Alcohol Use Trajectories Among Older Adults

描述（由申请人提供）：本研究的目标是支持公共卫生工作，以减少50岁及以上男性和女性饮酒相关的问题。大量饮酒会增加发病率和早期死亡率，但适量饮酒通过降低某些类型心脏病的风险，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，酒精问题可能在晚年发展，但很少有研究探讨饮酒如何在这个异质群体中随着时间的推移而变化。这项纵向研究将使用来自全国代表性队列的四个现存数据集来识别和描述老年人的酒精使用轨迹，这些数据集包括健康与退休研究（HRS），国家成熟女性纵向调查（NLS），NLS年轻女性以及最年长者资产和健康动态研究（AHEAD）。在我们的研究期间（1995-2004年），年轻女性队列的成员进入了他们的第六个十年。NLS老年男子和青年男子队列缺乏适当的酒精数据。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重复分析。1995年至2004年，所有队列均使用两组可比问题提供了5次酒精数据。酒精使用轨迹将被确定和表征的方法，以前已经产生了新的见解，青少年和年轻人的饮酒行为。潜在类别增长分析（基于半参数组的建模）和增长混合模型将以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。与风险累积概念模型一致，待检验的协变量包括人口统计学属性、儿童福祉指标、社会经济地位、健康行为、退休以及健康和功能状态。将包括在轨迹年期间收集的随时间变化的数据，以反映老年人中某些变量的动态性质。研究人员还计划确定经历重大生活事件的队列成员的子集（例如：退休），然后描述他们在该事件之后的饮酒轨迹。先前的研究表明，酒精使用轨迹描述了饮酒水平的增加，水平的降低，高水平和低水平的稳定使用，以及禁欲。所有这些轨迹对公共卫生实践都有重要影响。公共卫生将受益于利用研究结果，为迅速扩大的老年人口设计更适合年龄的预防酗酒和促进健康的干预措施。 公共卫生相关性：该项目与公共卫生有关，因为它对50岁及以上的成年人有重要影响，在大多数社区，50岁及以上的成年人构成了迅速增加的人口部分。酒精的使用可能对老年人产生深远的影响，这些影响是有害的还是有益的，这在很大程度上取决于总体和个别场合的饮酒量。这项具有成本效益的研究将利用现有的数据集来研究老年人饮酒行为随时间的变化，并确定可能增加有害饮酒可能性和降低有益或适度饮酒可能性的因素。

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.