Stability in the drinking habits of older problem-drinkers recruited from nontreatment settings

ABSTRACT. Objective: The aim of this study was to describe older adults' 20-year alcohol-consumption and drinking-problem trajectories, identify baseline predictors of them, and determine whether older men and women differ on late-life drinking trajectory characteristics and predictors. Method: Two-group simultaneous latent growth modeling was used to describe the characteristics and baseline predictors of older community-residing men's (n = 399) and women's (n = 320) 20-year drinking trajectories. Chi-square difference tests of increment in fi t of latent growth models with and without gender invariance constraints were used to determine gender differences in drinking trajectory characteristics and predictors. Results: Unconditional quadratic growth models best described older individuals' within-individual, 20-year drinking trajectories, with alcohol consumption following an average pattern of delayed decline, and drinking problems an average pattern of decline followed by leveling off. On average, older men declined in alcohol consumption somewhat later than did older women. The best baseline predictors of more rapid decline in alcohol consumption and drinking problems were drinking variables indicative of heavier, more problematic alcohol use at late middle age. Conclusions: The course of alcohol consumption and drinking problems from late middle age onward is one of net decline, but this decline is neither swift nor invariable. Gender differences in the timing of decline in drinking suggest that ongoing monitoring of alcohol consumption may be especially important for older men. Further research is needed to identify factors known at late middle age that prospectively explain long-term change in late-life use of alcohol. (J. Stud Alcohol Drugs, 72, 308-321, 2011) (Ahlstrom, 2008). However, there is scarce evidence to support this view, and it has been drawn from studies with important design and analytic limitations. Furthermore, there has been almost no research to identify predictors of late-life decline in alcohol consumption and drinking problems. From a public health perspective, it is important to identify factors known at late middle age that prospectively infl uence older adults' subsequent drinking trajectories; this might inform development of interventions aimed at promoting healthier late-life drinking practices.This study builds on others' and our previous work in this area Moos et al., 2009Moos et al., , 2010 by using latent growth modeling to describe the 20-year drinking trajectories of men and women as they mature from late middle age (about age 55-65) through "later" old age (about age 75-85). In addition, it extends earlier research by determining whether key demographic, health-related, coping, and social context characteristics known at late middle age predict the level and shape of older individuals' subsequent 20-year drinking trajectories. Because so little is known about older women's drinking behavior as distinct from that of older men, this study also addresses whether gender...

Section: Predictors Of Late-life Drinking Trajectoriesmentioning

confidence: 74%

Twenty-Year Alcohol-Consumption and Drinking-Problem Trajectories of Older Men and Women

Brennan¹,

Schutte²,

Moos³

et al. 2011

“…A key fi nding from this research is that alcohol consumption is not necessarily a stable behavior, especially among heavy drinkers (Kaskutas et al, 1997;Doll et al, 1994;Schuckit et al, 1997;Sesso et al, 2000;Skog and Duckert, 1993;Walton et al, 2000). Witkiewitz and Marlatt (2004) refer to relapse as a dynamic process in which drinkers move between drinking and nondrinking states.…”

