a Unit for Clinical Alcohol Research , University of Southern Denmark , Odense , Denmark.
b Department of Psychiatry , University of Southern Denmark , Odense , Denmark.
Subst Use Misuse. 2017 Oct 15;52(12):1575-1588. doi: 10.1080/10826084.2017.1293102. Epub 2017 May 19.
This systematic review seeks to expand the description and understanding of late-onset AUD and asks "Which risk factors have been reported for late-onset heavy drinking and AUD?"
Using PRISMA guidelines, a literature review and search was performed on May 19, 2015 using the following databases: MEDLINE, EMBASE, PubMed, and PsychInfo. Nine studies were included in the final review.
The search revealed that only very few studies have been conducted. Hence, the evidence is limited but suggests that stress, role/identity loss, and friends' approval of drinking are associated with an increased risk for late-onset AUD or heavy drinking, whereas retirement, death of a spouse or a close relative does not increase the risk.
Inherent differences in measurements and methodologies precluded a meta-analysis. Therefore, the results presented here are descriptive in nature. Most studies base their conclusions on a certain preconception of older adults with alcohol problems, which leads to a row of circular arguments. The factors that have been measured seem to have changed over time.
There has been a lack of focus on the field of late-onset AUD since the 1970s, which possibly has led to misrepresentations and preconceptions on the complex nature of late-onset AUD. There is limited evidence for any specific risk factor for late-onset AUD or heavy drinking. We suggest the adoption of a qualitative approach to uncover what is intrinsic to late-onset AUD followed by quantitative studies with more agreement on methods and definitions.
本系统评价旨在扩展对迟发性 AUD 的描述和理解，并提出“哪些风险因素与迟发性大量饮酒和 AUD 相关？”
使用 PRISMA 指南，于 2015 年 5 月 19 日在 MEDLINE、EMBASE、PubMed 和 PsychInfo 数据库上进行文献检索和综述。最终综述纳入了 9 项研究。
检索结果表明仅有少量研究开展过。因此，证据有限，但表明压力、角色/身份丧失以及朋友对饮酒的认可与迟发性 AUD 或大量饮酒风险增加相关，而退休、配偶或近亲死亡则不会增加风险。
由于测量和方法学上的固有差异，无法进行荟萃分析。因此，此处呈现的结果本质上是描述性的。大多数研究基于对有酒精问题的老年人的某种先入为主的观念得出结论，这导致了一系列循环论证。所测量的因素似乎随时间发生了变化。
自 20 世纪 70 年代以来，迟发性 AUD 领域的关注度一直不足，这可能导致对迟发性 AUD 复杂性质的误解和偏见。对于迟发性 AUD 或大量饮酒的任何特定风险因素的证据有限。我们建议采用定性方法来揭示迟发性 AUD 内在的因素，然后再进行更具共识的定量研究，包括方法和定义。
