Net Lifetime Health Effects of Alcohol Use & Abuse

描述（由申请人提供）：虽然酒精消费与许多特定疾病实体的风险之间的关系已经进行了非常详细的调查，但在了解整个成人寿命中酒精消费与健康和疾病的总体关系方面存在严重缺陷。鉴于酒精既具有有害作用，也可能具有有益作用，因此必须了解酒精对死亡风险以及可能与饮酒或滥用呈正相关或相反相关的若干疾病和健康状况的净影响。我们建议使用基于人群的弗雷明汉研究（Framingham Study）中10,000多名受试者在27-55岁期间收集的数据，将其成年后大部分时间内饮酒的数量和模式与生活中两个最重要的方面联系起来：(a)生存（总死亡率）和(b)认知功能指数。我们还将把饮酒与残疾指数以及与酒精摄入影响的一些其他疾病和状况联系起来，包括肝病、事故、特定癌症、高血压、冠状动脉疾病、中风、其他心血管疾病、癫痫、晕厥、跌倒和骨折。弗雷明汉研究的独特之处在于，它能够在基本上整个成年人的生命周期（大多数人直到老年，一半以上的受试者直到死亡）内，反复测量饮酒的数量和模式，以及健康和疾病的测量。拟议的研究将对在整个随访过程中与每个受试者每次会面时收集的健康信息进行广泛审查，根据酒精消费量（饮酒量和模式）对每个受试者进行分类，确定有酒精使用障碍的人，编制完整的疾病和死亡原因数据集（目前仅完成了心血管疾病和癌症的数据集），然后检查酒精使用和酒精使用障碍与总死亡率（总体和年龄层）以及随时间反复评估的认知功能指数的关系。不同饮酒量和模式的净影响与不同年龄的结果有关。这项研究将产生一个独特的数据集，并将提供信息，以提高我们对酒精在整个成年生活中的净影响的认识。

DESCRIPTION (provided by applicant): While the association of alcohol consumption and the risk of many specific disease entities has been investigated in great detail, there are serious deficiencies in knowing the overall relation of alcohol consumption to health and disease throughout the adult lifespan. Given that alcohol has both detrimental and possibly beneficial effects, it is important to know its net effects on the risk of death and of a number of diseases and health conditions that may relate, either positively or inversely, to its use or abuse. We propose to use data collected over 27-55 years among the 10,000+ subjects in the population-based Framingham Study to relate the amount and pattern of alcohol consumption over a large part of their adult lifetime to two of the most important aspects of life: (a) survival (total mortality) and (b) indices of cognitive function. We will also relate alcohol consumption to indices of disability and to a number of other diseases and conditions affected by alcohol intake, including liver disease, accidents, specific cancers, hypertension, coronary disease, stroke, other cardiovascular diseases, seizures, syncope, falls and fractures. The Framingham Study is unique in being able to provide repeated measurements of the amount and pattern of alcohol use and measures of health and disease over what is essentially the entire adult lifespan (until old age for most and until death for more than one half of subjects). The proposed study would carry out an extensive review of health information collected at every encounter with each subject throughout follow up, classify each subject at each encounter according to alcohol consumption (amount and pattern of drinking), identify those with alcohol use disorders, prepare a complete dataset of diseases and causes of death (currently complete only for cardiovascular disease and cancer), and then examine the relation of alcohol use and alcohol use disorders to total mortality (overall and by age strata) and to indices of cognitive function assessed repeatedly over time. The net effects of varying amounts and patterns of drinking would be related to outcomes at different ages. The study will produce a unique dataset and will provide information that should improve our knowledge of the net effects of alcohol throughout adult life.