Du Yong, Wolf Ingrid-Katharina, Knopf Hildtraud
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
YD and I-KW contributed equally.
BMJ Open. 2016 Oct 8;6(10):e012182. doi: 10.1136/bmjopen-2016-012182.
The use and combined use of psychotropic drugs and alcohol among older adults is a growing public health concern and should be constantly monitored. Relevant studies are scarce in Germany. Using data of the most recent national health survey, we analyse prevalence and correlates of psychotropic drug and alcohol use among this population.
Study participants were people aged 60-79 years (N=2508) of the German Health Interview and Examination Survey for Adults 2008-2011. Medicines used during the last 7 days were documented. Psychotropic drugs were defined as medicines acting on the nervous system (ATC code N00) excluding anaesthetics (N01), analgesics/antipyretics (N02B), but including opiate codeines used as antitussives (R05D). Alcohol consumption in the preceding 12 months was measured by frequency (drinking any alcohol-containing beverages at least once a week/a day) and quantity (alcohol consumed in grams/day; cut-offs: 10/20 g/day for women/men defining moderate and risky drinking). SPSS complex sample module was used for analysis.
21.4% of study participants use psychotropic medications, 66.9% consume alcohol moderately and 17.0% riskily, 51.0% drink alcohol at least once a week and 18.4% daily, 2.8% use psychotropic drugs combined with daily alcohol drinking. Among psychotropic drug users, 62.7% consume alcohol moderately, 14.2% riskily. The most frequently used psychotropic medications are antidepressants (7.9%) and antidementia (4.2%). Factors associated with a higher rate of psychotropic drug use are female sex, worse health status, certified disability and polypharmacy. Risky alcohol consumption is positively associated with male sex, smoking, upper social class, better health status, having no disability and not living alone.
Despite the high risk of synergetic effects of psychotropic drugs and alcohol, a substantial part of older psychotropic drug users consume alcohol riskily and daily. Health professionals should talk about the additional health risks of alcohol consumption when prescribing psychotropic drugs to older adults.
老年人使用精神药物及同时使用精神药物和酒精的情况日益引起公共卫生关注,应持续进行监测。德国相关研究较少。利用最新全国健康调查的数据,我们分析了该人群中精神药物使用及酒精使用的患病率及其相关因素。
研究参与者为2008 - 2011年德国成人健康访谈与检查调查中年龄在60 - 79岁的人群(N = 2508)。记录过去7天内使用的药物。精神药物定义为作用于神经系统的药物(解剖学治疗学及化学分类代码N00),不包括麻醉药(N01)、镇痛药/退热药(N02B),但包括用作镇咳药的阿片类可待因(R05D)。通过频率(每周/每天至少饮用一次含酒精饮料)和数量(每天摄入的酒精克数;界限值:女性/男性每天10/20克定义为适度饮酒和危险饮酒)来衡量前12个月内的酒精消费情况。使用SPSS复杂样本模块进行分析。
21.4%的研究参与者使用精神药物,66.9%适度饮酒,17.0%危险饮酒,51.0%每周至少饮酒一次,18.4%每天饮酒,2.8%同时使用精神药物和每天饮酒。在精神药物使用者中,62.7%适度饮酒,14.2%危险饮酒。最常使用的精神药物是抗抑郁药(7.9%)和抗痴呆药(4.2%)。与精神药物使用率较高相关的因素为女性、健康状况较差、经认证残疾和多种药物联用。危险饮酒与男性、吸烟、社会阶层较高、健康状况较好、无残疾和非独居呈正相关。
尽管精神药物和酒精存在协同作用的高风险,但相当一部分老年精神药物使用者每天都在危险饮酒。健康专业人员在为老年人开精神药物处方时应提及饮酒带来的额外健康风险。