Alcohol consumption trajectories over the Australian life course

Leggat, Geoffrey; Livingston, Michael; Kuntsche, Sandra; Callinan, Sarah

doi:10.1111/add.15849

Cited by 18 publications

(5 citation statements)

References 30 publications

(93 reference statements)

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“…Additionally, Indiana Biobank participants were older than COGA participants (mean ages at remission or last encounter >54 versus <35 years). Increased age might provide more opportunity to reduce one's problematic drinking (Britton et al., 2015; Knott et al., 2018; Leggat et al., 2022; Molander et al., 2010), but in a clinical sample, increased age might also reflect a longer history of problematic consumption and an elevated risk of associated medical problems. This may also explain the non‐significant findings in Indiana Biobank SUD cohort – they were about 5 years younger than those in Indiana Biobank liver diseases cohort.…”

Section: Discussionmentioning

confidence: 99%

Associations between alcohol use disorder polygenic score and remission in participants from high‐risk families and the Indiana Biobank

Lai,

Kuo,

Wetherill

et al. 2023

Alcohol, Clinical and Experimental Research

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BackgroundIn the United States, ~50% of individuals who meet criteria for alcohol use disorder (AUD) during their lifetimes do not remit. We previously reported that a polygenic score for AUD (PGSAUD) was positively associated with AUD severity as measured by DSM‐5 lifetime criterion count, and AUD severity was negatively associated with remission. Thus, we hypothesized that PGSAUD would be negatively associated with remission.MethodsIndividuals of European (EA) and African ancestry (AA) from the Collaborative Study on the Genetics of Alcoholism (COGA) who met lifetime criteria for AUD, and two EA cohorts ascertained for studies of liver diseases and substance use disorders from the Indiana Biobank were included. In COGA, 12‐month remission was defined as any period of ≥12 consecutive months without meeting AUD criteria except craving and was further categorized as abstinent and non‐abstinent. In the Indiana Biobank, remission was defined based on ICD codes and could not be further distinguished as abstinent or non‐abstinent. Sex and age were included as covariates. COGA analyses included additional adjustment for AUD severity, family history of remission, and AUD treatment history.ResultsIn COGA EA, PGSAUD was negatively associated with 12‐month and non‐abstinent remission (p ≤ 0.013, βs between −0.15 and −0.10) after adjusting for all covariates. In contrast to the COGA findings, PGSAUD was positively associated with remission (p = 0.004, β = 0.28) in the Indiana Biobank liver diseases cohort but not in the Indiana Biobank substance use disorder cohort (p = 0.17, β = 0.15).ConclusionsPGSAUD was negatively associated with 12‐month and non‐abstinent remission in COGA EA, independent of behavioral measures of AUD severity and family history of remission. The discrepant results in COGA and the Indiana Biobank could reflect different ascertainment strategies: the Indiana Biobank participants were older and had higher rates of liver disease, suggesting that these individuals remitted due to alcohol‐related health conditions that manifested in later life.

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Section: Discussionmentioning

confidence: 99%

Associations between alcohol use disorder polygenic score and remission in participants from high‐risk families and the Indiana Biobank

Lai,

Kuo,

Wetherill

et al. 2023

Alcohol, Clinical and Experimental Research

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“…Initial findings demonstrated good feasibility, acceptability and significant reductions in alcohol use, craving and dependence. Although encouraging, our published findings were on a heterogenous sample, spanning a wide age range (18–75 years), where different alcohol consumption patterns and cultures have been recognised [59]. ApBM research on middle–older adults specifically remains scarce, with mixed findings as to whether older age predicts training success in clinical trials [60, 61], and primarily younger cohorts examined in previous studies of smartphone‐delivered ApBM amongst community samples [54, 55, 57].…”

Section: Introductionmentioning

confidence: 94%

Smartphone‐delivered approach bias modification for reducing harmful drinking amongst middle–older age adults: Secondary analyses of a single‐arm pilot study

