Department of Psychiatry, University of California, San Diego, La Jolla, California.
University of Iowa, Iowa City, Iowa.
Alcohol Clin Exp Res. 2018 Sep;42(9):1704-1714. doi: 10.1111/acer.13810. Epub 2018 Jul 5.
Recent reports indicate higher-than-expected problematic drinking in older populations. However, few data describe how to predict which older individuals are most likely to demonstrate alcohol-related problems, including those with earlier alcohol use disorders (AUDs). These analyses evaluate predictors of alcohol outcomes in individuals with earlier AUDs in the Collaborative Study on Genetics of Alcoholism (COGA).
Original COGA participants with baseline AUDs at about age 40 were interviewed 13 to 26 years later and placed into clinically derived outcome categories. Chi-square and analysis of variance evaluated baseline differences across 4 outcome groups, with significant items entered into binary logistic regression backwards elimination analyses predicting outcomes.
Low-Risk Drinkers (N = 100) at follow-up were predicted by baseline higher levels of response to alcohol (high LRs), lower histories of alcohol treatment, experience with fewer types of illicit drugs, and were more likely to have been widowed. At follow-up, Problem Drinkers (N = 192) differed from High-Risk Drinkers (N = 93) who denied multiple alcohol problems by exhibiting baseline lower LRs, higher Sensation Seeking, and a higher proportion who were widowed. Abstinent (N = 278) outcomes were predicted by a history of higher baseline AUD treatments, higher alcohol problems, lower usual drinks, as well as older age and European American heritage. Thirty-four subjects (4.9%) could not be classified and were not included in these analyses.
These results generated from AUD individuals from both treatment and nontreatment settings reinforce low probabilities of recent Low-Risk Drinking in individuals with AUDs, but also suggest many individuals with AUDs demonstrate good outcomes 2 decades later.
最近的报告表明，老年人中的问题性饮酒高于预期。然而，很少有数据描述如何预测哪些老年人最有可能出现与酒精相关的问题，包括那些有早期酒精使用障碍（AUD）的人。这些分析评估了合作酒精遗传学研究（COGA）中早期 AUD 个体的酒精结局预测因素。
在大约 40 岁时基线有 AUD 的原始 COGA 参与者在 13 到 26 年后接受了访谈，并被放入临床衍生的结局类别中。卡方检验和方差分析评估了 4 个结局组之间的基线差异，具有显著意义的项目被纳入二元逻辑回归向后消除分析，以预测结局。
低风险饮酒者（N=100）在随访时预测基线较高的酒精反应水平（高 LR）、较低的酒精治疗史、较少的非法药物使用经历，并且更有可能丧偶。在随访时，问题饮酒者（N=192）与高风险饮酒者（N=93）不同，他们通过表现出基线较低的 LR、较高的感觉寻求以及更高的丧偶比例，否认了多种酒精问题。戒酒者（N=278）的结局由基线较高的 AUD 治疗史、较高的酒精问题、较低的常规饮酒量、较老的年龄和欧洲裔美国人血统预测。34 名受试者（4.9%）无法分类，因此未包含在这些分析中。
这些来自治疗和非治疗环境中 AUD 个体的结果强化了 AUD 个体近期低风险饮酒的低概率，但也表明 20 年后许多 AUD 个体表现出良好的结局。
