Schutte K K, Nichols K A, Brennan P L, Moos R H
Center for Health Care Evaluation, Department of Veterans Affairs Health Care System & Stanford University Medical Center, Menlo Park California 94025, USA.
J Stud Alcohol. 2003 May;64(3):367-74. doi: 10.15288/jsa.2003.64.367.
This study examines the risk, predictors of relapse and the effects of successfully sustained remission on the drinking behavior, functioning, life context, coping and help seeking of older adults who were problem drinkers earlier in life.
Older former problem drinkers (n = 447) were prospectively followed for 10 years and compared to lifetime nonproblem drinkers.
Of former problem drinkers, 31% (n = 141) died over the 10-year interval, a rate 1.6 times higher than that of lifetime nonproblem drinkers. Among surviving former problem drinkers, although relapse was relatively uncommon (11%), a less severe drinking history, heavier baseline alcohol consumption, and lower baseline income were associated with relapse. The majority (63%) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol, though at levels below those consumed by older lifetime nonproblem drinkers (n = 339). Stably remitted problem drinkers who were abstinent (SRAs) generally reported more severe drinking histories, greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent (SRNs). Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval, they continued to experience financial, health-related and life context deficits relative to older lifetime nonproblem drinkers.
Results suggest there are long-term costs associated with earlier drinking problems, even when remission is maintained. Both current drinking behavior and drinking history are worth considering when making recommendations regarding older adults' alcohol consumption.
本研究探讨了曾有饮酒问题的老年人在饮酒行为、功能、生活环境、应对方式和求助行为方面，复发的风险、预测因素以及成功维持戒酒的效果。
对447名曾有饮酒问题的老年人进行了为期10年的前瞻性随访，并与终生无饮酒问题者进行比较。
在曾有饮酒问题的老年人中，141人（31%）在10年期间死亡，死亡率比终生无饮酒问题者高1.6倍。在存活的曾有饮酒问题的老年人中，虽然复发相对不常见（11%），但饮酒史较轻、基线酒精消费量较高和基线收入较低与复发有关。大多数成功实现持续戒酒的曾有饮酒问题的老年人（63%）仍继续饮酒，不过饮酒量低于终生无饮酒问题的老年人（339人）。与仍在饮酒的稳定戒酒者相比，完全戒酒的稳定戒酒者通常报告有更严重的饮酒史、更大的功能和生活环境缺陷以及更多的求助行为。虽然完全戒酒者和仍在饮酒的稳定戒酒者在10年期间功能都有所改善，但相对于终生无饮酒问题的老年人，他们在经济、健康和生活环境方面仍存在缺陷。
结果表明，即使维持了戒酒状态，早期饮酒问题仍会带来长期代价。在就老年人饮酒问题提出建议时，当前饮酒行为和饮酒史都值得考虑。
