Alcohol Use Trajectories Among Older Adults

描述(由申请人提供)：这项研究的目标是支持公共卫生努力，以减少50岁及以上男性和女性与饮酒有关的问题。大量饮酒会增加发病率和早期死亡率，但适度饮酒可以降低某些类型心脏病的风险，从而为许多老年人提供健康益处。众所周知，许多老年人经常饮酒，酒精问题可能会在晚年出现，但很少有研究研究这一异质性群体中饮酒随时间的变化。这项纵向研究将使用来自全国代表性队列的四个现有数据集来识别和描述老年人的酒精使用轨迹，这些队列包括健康和退休研究(HRS)、全国成熟女性纵向调查(NLS)、NLS年轻女性以及高龄老年人资产和健康动态研究(AHEAD)。在我们的研究期间(1995-2004年)，青年妇女队列成员进入了她们的60岁。NLS的老年男性和年轻男性队列缺乏合适的酒精数据。使用四个队列扩大了感兴趣的年龄范围，增加了要考虑的协变量的数量，并支持在妇女中进行复制分析。从1995年到2004年，所有队列都使用两组可比较的问题提供了5次酒精数据。酒精使用轨迹将用以前对青少年和年轻人饮酒行为产生新见解的方法来确定和表征。潜在班级增长分析(基于半参数组的建模)和增长混合模型将以个人为中心的定量方法与传统的以变量为中心的方法相结合。与累积风险概念模型一致，待检验的协变量包括人口统计属性、儿童幸福感的测量、社会经济地位、健康行为、退休以及健康和功能状况。在轨迹年期间收集的依赖时间的数据将被包括在内，以反映其中一些变量在老年人中的动态性质。研究人员还计划确定在研究间隔之前或早期经历重大生活事件(例如：退休)的队列成员的子集，然后描述他们在事件发生后的饮酒轨迹。先前的研究表明，酒精使用轨迹将被确定，描述了饮酒水平的增加、水平的下降、高水平和低水平的稳定使用以及戒酒。所有这些轨迹都对公共卫生实践具有重要影响。公共卫生将受益于利用研究结果为迅速增长的老年人口设计更适合年龄的酒精滥用预防和健康促进干预措施。 公共卫生相关性：该项目与公共卫生相关，因为它对50岁及50岁以上的成年人有重要影响，这些人构成了大多数社区中迅速增长的人口部分。饮酒可能会对老年人产生深远的影响，这在很大程度上取决于总体和个别场合的饮酒量。拟议的成本效益研究将使用现有的数据集来研究老年人酒精使用行为随时间的变化，并确定可能增加有害饮酒的可能性和降低有益或适度饮酒的可能性的因素。

DESCRIPTION (provided by applicant): The goal of this research is to support public health efforts to reduce problems associated with alcohol use among men and women ages 50 and older. Heavy drinking increases morbidity and early mortality, but moderate drinking offers health benefits to many older adults by reducing risk for certain types of heart disease. It is well-established that many older adults drink regularly and that alcohol problems can develop late in life, but few studies have examined how drinking changes over time in this heterogeneous group. This longitudinal study will identify and describe alcohol use trajectories among older adults using four extant datasets from nationally representative cohorts including the Health and Retirement Study (HRS), the National Longitudinal Survey (NLS) of Mature Women, the NLS Young Women, and the Study of Assets and Health Dynamics among the Oldest Old (AHEAD). Members of the Young Women cohort entered their 6th decade of life during our study interval (1995-2004). The NLS Older Men and Young Men cohorts lack suitable alcohol data. Using four cohorts expands the age range of interest, increases the number of covariates to be considered, and supports replication analyses among women. All cohorts provided alcohol data on 5 occasions from 1995 to 2004 using two sets of comparable questions. Alcohol use trajectories will be identified and characterized with methods that have previously yielded new insights on drinking behaviors among adolescents and young adults. Latent class growth analysis (semi-parametric group based modeling) and growth mixture models will integrate person-centered quantitative methods with traditional variable-centered approaches. Consistent with an accumulation of risk conceptual model, covariates to be tested include demographic attributes, measures of childhood well-being, socioeconomic status, health behaviors, retirement, and health and functional status. Time-dependent data collected during the trajectory years will be included to reflect the dynamic nature of some of these variables among older adults. The investigators also plan to identify subsets of cohort members who experienced a major life event (e.g.: retirement) immediately prior to, or early in, the study interval and then characterize their drinking trajectories subsequent to that event. Prior research suggests alcohol use trajectories describing increasing levels of drinking, decreasing levels, stable use at both high and low levels, and abstinence will be identified. All of these trajectories have important implications for public health practice. Public health will benefit by using research findings to design more age-appropriate alcohol abuse prevention and health promotion interventions for the rapidly expanding older adult population. Public Health Relevance: This project is relevant to public health because it has important implications for adults ages 50 and older who comprise a rapidly increasing population segment in most communities. Alcohol use can have profound effects on older adults that are either harmful or beneficial depending in large part on how much is consumed overall and on individual occasions. The proposed cost-efficient research will using existing datasets to study changes in alcohol use behaviors over time among older adults and identify factors that may increase the likelihood of harmful drinking and decrease the likelihood of beneficial or moderate alcohol use.