Department of Applied Psychology, Center of Alcohol and Substance Use Studies (CAS), Rutgers University, New Brunswick-Piscataway, NJ, USA.
Department of Psychology, Buffalo State College, Buffalo, NY, 14222, USA.
Prev Sci. 2023 Jul;24(5):887-900. doi: 10.1007/s11121-023-01541-1. Epub 2023 Jul 29.
Older adult drinking poses a growing public health concern, especially given the ongoing aging of the United States population. As part of a larger lifespan developmental project contrasting predictors of drinking reductions across different periods of adulthood, we tested age differences in effects of health problems on drinking declines across young adulthood, midlife, and older adulthood. We predicted these effects to be developmentally specific to midlife and older adulthood. We also tested moderation by alcohol use disorder (AUD) symptomatology and by indices of sociodemographic disadvantage (sex and race/ethnicity). Analyses used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), leveraging NESARC's vast age range (18-90 + ; N = 43,093) and two waves of longitudinal data. Multiple-group cross-lag models tested differences across age groups in cross-lag paths between health problems and alcohol consumption. As hypothesized, health problem effects on drinking reductions were developmentally specific to midlife and older adulthood. However, models testing moderation by AUD symptomatology showed that these adaptive effects of health problems on drinking reductions did not extend to those with one or more AUD symptoms. Little evidence was found for moderation by sex or race/ethnicity. Findings support the notion of health concerns as a pathway to drinking reduction that increases in importance across the adult lifespan. However, given the moderation by AUD symptoms, findings also highlight a need to understand barriers to health-related pathways to drinking reduction among relatively severe midlife and older adult drinkers. These findings hold implications for lifespan developmental tailoring of clinical, public health, and policy interventions.
老年人饮酒问题日益引起公众关注，尤其是考虑到美国人口的老龄化趋势。作为一个更大的生命历程发展项目的一部分，该项目对比了不同成年阶段饮酒量减少的预测因素，我们测试了健康问题对青年期、中年期和老年期饮酒量减少的影响在不同年龄段的差异。我们预测这些影响在中年和老年期具有发展的特异性。我们还测试了酒精使用障碍（AUD）症状和社会人口劣势指标（性别和种族/民族）的调节作用。分析使用了国家酒精流行病学调查和相关条件（NESARC）的数据，利用 NESARC 的广泛年龄范围（18-90 岁及以上；N=43093）和两波纵向数据。多组交叉滞后模型测试了健康问题和酒精消费之间的交叉滞后路径在不同年龄组之间的差异。正如假设的那样，健康问题对饮酒减少的影响在中年和老年期具有发展的特异性。然而，测试 AUD 症状调节作用的模型表明，健康问题对饮酒减少的这种适应性影响并不扩展到有一个或多个 AUD 症状的人。几乎没有证据表明性别或种族/民族有调节作用。研究结果支持健康问题是减少饮酒的一种途径的观点，这种途径在成年期的重要性逐渐增加。然而，鉴于 AUD 症状的调节作用，研究结果也强调了需要了解相对严重的中年和老年饮酒者在健康相关的减少饮酒途径方面的障碍。这些发现对临床、公共卫生和政策干预措施的生命历程发展调整具有重要意义。
