Persisting, new, and renewed drinking problems are a significant health issue for many adults in mid- to late life. Physical health changes in later life, such as increased pain, may play an important role in the development and maintenance of these problems, but almost no research has focused on the relationship between pain and use of alcohol in later life. Guided by an empirically-based conceptual model, the proposed research will entail secondary analyses of two existing longitudinal datasets (Alcohol and Aging, n=1,231;and Health and Retirement Study, n=6,121) comprised of survey data from individuals age 55-65 at initial assessment who were readministered commensurate survey items over multiple time-points for the next 10 and 8 years, respectively. Its main objectives are to: (a) determine prospective relationships between pain and alcohol use among individuals in mid- to late-life, (b) elucidate the mediating role of depressive symptoms in this relationship, and (c) ascertain the moderating roles of key personal characteristics (gender, race, age, lifetime history of drinking problems, avoidance coping) and life context factors (stressors and social resources) on relationships among pain, depressive symptoms, and drinking outcomes. In addition, analyses will (d) determine whether elevated pain, depressive symptoms, and hazardous drinking culminate in poorer health related outcomes for older adults, and (e) whether a lifetime history of drinking problems, known at baseline assessment in late-middle-age, foreshadows more pain, and more negative consequences of pain, over the next 8 to 10 years. To meet these objectives, analyses will first focus on use of statistical procedures derived from classical test and item response theory, followed by tests of concurrent and predictive validity, to determine the psychometric properties of two key measures: pain, as assessed by number and chronicity of participants'painful medical conditions, and risk of adverse alcohol-medication interactions, as calculated from information about participants'alcohol consumption and medication use. Next, objectives will be met through use of multilevel statistical methods appropriate for analysis of longitudinal data, including multilevel regression, latent transition, discrete-time survival analyses, and structural equation modeling. Results of these analyses will provide the foundation for future primary research in this area and will have implications for improved healthcare for older adults. Specifically, they will help health care providers identify which of their older patients presenting with pain may be at elevated risk for subsequent adverse drinking and related health outcomes. Moreover, they will highlight for health care providers the relevance of drinking history and current drinking problems for predicting the development and course of pain symptoms among older patients.
Findings will contribute to public health by helping clinicians identify which of their older patients presenting with pain may be at elevated risk for subsequent adverse drinking and related health outcomes. Further, they will highlight for clinicians the relevance of current and lifetime history of drinking problems for predicting the extent and course of pain symptoms in later life. This information should encourage health care providers to better integrate pain assessment and treatment with more detailed alcohol screening in the delivery of health care to older patients.
| Brennan, Penny L; SooHoo, Sonya; Lemke, Sonne et al. (2016) Alcohol Use Predicts 10-Year Depressive Symptom Trajectories in the Health and Retirement Study. J Aging Health 28:911-32 |
| Brennan, Penny L; SooHoo, Sonya (2014) Psychiatric disorders and pain treatment in community nursing homes. Am J Geriatr Psychiatry 22:792-800 |
| Brennan, Penny L; Soohoo, Sonya (2013) Pain and use of alcohol in later life: prospective evidence from the health and retirement study. J Aging Health 25:656-77 |
| Brennan, P L; Holland, J M; Schutte, K K et al. (2012) Coping trajectories in later life: a 20-year predictive study. Aging Ment Health 16:305-16 |
| Brennan, Penny L; Schutte, Kathleen K; SooHoo, Sonya et al. (2011) Painful medical conditions and alcohol use: a prospective study among older adults. Pain Med 12:1049-59 |
