohol problems. A national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15:84–91.PubMedCentralPubMedCrossRef Friedmann PD, McCullough D, Chin MH, Saitz R. Screening and intervention for alcohol problems. A national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15:84–91.PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Kuehn BM. Despite benefit, physicians slow to offer brief advice on harmful alcohol use. JAMA. 2008;299(7):751–3.PubMedCrossRef Kuehn BM. Despite benefit, physicians slow to offer brief advice on harmful alcohol use. JAMA. 2008;299(7):751–3.PubMedCrossRef
Metadaten
Titel
The Prevalence of Harmful and Hazardous Alcohol Consumption in Older U.S. Adults: Data from the 2005–2008 National Health and Nutrition Examination Survey (NHANES)
verfasst von
Sandra R. Wilson, PhD
Sarah B. Knowles, PhD, MPH
Qiwen Huang, MS
Arlene Fink, PhD
Publikationsdatum
01.02.2014
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 2/2014
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-013-2577-z

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