Trajectories of risky drinking around the time of statutory retirement: a longitudinal latent class analysis

Halonen, Jaana I.; Stenholm, Sari; Pulakka, Anna; Kawachi, Ichiro; Aalto, Ville; Pentti, Jaana; Lallukka, Tea; Virtanen, Marianna; Vahtera, Jussi; Kivimäki, Mika

doi:10.1111/add.13811

Cited by 30 publications

(29 citation statements)

References 28 publications

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“…Older participants may have been more likely to experience lifestyle changes that influenced their drinking habits. Retirement, for example, is known to co-occur with increases in alcohol intake [ 45 , 46 ], particularly amongst existing drinkers [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data

O’Neill

Britton

Hannah

et al. 2018

BMC Med

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BackgroundStudies have shown that alcohol intake trajectories differ in their associations with biomarkers of cardiovascular functioning, but it remains unclear if they also differ in their relationship to actual coronary heart disease (CHD) incidence. Using multiple longitudinal cohort studies, we evaluated the association between long-term alcohol consumption trajectories and CHD.MethodsData were drawn from six cohorts (five British and one French). The combined analytic sample comprised 35,132 individuals (62.1% male; individual cohorts ranging from 869 to 14,247 participants) of whom 4.9% experienced an incident (fatal or non-fatal) CHD event. Alcohol intake across three assessment periods of each cohort was used to determine participants’ intake trajectories over approximately 10 years. Time to onset for (i) incident CHD and (ii) fatal CHD was established using surveys and linked medical record data. A meta-analysis of individual participant data was employed to estimate the intake trajectories' association with CHD onset, adjusting for demographic and clinical characteristics.ResultsCompared to consistently moderate drinkers (males: 1–168 g ethanol/week; females: 1–112 g ethanol/week), inconsistently moderate drinkers had a significantly greater risk of incident CHD [hazard ratio (HR) = 1.18, 95% confidence interval (CI) = 1.02–1.37]. An elevated risk of incident CHD was also found for former drinkers (HR = 1.31, 95% CI = 1.13–1.52) and consistent non-drinkers (HR = 1.47, 95% CI = 1.21–1.78), although, after sex stratification, the latter effect was only evident for females. When examining fatal CHD outcomes alone, only former drinkers had a significantly elevated risk, though hazard ratios for consistent non-drinkers were near identical. No evidence of elevated CHD risk was found for consistently heavy drinkers, and a weak association with fatal CHD for inconsistently heavy drinkers was attenuated following adjustment for confounding factors.ConclusionsUsing prospectively recorded alcohol data, this study has shown how instability in drinking behaviours over time is associated with risk of CHD. As well as individuals who abstain from drinking (long term or more recently), those who are inconsistently moderate in their alcohol intake have a higher risk of experiencing CHD. This finding suggests that policies and interventions specifically encouraging consistency in adherence to lower-risk drinking guidelines could have public health benefits in reducing the population burden of CHD. The absence of an effect amongst heavy drinkers should be interpreted with caution given the known wider health risks associated with such intake.Trial registrationClinicalTrials.gov, NCT03133689.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1123-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data

O’Neill

Britton

Hannah

et al. 2018

BMC Med

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“…In both studies, information from the last questionnaire preceding retirement was used to define smoking status (no vs yes), alcohol risk use (no vs yes; >24 units for men and >16 units for women),23 low physical activity (no vs yes; <14 metabolic equivalent)24 and body mass index (BMI; normal weight <25 kg/m 2 , overweight ≥25 to <30 kg/m 2 and obese ≥30 kg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%

Trajectories of self-rated health before and after retirement: evidence from two cohort studies

et al. 2019

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ObjectivesPrevious studies have produced conflicting findings on the health consequences of retirement. We aimed at identifying trajectories of self-rated health over retirement transition using repeated measurements and examined which preretirement factors predicted membership to each trajectory.MethodsThe study population consisted of Finnish public sector employees from two independent cohorts (Finnish Public Sector Study (FPS), n=5776 with a 4-year follow-up interval; and Finnish Retirement and Aging Study (FIREA), n=2796 with a 1-year follow-up interval). Both cohorts included assessment of self-rated health one to three times before and one to three times after retirement (average number of measurement points: 3.7 in FPS and 3.5 in FIREA). We used latent trajectory analysis to identify trajectories of self-rated health.ResultsIn both cohorts four similar trajectories were identified: ‘Sustained good health’ (47% in FPS and 74% in FIREA), ‘From good to suboptimal health’ (19% and 6%), ‘From suboptimal to good health’ (14% and 8%) and ‘Sustained suboptimal health’ (20% and 12%). There were more women and persons in high occupational status in the ‘From suboptimal to good health’ trajectory group when compared with ‘Sustained suboptimal health’ trajectory group in FPS. Those in the trajectory ‘From good to suboptimal health’ had lower occupational status and higher job strain in comparison with those in the ‘Sustained good health’ trajectory in both cohorts.ConclusionsA large majority of public sector employees maintain their perceived health status during retirement transition. Adverse trajectory in self-rated health relate to low occupational status and work-related stressors.

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“…The authors proposed health decline as the mechanism driving reductions in heavy drinking, but in the absence of concurrent measurement of health across time, it is unclear whether this is correct. Halonen et al (2017) provide further insights into drinking trajectories and sociodemographic characteristics of older drinkers. They investigated 12-year drinking trajectories of Finnish public-sector employees in the transition from work to retirement.…”

mentioning

confidence: 98%

Ten-Year Trajectories of Alcohol Consumption in Older Adult New Zealanders

Szabó

Towers

Sheridan

et al. 2019

The Journals of Gerontology: Series B

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Objective Older adults are often treated as a homogenous drinking group, but research suggests they engage with alcohol in various ways, ranging from abstention to heavy drinking. The study aimed to 1) identify subgroups of older adults based on changes in frequency and quantity of alcohol use over ten years, and 2) examine co-occurring changes in mental and physical health. Methods Data were collected between 2006 and 2016 biennially from 2632 New Zealanders (55-70 years old at baseline). Latent class growth analysis was performed to identify trajectories of alcohol use. Co-occurring changes in physical and mental health were examined using latent growth curve analysis. Results Five drinking profiles emerged: 1) infrequent, low quantity consumers; 2) highly frequent, low quantity consumers; 3) moderately frequent, high quantity consumers; 4) moderately frequent, low quantity consumers; and 5) highly frequent, high quantity consumers. Drinking trajectories demonstrated no change or slight declines in frequency and quantity over time. Frequent and moderately frequent, high quantity drinking was more prevalent among men, younger participants, and active smokers. Moderately frequent, heavy drinkers were in very poor health. Frequent and moderately frequent, low quantity drinking was associated with better health and economic wellbeing. Infrequent, low quantity consumers were more likely to be women and in poor health. Discussion The five drinking profiles indicate that older adults engage with alcohol in diverse ways. Two of these patterns indicated potentially hazardous use, which highlights the need for screening and intervention in this age group.

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Trajectories of risky drinking around the time of statutory retirement: a longitudinal latent class analysis

Cited by 30 publications

References 28 publications

Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data

Association of longitudinal alcohol consumption trajectories with coronary heart disease: a meta-analysis of six cohort studies using individual participant data

Trajectories of self-rated health before and after retirement: evidence from two cohort studies

Ten-Year Trajectories of Alcohol Consumption in Older Adult New Zealanders

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