自我报告的残疾类型与酒精性死亡风险 - 一项基于全国代表性数据的纵向研究。

Self-Reported Disability Type and Risk of Alcohol-Induced Death - A Longitudinal Study Using Nationally Representative Data.

机构信息

Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA.

Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA.

出版信息

Subst Use Misuse. 2024;59(9):1323-1330. doi: 10.1080/10826084.2024.2340993. Epub 2024 Apr 18.

DOI:10.1080/10826084.2024.2340993

PMID:38635979

Abstract

BACKGROUND

Disability is associated with alcohol misuse and drug overdose death, however, its association with alcohol-induced death remains understudied.

OBJECTIVE

To quantify the risk of alcohol-induced death among adults with different types of disabilities in a nationally representative longitudinal sample of US adults.

METHODS

Persons with disabilities were identified among participants ages 18 or older in the Mortality Disparities in American Communities (MDAC) study ( = 3,324,000). Baseline data were collected in 2008 and mortality outcomes were ascertained through 2019 using the National Death Index. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated for the association between disability type and alcohol-induced death, controlling for demographic and socioeconomic covariates.

RESULTS

During a maximum of 12 years of follow-up, 4000 alcohol-induced deaths occurred in the study population. In descending order, the following disability types displayed the greatest risk of alcohol-induced death (compared to adults without disability): complex activity limitation (aHR = 1.7; 95% CI = 1.3-2.3), vision limitation (aHR = 1.6; 95% CI = 1.2-2.0), mobility limitation (aHR = 1.4; 95% CI = 1.3-1.7), ≥2 limitations (aHR = 1.4; 95% CI = 1.3-1.6), cognitive limitation (aHR = 1.2; 95% CI = 1.0-1.4), and hearing limitation (aHR = 1.0; 95% CI = 0.9-1.3).

CONCLUSIONS

The risk of alcohol-induced death varies considerably by disability type. Efforts to prevent alcohol-induced deaths should be tailored to meet the needs of the highest-risk groups, including adults with complex activity (i.e., activities of daily living - "ALDs"), vision, mobility, and ≥2 limitations. Early diagnosis and treatment of alcohol use disorder within these populations, and improved access to educational and occupational opportunities, should be considered as prevention strategies for alcohol-induced deaths.

摘要

背景

残疾与酒精滥用和药物过量死亡有关，但它与酒精引起的死亡之间的关联仍研究不足。

目的

在一项美国成年人全国代表性纵向样本中，量化不同类型残疾成年人中酒精引起的死亡风险。

方法

在 Mortality Disparities in American Communities (MDAC) 研究中，识别出年龄在 18 岁或以上的残疾人（ = 3324000 人）。基线数据于 2008 年收集，死亡率结果通过国家死亡索引确定，截至 2019 年。控制人口统计学和社会经济协变量，估计残疾类型与酒精引起的死亡之间的关联的调整后的危险比 (aHR) 和 95%置信区间 (CI)。

结果

在最长 12 年的随访期间，研究人群中发生了 4000 例酒精引起的死亡。按降序排列，以下残疾类型显示出最大的酒精引起的死亡风险（与无残疾成年人相比）：复杂活动受限（aHR = 1.7；95%CI = 1.3-2.3）、视力受限（aHR = 1.6；95%CI = 1.2-2.0）、行动受限（aHR = 1.4；95%CI = 1.3-1.7）、≥2 种限制（aHR = 1.4；95%CI = 1.3-1.6）、认知受限（aHR = 1.2；95%CI = 1.0-1.4）和听力受限（aHR = 1.0；95%CI = 0.9-1.3）。