Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults

O’Dean, Siobhan; Mewton, Louise; Chung, Tammy; Clay, Peter; Clare, Philip; Bruno, Raimondo; Yuen, Wing See; McBride, Nyanda; Swift, Wendy; Isik, Ashling; Upton, Emily; Tibbetts, Joel; Johnson, Phoebe; Kypri, Kypros; Slade, Tim

doi:10.1111/add.15991

Cited by 3 publications

(5 citation statements)

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“…Interestingly, our study indicates that the rate of accelerated ageing remains steady or slightly decreases when pure alcohol intake exceeds a certain amount. One explanation is the development of alcohol tolerance, where the body's defensive mechanisms may counteract the ageing effects of alcohol [37]. Smaller sample sizes for excessive alcohol consumers could contribute to broader 95% confidence intervals and less precise point estimates, consistent with previous Mendelian randomization research [34].…”

Section: Discussionmentioning

confidence: 65%

Alcohol consumption and accelerated biological ageing in middle‐aged and older people: A longitudinal study from two cohorts

Chen,

Yin,

Xiang

et al. 2024

Addiction

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Background and aimsThe relationship between alcohol consumption and age‐related diseases is inconsistent. Biological age (BA) serves as both a precursor and a predictor of age‐related diseases; however, longitudinal associations between alcohol consumption and BA in middle‐aged and older people remain unclear. We measured whether there was a longitudinal association between drinking frequency and pure alcohol intake with BA among middle‐aged and older people.Design and setting and participantsThis study involved two prospective cohort studies, set in Southwestern China and the United Kingdom. A total of 8046 participants from the China Multi‐Ethnic Cohort study (CMEC) and 5412 participants from the UK Biobank (UKB), aged 30–79 years, took part, with complete data from two waves of clinical biomarkers.MeasurementsBA was calculated by the Klemera Doubal's method. Accelerated BA equalled BA minus chronological age. Drinking frequency and pure alcohol intake were obtained through self‐reported questionnaires. Drinking frequency in the past year was classified as current non‐drinking, occasional (monthly drinking) and regular (weekly drinking).FindingsCompared with consistent current non‐drinkers, more frequent drinkers [CMEC: β = 0.46, 95% confidence interval (CI) = 0.13–0.80; UKB: β = 0.65, 95% CI = 0.01–1.29)], less frequent drinkers (CMEC: β = 0.62, 95% CI = 0.37–0.87; UKB: β = 0.54, 95% CI = −0.01–1.09), consistent occasional drinkers (CMEC: β = 0.51, 95% CI = 0.23–0.79; UKB: β = 0.63, 95% CI = 0.13–1.13) and consistent regular drinkers (CMEC: β = 0.56, 95% CI = 0.17–0.95; UKB: β = 0.46, 95% CI = 0.00–0.91) exhibited increased accelerated BA. A non‐linear relationship between pure alcohol intake and accelerated BA was observed among consistent regular drinkers.ConclusionsIn middle‐aged and older people, any change in drinking frequency and any amount of pure alcohol intake seem to be positively associated with acceleration of biological ageing, compared with maintaining abstinence.

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Section: Discussionmentioning

confidence: 65%

Alcohol consumption and accelerated biological ageing in middle‐aged and older people: A longitudinal study from two cohorts

Chen,

Yin,

Xiang

et al. 2024

Addiction

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“…The SCID‐IV used in the RADAR study was modified by one researcher and author (TC) to allow for diagnosis of DSM‐5 and ICD‐11 AUD. Detailed description of these modifications, study processes, sample sizing, and measures can be found elsewhere (O'Dean et al., 2022; Slade et al., 2017, 2021). The two previous RADAR studies report on the baseline prevalence and patterns of AUD symptom endorsement (Slade et al., 2021) and on issues specifically around the measurement of tolerance to the effects of alcohol—one of the 11 criteria of AUD (O'Dean et al., 2022).…”

Section: Methodsmentioning

confidence: 99%

“…Detailed description of these modifications, study processes, sample sizing, and measures can be found elsewhere (O'Dean et al., 2022; Slade et al., 2017, 2021). The two previous RADAR studies report on the baseline prevalence and patterns of AUD symptom endorsement (Slade et al., 2021) and on issues specifically around the measurement of tolerance to the effects of alcohol—one of the 11 criteria of AUD (O'Dean et al., 2022). The current paper extends these two papers by tracking change over time in all 11 AUD criteria.…”

Section: Methodsmentioning

confidence: 99%

“…The assessment of severity and frequency required a judgment of whether the symptom was experienced as persistent (e.g., lasting for more than 1 month), and/or recurrent (e.g., happened on more than three occasions) in the previous 6 months. As the tolerance criterion is over‐endorsed in emerging adults due to relatively naïve drinking careers, we applied additional thresholds to satisfy the tolerance criterion (O'Dean et al., 2022). These additional thresholds required an initial quantity of four (for women) or five (for men) standard drinks to feel drunk, and a 50% minimum increase in drinking quantity to feel drunk.…”

Section: Methodsmentioning

confidence: 99%

“…These additional thresholds required an initial quantity of four (for women) or five (for men) standard drinks to feel drunk, and a 50% minimum increase in drinking quantity to feel drunk. This definition of tolerance has been tested on this sample, and is more strongly associated with new onset AUD, and persistent and limited AUD than the definition without thresholds (see O'Dean et al., 2022 for more detail).…”

Section: Methodsmentioning

confidence: 99%

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The key role of specific DSM‐5 diagnostic criteria in the early development of alcohol use disorder: Findings from the RADAR prospective cohort study

Slade,

O'Dean,

Chung

et al. 2024

Alcohol, Clinical and Experimental Research

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BackgroundPrevention and early intervention of alcohol use disorder (AUD) is a public health priority, yet there are gaps in our understanding of how AUD emerges, which symptoms of AUD come first, and whether there are modifiable risk factors that forecast the development of the disorder. This study investigated potential early‐warning‐sign symptoms for the development of AUD.MethodsData were from the RADAR study, a prospective cohort study of contemporary emerging adults across Australia (n = 565, mean age = 18.9, range = 18–21 at baseline, 48% female). Participants were interviewed five times across a 2.5‐year period. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) AUD criteria and diagnoses were assessed by clinical psychologists using the Structured Clinical Interview for DSM‐IV (SCID‐IV), modified to cover DSM‐5 criteria. Hazard analyses modeled the time from first alcoholic drink to the emergence of any AUD criteria and determined which first‐emergent AUD criteria were associated with a faster transition to disorder.ResultsBy the final time point, 54.8% of the sample had experienced at least one DSM‐5 AUD criterion and 26.1% met criteria for DSM‐5 AUD. The median time from first AUD criterion to a diagnosis of AUD was 4 years. Social problems from drinking (hazard ratio [HR] = 3.24, CI95 = 2.14, 4.92, p < 0.001), major role (HR = 2.53, CI95 = 1.58, 4.06, p < 0.001), and drinking larger amounts/for longer than intended (HR = 2.04, CI95 = 1.20, 3.46, p = 0.008) were first‐onset criteria associated with a faster transition to AUD.ConclusionIn the context of a prospective general population cohort study of the temporal development of AUD, alcohol‐related social problems, major role problems, and using more or for longer than intended are key risk factors that may be targeted for early intervention.

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