Objective-To estimate one-year prevalence and correlates of alcohol abuse, dependence, and subthreshold dependence (diagnostic orphans) among middle-aged and elderly persons in the United States.
Design-2005-2007National Surveys on Drug Use and Health.Method-Sample included 10,015 respondents 50-64 years of age and 6,289 respondents 65+ years of age. Data were analyzed by bivariate and multinomial regression analyses.Measurements-Sociodemographic variables, alcohol use and DSM-IV abuse and dependence, major depression, nicotine dependence, illicit drug use, and nonmedical use of prescription drugs.Results-Fifty-one percent of the sample used alcohol during the past year (56% in the 50-64 age group and 43% in the 65+ age group). Overall, 11% (dependence 1.9%, abuse 2.3%, and subthreshold dependence 7.0%) of adults aged 50-64 and about 6.7% (dependence 0.6%, abuse 0.9%, and subthreshold dependence 5.2%) of those aged 65+ reported alcohol abuse, dependence or dependence symptoms. Among past-year alcohol users, 20% (dependence 3.4%, abuse 4.0%, and subthreshold dependence 12.5%) of adults aged 50-64 and 15.4% (dependence 1.3%, abuse 2.1%, and subthreshold dependence 12.0%) of those aged 65+ endorsed alcohol abuse or dependence symptoms. "Tolerance" (48%) and "time spent using" (37%) were the two symptoms most frequently endorsed by the subthreshold group. Compared with alcohol users without alcohol abuse or dependence symptoms, Blacks or Hispanics, and those who had nicotine dependence or used nonmedical prescription drugs had increased odds of subthreshold dependence. Diagnostic orphans also were more likely to engage in binge drinking than the asymptomatic group.Conclusions-Diagnostic orphans among middle-aged and elderly community adults show an elevated rate for binge drinking and nonmedical use of prescription drugs that require attention from health care providers.