Section: Stability In Problem Drinking Using a Trajectories-based Appmentioning

confidence: 96%

Transitioning Into and Out of Problem Drinking Across Seven Years

Delucchi¹,

Weisner²

2010

ABSTRACT. Objective: The extent to which problem drinkers transition into and out of problem drinking was examined using Markov modeling. Method: Study participants (N = 1,350) were randomly sampled from one county's general population and from consecutive admissions to public and private alcohol treatment programs in the same county, and they were assessed at 1-, 3-, 5-, and 7-year follow-ups. At baseline, all met the criteria for problem drinking. Individuals were classifi ed as "problem drinkers" if they reported at least two of three criteria (heavy episodic drinking, social consequences, dependence symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) during the prior 12 months. Results: Although all possible patterns were observed, a latent Markov model with heterogeneous transitions and fi ve patterns fi t the data. The sampling frame and baseline alcohol severity related to pattern. Conclusions: The data indicate that, although they do change over time, problem drinkers on the whole are more likely either to remain problem drinkers or to cease to be problem drinkers than they are to move into and out of problem-drinking status. Once they transition out of problem drinking, they are more likely to remain nonproblem drinkers. O NE OF THE UNRESOLVED QUESTIONS in alcohol-related research is that of behavioral stability among adult drinkers. To what extent will they alter their drinking? What is the probability someone will change his or her drinking behavior, and what factors infl uence this probability? Does this probability change over time? These questions have clinical signifi cance because relapse is common and affects the effi cacy and cost of treatment. Positive change is the goal of treatment, and community interventions are diffi cult to accomplish. If we understood how often and how likely changes in drinking behavior occur, and what factors infl uence these changes, more targeted and effective interventions could be developed, and family members of problem drinkers would have a better idea of what to expect. Demonstrating that individuals effectively move out of problem drinking may help reduce the stigma associated with alcohol problems and encourage problem drinkers to seek help. This study addressed one aspect of the stability of problem drinking by estimating the probability that a problem drinker from a representative sample would transition into and out of problem drinking, and whether that probability of change varies over 7 years. Stability in problem drinking using a trajectories-based approachImprovements in longitudinal methods have made possible understanding changes in drinking behaviors and outcomes. A key fi nding from this research is that alcohol consumption is not necessarily a stable behavior, especially among heavy drinkers (Kaskutas et al

“…Most nationally representative studies of alcohol use among the elderly have been cross sectional Kerr et al, 2004;Kirchner et al, 2007;Merrick et al, 2008), and most longitudinal studies have not been nationally representative (Eigenbrodt et al, 2001;Moos et al, 2004;Walton et al, 2000). Nationally representative and longitudinal studies generally have observed drinking patterns for less than 5 years (Dawson et al, 2008;Karlamangla et al, 2006;Perreira and Sloan, 2001) or fewer than fi ve interviews (Goodwin et al, 1987;Moore et al, 2005;Perreira and Sloan, 2001).…”

Section: H Igh Levels Of Alcohol Consumption Bymentioning

confidence: 99%

Alcohol-Consumption Trajectories and Associated Characteristics Among Adults Older Than Age 50

Platt¹,

Sloan²,

Costanzo³

2010

108

118

ABSTRACT. Objective: This study examined changes in drinking behavior after age 50 and baseline personal characteristics and subsequent life events associated with different alcohol-consumption trajectories during a 14-year follow-up period. Method: Data were taken from the Health and Retirement Study. The study sample included individuals ages 51-61 in 1992 who survived the sample period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) and had at least fi ve interviews with alcohol consumption information, yielding an analysis sample of 6,787 (3,760 women). We employed linear regression to determine drinking trajectories over 1992-2006. Based on these fi ndings, each sample person was classifi ed into one of fi ve drinking categories. We used multinomial logit analysis to assess the relationship between personal demographic, income, health, and attitudinal characteristics as well as life events and drinking-trajectory category. Results:Overall, alcohol consumption declined. However, rates of decline differed appreciably among sample persons, and for a minority, alcohol consumption increased. Persons with increasing consumption over time were more likely to be affl uent (relative-risk ratio [RRR] = 1.09, 95% CI [1.05, 1.12]), highly educated (RRR = 1.20, 95% CI [1.09, 1.31]), male, White (RRR = 3.54, 95% CI [1.01, 12.39]), unmarried, less religious, and in excellent to good health. A history of problem drinking before baseline was associated with increases in alcohol use, whereas the reverse was true for persons with histories of few or no drinking problems. Conclusions: There are substantial differences in drinking trajectories at the individual level in midlife and late life. A problem-drinking history is predictive of alcohol consumption patterns in later life. (J. Stud. Alcohol Drugs, 71, 169-179, 2010)