Kraus Ludwig, Østhus Ståle, Amundsen Ellen J, Piontek Daniela, Härkönen Janne, Legleye Stéphane, Bloomfield Kim, Mäkelä Pia, Landberg Jonas, Törrönen Jukka
Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden.
IFT Institut für Therapieforschung, München, Germany.
Addiction. 2015 Sep;110(9):1443-52. doi: 10.1111/add.12989. Epub 2015 Jul 14.
To investigate age, period and cohort effects on time trends of alcohol-related mortality in countries with different drinking habits and alcohol policies.
Age-period-cohort (APC) analyses on alcohol-related mortality were conducted in Denmark, Finland, Norway, Sweden, France and Germany.
Cases included alcohol-related deaths in the age range 20-84 years between 1980 and 2009.
Mortality data were taken from national causes of death registries and covered the ICD codes alcoholic psychosis, alcohol use disorders, alcoholic liver disease and toxic effect of alcohol.
In all countries changes across age, period and cohort were found to be significant for both genders [effect value with confidence interval (CI) shown in Supporting information, Table S1]. Period effects pointed to an increase in alcohol-related mortality in Denmark, Finland and Germany and a slightly decreasing trend in Sweden, while in Norway an inverse U-shaped curve and in France a U-shaped curve was found. Compared with the cohorts born before 1960, the risk of alcohol-related mortality declined substantially in cohorts born in the 1960s and later. Pairwise between-country comparisons revealed more statistically significant differences for period (P < 0.001 for all 15 comparisons by gender) than for age [P < 0.001 in seven (men) and four (women) of 15 comparisons] or cohort [P < 0.01 in two (men) and three (women) of 15 comparisons].
Strong period effects suggest that temporal changes in alcohol-related mortality in Denmark, Finland, Norway, Sweden, France and Germany between 1980 and 2009 were related to secular differences affecting the whole population and that these effects differed across countries.
研究不同饮酒习惯和酒精政策国家中，年龄、时期和队列效应与酒精相关死亡率时间趋势的关系。
对丹麦、芬兰、挪威、瑞典、法国和德国的酒精相关死亡率进行年龄-时期-队列（APC）分析。
病例包括1980年至2009年间年龄在20 - 84岁的酒精相关死亡。
死亡率数据取自国家死亡原因登记处，涵盖国际疾病分类（ICD）编码的酒精性精神病、酒精使用障碍、酒精性肝病和酒精中毒效应。
在所有国家，年龄、时期和队列的变化对男女两性均具有显著意义[效应值及置信区间（CI）见补充信息表S1]。时期效应表明，丹麦、芬兰和德国的酒精相关死亡率呈上升趋势，瑞典呈略有下降趋势，而挪威呈倒U形曲线，法国呈U形曲线。与1960年前出生的队列相比，20世纪60年代及以后出生的队列中，酒精相关死亡风险大幅下降。国家间两两比较显示，时期差异在统计学上更显著（按性别进行的所有15项比较中P < 0.001），年龄差异次之[15项比较中男性有7项（P < 0.001），女性有4项（P < 0.001）]，队列差异最小[15项比较中男性有2项（P < 0.01），女性有3项（P < 0.01）]。
强烈的时期效应表明，1980年至2009年间丹麦、芬兰、挪威、瑞典、法国和德国酒精相关死亡率的时间变化与影响整个人口的长期差异有关，且这些效应在不同国家有所不同。