Bolt,

Piercy,

Bradshaw

et al. 2024

Drug and Alcohol Review

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IntroductionNovel, scalable, low‐cost interventions are needed to reduce harmful drinking amongst middle–older adults. Approach bias modification (ApBM) is a promising form of cognitive training for preventing/reducing alcohol use that can be delivered via smartphone. This study explored the acceptability and preliminary effectiveness of smartphone delivered and personalised ApBM amongst Australians ≥55 years, an age cohort at risk of alcohol‐related harms.MethodsSecondary analyses in a middle–older adult subsample (≥55 years, n = 289) of an open‐label pilot study using a retrospective, repeated measures design. We explored acceptability (adherence, user mobile acceptability ratings, free‐text responses) and preliminary effectiveness (changes in drinking quantity and frequency, craving, dependence and proportion drinking within government‐recommended guidelines) of two sessions/week over 4 weeks of evidence‐based ApBM training, adapted to include personalisation and smartphone delivery amongst Australians ≥55 years.ResultsAlthough minor adaptations to training were suggested, the intervention was acceptable amongst survey completers, with 72% training adherence. Relative to baseline, there was a significant increase in the proportion of drinking within recommended single‐session and weekly guidelines post‐training (from 25% to 41% and 6% to 28%, respectively, p < 0.001), with past‐week standard drinks significantly decreasing by 18% (p < 0.001) and significant reductions in drinking days, mean craving and dependence scores (p < 0.001).Discussion and ConclusionsFindings suggest smartphone ApBM is acceptable amongst middle‐to‐older aged Australians and may support this ‘at risk’ cohort to remain within government‐recommended alcohol consumption guidelines to optimise healthy aging, although, in the context of a single‐arm study, preliminary results should be interpreted cautiously.

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“…There remain substantial methodological challenges in unpicking the differential effects of age, period and cohort statistically, which we discuss in more detail in the Methods section below. Nevertheless, despite these methodological debates, it seems clear that alcohol consumption can vary at a population-level due to changes in drinking between generations (cohort effects [10]), shifts in consumption throughout the life-course (age effects [12,13]) and among the entire population as the cultural and regulatory position of alcohol changes (period effects [14]). How these age, period and cohort variations in drinking patterns affect harm rates is complex, with different kinds of alcohol-related harms occurring at different points during the life-course (e.g.…”

Section: Introductionmentioning

confidence: 99%

Trends in alcohol‐related liver disease mortality in Australia: An age–period–cohort perspective

et al. 2023

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Background and AimsThere have been few systematic attempts to examine how alcohol‐related mortality has changed in Australia, and no studies that have explored cohort effects in alcohol‐related mortality. This study uses more than 50 years of data to measure age, period and cohort trends in alcohol‐related liver disease (ALD) mortality.Design, Setting and CasesThis was a retrospective age–period–cohort analysis of total Australian ALD mortality data from 1968 to 2020 in Australia. There was a total of 35 822 deaths—27 208 men (76%) and 8614 women (24%).MeasurementsDeaths from ALD were grouped into 5‐year age groups and periods (e.g. deaths for 20–24‐year‐olds between 1968 and 1972 were combined).FindingsALD mortality peaked in the late 1970s and early 1980s for both men and women. In age–period–cohort models, mortality was highest for cohorts born 1915–30. For example, men born between 1923 and 1927 had a relative risk of 1.58 [95% confidence interval (CI) = 1.52, 1.64] compared with men born between 1948 and 1952. For women, there was an increase in risk for cohorts born in the 1960s [e.g. the 1963–67 cohort had a relative risk (RR) of 1.16 (95% CI = 1.07, 1.25) compared with women born in 1948–52]. For men, there was a broad decline in mortality over time [e.g. in 2020, the RR was 0.87 (95% CI = 0.82, 0.92) compared with the reference year of 2000]. For women, mortality declined until 2000 and has been stable since.ConclusionsAlcohol‐related liver disease mortality has declined across the Australian population since the 1970s and 1980s partly due to cohort‐specific shifts as the highest‐risk birth cohorts age. For women, this decline had stalled by the year 2000, and cohorts of women born during the 1960s were at higher risk than earlier cohorts, suggesting the need for thoughtful interventions as this population enters its highest‐risk years for ALD mortality.

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Alcohol consumption trajectories over the Australian life course

Cited by 18 publications

References 30 publications

Associations between alcohol use disorder polygenic score and remission in participants from high‐risk families and the Indiana Biobank

Associations between alcohol use disorder polygenic score and remission in participants from high‐risk families and the Indiana Biobank

Smartphone‐delivered approach bias modification for reducing harmful drinking amongst middle–older age adults: Secondary analyses of a single‐arm pilot study

Trends in alcohol‐related liver disease mortality in Australia: An age–period–cohort perspective

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