Schutte Kathleen K, Moos Rudolf H, Brennan Penny L
Center for Health Care Evaluation, Department of Veterans Affairs, Veterans Affairs Palo Alto Health Care System, and Stanford University School of Medicine, Menlo Park, California 94025, USA.
J Stud Alcohol. 2006 May;67(3):354-62. doi: 10.15288/jsa.2006.67.354.
Studies of mixed-aged samples have suggested that a majority of problem drinkers achieve remission "naturally", without formal treatment. We sought to describe the life history predictors of untreated remission among older adults.
We compared 330 older untreated remitters to 120 older treated remitters and to 130 untreated nonremitters.
A majority (73%) of remitted, older problem drinkers attained remission without any formal treatment for drinking problems. Compared with treated remitters, late-life untreated remitters were more likely to be women and had completed more schooling, reached their peak alcohol consumption and ceased development of new drinking problems earlier, had much less severe drinking and depression histories, and were less likely to have received any advice to reduce consumption. Compared with untreated nonremitters, untreated remitters were more likely to be women, reached their peak alcohol consumption and stopped developing new drinking problems almost a decade earlier, had somewhat less severe drinking histories, were less likely to have been advised to reduce consumption, and were more likely to have reacted to late-life health problems by reducing their alcohol consumption.
Many late-life problem drinkers with milder drinking problems achieve remission without treatment or advice to reduce consumption. However, a notable percentage of untreated older individuals who have more severe drinking problems could benefit from public health efforts to aid detection of late-life drinking problems and interventions aimed at reducing alcohol consumption. Results suggest that such interventions should highlight the negative health consequences of excessive late-life drinking.
对不同年龄混合样本的研究表明,大多数有饮酒问题者会“自然”缓解,无需正规治疗。我们试图描述老年人未经治疗而缓解的生活史预测因素。
我们将330名未经治疗的老年缓解者与120名接受治疗的老年缓解者以及130名未经治疗的未缓解者进行了比较。
大多数(73%)缓解的老年饮酒问题者在未接受任何针对饮酒问题的正规治疗的情况下实现了缓解。与接受治疗的缓解者相比,晚年未经治疗的缓解者更可能为女性,受教育程度更高,饮酒量达到峰值且更早停止出现新的饮酒问题,饮酒和抑郁史严重程度低得多,且不太可能收到过减少饮酒量的建议。与未经治疗的未缓解者相比,未经治疗的缓解者更可能为女性,饮酒量达到峰值并停止出现新的饮酒问题的时间几乎早了十年,饮酒史严重程度略低,不太可能收到减少饮酒量的建议,且更可能通过减少饮酒量来应对晚年健康问题。
许多晚年饮酒问题较轻的饮酒者在未接受治疗或未收到减少饮酒量建议的情况下实现了缓解。然而,相当一部分未经治疗的、饮酒问题较严重的老年人可能会从公共卫生部门为帮助发现晚年饮酒问题以及采取旨在减少饮酒量的干预措施中受益。结果表明,此类干预措施应强调晚年过度饮酒对健康的负面后果。