Women, aging, and alcohol use disorders
Women, aging, and alcohol use disorders
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DOI：
10.1300/j074v19n01_03
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发表时间：
2007-01-01
影响因子：
1.5
通讯作者：
Al-Otaiba, Zayed
中科院分区：
文献类型：
--
作者：
Epstein, Elizabeth E.;Fischer-Elber, Kimberly;Al-Otaiba, Zayed
年轻女性饮酒者与年长女性饮酒者相比，酒精使用障碍患病率的增加比男性饮酒者患病率的相应增加高出许多倍。因此，随着男女饮酒率之间的差距缩小，预计今后20年中老年女性饮酒者的人数和影响将增加。由于酒精代谢的差异，与男性相比，所有年龄段的女性都有更高的风险，与风险和较高水平的酒精消费相关的负面身体，医疗，社会和心理后果。老年妇女面临着与中年和老年人生活阶段的挑战有关的一系列新的前因，如更年期、退休、“空巢”、行动不便和疾病。随着年龄的增长，他们是。对酒精的作用具有更大的生理敏感性，以及酒精与处方药组合的协同作用的风险。另一方面，有混合研究表明，老年妇女可能受益于低水平酒精对更年期相关激素下降的缓冲作用，可能是预防冠心病和骨质疏松症的保护因素。然而，随着饮酒量的增加，这些好处要么被逆转，要么黯然失色。此外，任何饮酒都会增加老年妇女患乳腺癌的风险。酒精可能的有益影响必须与以下事实进行权衡：研究通常不会建立因果关系，低风险饮酒相当于每天一杯标准饮料，存在酒精依赖进展的风险，并且有替代方法可以获得相同的益处而没有相关风险。老年妇女在发现和治疗酒精问题方面也遇到了独特的障碍。目前专门针对老年妇女的治疗选择有限，但研究人员正开始探讨老年妇女的不同治疗反应，并制定专门针对老年妇女的治疗方法。治疗方案包括自助/相互同伴支持，这提供了辅助优势，在初级保健环境中进行短暂干预，这已被证明能有效降低饮酒水平，以及认知行为技术，这已被证明是有用的;但需要更多的研究和更大的样本。针对老年人的治疗在内容上必须适当，以应对与生命阶段相关的挑战，如失去父母角色和丧偶，在过程上也必须适当，如以尊重的治疗方式和较慢的速度提供。未来的研究方向应解决缺乏评估工具，同时使用酒精和处方药的风险，以及老年妇女在酒精治疗随机试验中的代表性不足。
The increase in prevalence rates of alcohol use disorders in younger versus older cohorts of female drinkers is many times higher than the corresponding increase in prevalence rates for male drinkers. Thus, the number and impact of older female drinkers is expected to increase over the next 20 years as the disparity between men's and women's drinking rates decrease. Due to differences in metabolism of alcohol, women of all ages compared to men are at higher risk for negative physical, medical, social, and psychological consequences associated with at-risk and higher levels of alcohol consumption. Aging women face new sets of antecedents related to challenges in the middle and older adult phases of life, such as menopause, retirement, "empty nest," limited mobility, and illness. As women age, they are. subject to an even greater physiological Susceptibility to alcohol's effect, as well as to a risk of synergistic effects of alcohol in combination with prescription drugs. On the other hand, there is mixed research indicating that older women may benefit from the buffering effect of low levels of alcohol on hormonal declines associated with menopause, perhaps serving as a protective factor against Coronary Heart Disease and osteoporosis. However, with heavier drinking, these benefits are either reversed or eclipsed. In addition, any alcohol consumption increases the risk for breast cancer in older women. The possible beneficial effects of alcohol must be weighed with the fact that the research does not typically establish causality, that low-risk drinking equates to one standard drink per day, that there is a risk of progression towards alcohol dependence, and that there are alternate methods to gain the same benefits without the associated risks. Older women also experience unique barriers to detection of and treatment for alcohol problems. Current treatment options specifically for older women are limited, though researchers are beginning to address differential treatment response of older women, as well as development of elder women-specific treatment approaches. Treatment options include self-help/mutual peer support, which provides ancillary advantages, brief interventions in primary care settings, which have been demonstrated to be effective in reducing drinking levels, and cognitive behavioral techniques, which have been demonstrated to be useful; but more studies and larger samples are needed. Elder-specific treatments need to be appropriate in terms of content, to address the challenges associated with life stage, such as the loss of the parental role and widowhood, and in terms of process, such as delivery in a respectful therapeutic style and at a slower pace. Future directions in research should address the lack of assessment instruments, the risks of simultaneous use of alcohol and prescription medications, and the under-representation of older women in randomized trials of alcohol treatments.