Alcohol Problems: Long-Term Course in Late-Life

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The purpose of this research is to describe the long-term course of late-life problem drinking and to examine how health and help-seeking, life context and coping, and gender and family factors influence late- life drinking careers. Specifically, we propose to extend an NIAAA-funded 10-year study of late-life problem drinking to 21 years in order to determine the course of older adults' alcohol consumption and problem drinking as they move from being young-old (55 to 65 years at baseline) to being old-old (75 to 86 years at follow-up). Guided by a stress and coping model, we will focus on four sets of issues: (1) We will examine the 21-year course of late-life alcohol consumption and problem drinking and identify high-risk patterns of alcohol consumption and the predictive validity of alternative alcohol consumption guidelines. In addition, we will focus on the rates and predictors of new late-life drinking problems and of remission, and consider the consequences of late-life drinking problems and remission, including whether stably remitted problem drinkers' functioning and life contexts normalize over time or whether there is permanent "scarring" associated with prior drinking problems. (2) We will examine health-related factors, such as medical conditions, medication use, pain, and depression and suicidal ideation, in relation to fluctuations in late-life drinking patterns. We will also focus on late-life and the lifetime history of help-seeking for alcohol-related and personal problems, as well as natural recovery of drinking problems. (3) We will consider the role of social context and coping, including friends and social resources, and life history factors, in fluctuations in late-life alcohol consumption, drinking problems, and remission and relapse. Finally, (4) we will examine gender and current family influences on the course of late-life problem drinking. By spotlighting the extent of at-risk drinking, late-onset problem drinking, and relapse among adults of advanced age, this research should help health care providers more readily recognize the existence and potential for drinking problems among their oldest patients. By providing insight into reasons adults at this life stage do or do not seek help for drinking problems, and patterns of help-seeking predictive of more favorable drinking outcomes, the research may help to provide the scientific underpinnings to promote development of more accessible and effective alcohol prevention programs for older adults.