Alcohol use, survival, and quality of life at older ages: A prospective study.

描述(申请人提供)：本申请是R21 AG033796-01的修订版，最近一次由ZRG1HOP-L(90岁)于2008年10月审查。修订明确了概念组成部分和研究设计，并增加了成瘾与心理健康中心的诺曼·吉斯布雷希特博士作为省级酒精政策和工具变量选择的顾问。人们对老年人饮酒的纵向模式知之甚少。此外，关于酒精消费的纵向测量与老龄化人口发病率之间的关联的数据也很少。这一信息与公共健康高度相关，因为大多数老年人饮酒。然而，目前还不清楚在这个人群中常规使用的酒精含量是多少(如果有的话)是安全的。例如，国家酒精滥用和酒精中毒研究所建议，对于老年人来说，每天饮酒不应超过一杯。相反，国家老龄研究所支持和/或雇用的研究人员最近建议，老年人的酒精使用指南应该与年轻人相同(每天不超过两杯)。现在需要的是证据，为制定老年人饮酒指南提供信息。令人不便的是，考察饮酒和死亡率之间关系的许多研究，如果不是大多数，都是基于基线上报告的饮酒行为。很少有项目使用随时间推移的酒精消费模式来预测死亡率。此外，关于酒精使用的纵向模式与诸如与健康相关的生活质量或医疗保健利用等发病率指标之间的联系的信息很少。也很难解决健康状况会影响酒精消费的可能的反向因果关系。拟议的项目将通过分析加拿大纵向全国人口健康调查来解决这些问题。这个具有全国代表性的数据集包括12年来关于酒精使用的详细自我报告信息。该数据库还涉及饮食、体力活动、吸烟以及许多其他健康决定因素。每两年的调查周期包括与健康有关的生活质量信息以及住院和长期护理安置的数据。该项目将使用纵向数据来(A)描述基线年龄在50岁或以上的参与者随时间的饮酒模式，(B)评估纵向饮酒与自我报告住院之间的关系，(C)分析纵向饮酒模式与长期护理安置之间的关系，(D)研究纵向饮酒模式与与健康相关的生活质量之间的关系，以及(E)检验纵向饮酒模式与死亡率之间的关系。这一结果将为老年人纵向饮酒与健康相关结果之间的关系提供重要信息。反过来，这些结果可以用来制定关于老年人饮酒的指南。 公共卫生相关性：该项目将使用加拿大纵向国家人口健康调查的数据来检查酒精消费模式与健康结果之间的关系，包括50岁及以上成年人的制度化和死亡率。随着老年人饮酒指南的更新，这项研究的信息将与公共健康具有相当大的相关性。

DESCRIPTION (provided by applicant): This application is a revision of R21 AG033796-01, which was most recently reviewed by ZRG1 HOP-L (90) in October 2008. The revision clarifies the conceptual component and research design, and adds Dr. Norman Giesbrecht of the Centre for Addiction & Mental Health as a consultant on provincial alcohol policies and the selection of instrumental variables. Little is known about longitudinal patterns of alcohol use among older adults. Moreover, there are few if any data regarding associations between longitudinal measures of alcohol consumption and morbidity in an aging population. This information is highly relevant to public health because most older adults consume alcohol. However, it is unclear what (if any) amounts of alcohol are safe for routine use in this population. For example, the National Institute on Alcohol Abuse and Alcoholism suggests that for older individuals, alcohol use should be no more than one drink per day. Conversely, researchers supported and/or employed by the National Institute on Aging recently suggested that the alcohol use guidelines should be the same for older as for younger adults (no more than two drinks per day). Needed now is evidence to inform development of guidelines regarding alcohol use for older individuals. Inconveniently, many if not most studies examining relationships between alcohol consumption and mortality are based on drinking behavior reported at baseline. Few projects have used patterns of alcohol consumption over time to predict mortality. Moreover, there is little if any information about connections between longitudinal patterns of alcohol use and measures of morbidity such as health-related quality of life or health care utilization. It has also been difficult to address possible reverse causation in which health status can influence alcohol consumption. The proposed project will address these issues by analyzing the Canadian longitudinal National Population Health Survey. This nationally representative data set includes twelve years of detailed self-reported information about alcohol use. The database also addresses diet, physical activity, and smoking as well as numerous other health determinants. Each two-year cycle of the survey includes health-related quality of life information as well as data on hospitalization and long-term care placement. This project will use the longitudinal data to (a) describe patterns of alcohol consumption over time among participants who were 50 years or older at baseline, (b) assess the relationships between longitudinal alcohol use and self-reported hospitalization, (c) analyze associations between longitudinal drinking patterns and long-term care placement, (d) study connections between longitudinal drinking patterns and health-related quality of life, and (e) examine relationships between longitudinal alcohol use patterns and mortality. The results will provide important information about relationships between longitudinal alcohol consumption and health-related outcomes for older adults. These results, in turn, can be used to develop guidelines regarding alcohol use in an older population. PUBLIC HEALTH RELEVANCE: This project will use data from the Canadian longitudinal National Population Health Survey to examine the relationship between patterns of alcohol consumption and health outcomes, including institutionalization and mortality among adults aged 50 and older. Information from this study will be of considerable relevance to public health as guidelines for alcohol use among older adults are updated.