Unit of Clinical Alcohol Research (UCAR), Faculty of Health, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Mental Health Odense, Region of Southern Denmark, Vejle, Denmark.
Alcohol Clin Exp Res. 2021 Mar;45(3):638-649. doi: 10.1111/acer.14562. Epub 2021 Mar 3.
Studies have found that reductions in World Health Organization (WHO) drinking risk levels may be a stable outcome of treatment for alcohol use disorder (AUD) and associated with functional improvements. The aim of this study was to investigate whether posttreatment reductions in WHO drinking risk levels are stable over time among older adults and associated with a decrease in consequences of drinking and AUD symptoms and improved quality of life.
Participants. Individuals 60+ years old, suffering from DSM-5 AUD (n = 693), and seeking outpatient treatment.
WHO drinking risk levels, prior to treatment and at all follow-up points up to 1 year after treatment start, were assessed with Form 90. Outcomes at follow-up included consequences of drinking (Drinker Inventory of Consequences), quality of life (WHOQOL-BREF), and DSM-5 AUD symptoms (Mini International Neuropsychiatric Interview). Logistic regression and linear mixed models were used to examine the probability of maintaining risk-level reductions at follow-up and the association between risk-level reductions and outcomes, respectively.
Reductions in risk levels were maintained over time (at least 1 level: OR 5.39, 95% CI 3.43, 8.47; at least 2 levels: OR 9.30, 95% CI 6.14, 14.07). Reductions were associated with reduced consequences of drinking and number of AUD symptoms, and minor, but statistically significant, improvements in quality of life.
Maintaining reductions in WHO risk levels appears achievable for older adults seeking treatment for AUD. The small reduction of AUD symptoms and improvement of quality of life indicates that these reductions may not be adequate as the only treatment goal.
研究发现，世界卫生组织（WHO）饮酒风险水平的降低可能是酒精使用障碍（AUD）治疗的稳定结果，并与功能改善相关。本研究旨在调查在老年人中，治疗后 WHO 饮酒风险水平的降低是否随着时间的推移而稳定，以及是否与饮酒后果和 AUD 症状的减少以及生活质量的提高相关。
参与者为 60 岁以上、患有 DSM-5 AUD（n=693）并寻求门诊治疗的个体。
使用 Form 90 评估治疗前和治疗开始后所有随访点（最长 1 年）的 WHO 饮酒风险水平。随访时的结果包括饮酒后果（饮酒者后果问卷）、生活质量（WHOQOL-BREF）和 DSM-5 AUD 症状（迷你国际神经精神访谈）。使用逻辑回归和线性混合模型分别检验维持随访时风险水平降低的概率和风险水平降低与结果之间的关联。
风险水平的降低在随访期间得到维持（至少降低 1 级：OR 5.39，95%CI 3.43，8.47；至少降低 2 级：OR 9.30，95%CI 6.14，14.07）。降低与饮酒后果减少和 AUD 症状数量减少相关，并且生活质量有较小但具有统计学意义的改善。
对于寻求 AUD 治疗的老年人来说，维持 WHO 风险水平的降低似乎是可行的。AUD 症状的少量减少和生活质量的提高表明，这些降低可能不足以作为唯一的治疗目标。
