Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
Am J Geriatr Psychiatry. 2011 Aug;19(8):685-94. doi: 10.1097/JGP.0b013e3182006a96.
To estimate 1-year prevalence and correlates of alcohol abuse, dependence, and subthreshold dependence (diagnostic orphans) among middle-aged and elderly persons in the United States.
2005-2007 National Surveys on Drug Use and Health.
Sample included 10,015 respondents aged 50-64 years and 6,289 respondents older than 65 years. Data were analyzed by bivariate and multinomial regression analyses.
Sociodemographic variables; alcohol use; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition abuse and dependence; major depression; nicotine dependence; illicit drug use; and nonmedical use of prescription drugs.
Fifty-one percent of the sample used alcohol during the past year (56% in the 50-64 age group and 43% in the older than 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 older than 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 older than 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.
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 healthcare providers.
估计美国中老年人群中酒精滥用、依赖和亚阈值依赖（诊断孤儿）的 1 年患病率及其相关因素。
2005-2007 年全国毒品使用与健康调查。
样本包括 10015 名 50-64 岁和 6289 名年龄大于 65 岁的受访者。通过双变量和多变量回归分析进行数据分析。
社会人口统计学变量；酒精使用；《精神障碍诊断与统计手册》第四版滥用和依赖；重度抑郁症；尼古丁依赖；非法药物使用；以及非医疗处方药物使用。
样本中 51%（50-64 岁年龄组为 56%，年龄大于 65 岁年龄组为 43%）的人在过去一年中使用过酒精。总体而言，50-64 岁成年人中约有 11%（依赖症 1.9%，滥用症 2.3%，亚阈值依赖症 7.0%），年龄大于 65 岁的成年人中约有 6.7%（依赖症 0.6%，滥用症 0.9%，亚阈值依赖症 5.2%）报告了酒精滥用、依赖或依赖症状。在过去一年中有饮酒行为的人群中，50-64 岁成年人中约有 20%（依赖症 3.4%，滥用症 4.0%，亚阈值依赖症 12.5%），年龄大于 65 岁的成年人中约有 15.4%（依赖症 1.3%，滥用症 2.1%，亚阈值依赖症 12.0%）报告了酒精滥用或依赖症状。“耐受”（48%）和“使用时间”（37%）是亚阈值组最常报告的两个症状。与没有酒精滥用或依赖症状的酒精使用者相比，黑人或西班牙裔以及尼古丁依赖者或非医疗处方药物使用者更有可能出现亚阈值依赖。诊断孤儿也更有可能暴饮，而非无症状组。
社区中老年成年人中的诊断孤儿表现出更高的暴饮和非医疗处方药物使用率，这需要医疗保健提供者关注。
