The goal of this research is to support public health efforts to reduce problems associated with alcohol use among men and women ages 50 and older. Heavy drinking increases morbidity and early mortality, but moderate drinking offers health benefits to many older adults by reducing risk for certain types of heart disease. It is well-established that many older adults drink regularly and that alcohol problems can develop late in life, but few studies have examined how drinking changes over time in this heterogeneous group. This longitudinal study will identify and describe alcohol use trajectories among older adults using four extant datasets from nationally representative cohorts including the Health and Retirement Study (HRS), the National Longitudinal Survey (NLS) of Mature Women, the NLS Young Women, and the Study of Assets and Health Dynamics among the Oldest Old (AHEAD). Members of the Young Women cohort entered their 6th decade of life during our study interval (1995-2004). The NLS Older Men and Young Men cohorts lack suitable alcohol data. Using four cohorts expands the age range of interest, increases the number of covariates to be considered, and supports replication analyses among women. All cohorts provided alcohol data on 5 occasions from 1995 to 2004 using two sets of comparable questions. Alcohol use trajectories will be identified and characterized with methods that have previously yielded new insights on drinking behaviors among adolescents and young adults. Latent class growth analysis (semi-parametric group based modeling) and growth mixture models will integrate person-centered quantitative methods with traditional variable-centered approaches. Consistent with an accumulation of risk conceptual model, covariates to be tested include demographic attributes, measures of childhood well-being, socioeconomic status, health behaviors, retirement, and health and functional status. Time-dependent data collected during the trajectory years will be included to reflect the dynamic nature of some of these variables among older adults. The investigators also plan to identify subsets of cohort members who experienced a major life event (e.g.: retirement) immediately prior to, or early in, the study interval and then characterize their drinking trajectories subsequent to that event. Prior research suggests alcohol use trajectories describing increasing levels of drinking, decreasing levels, stable use at both high and low levels, and abstinence will be identified. All of these trajectories have important implications for public health practice. Public health will benefit by using research findings to design more age-appropriate alcohol abuse prevention and health promotion interventions for the rapidly expanding older adult population. Public Health Relevance: This project is relevant to public health because it has important implications for adults ages 50 and older who comprise a rapidly increasing population segment in most communities. Alcohol use can have profound effects on older adults that are either harmful or beneficial depending in large part on how much is consumed overall and on individual occasions. The proposed cost-efficient research will using existing datasets to study changes in alcohol use behaviors over time among older adults and identify factors that may increase the likelihood of harmful drinking and decrease the likelihood of beneficial or moderate alcohol use.
| Bobo, Janet Kay; Greek, April A; Klepinger, Daniel H et al. (2013) Predicting 10-year alcohol use trajectories among men age 50 years and older. Am J Geriatr Psychiatry 21:204-13 |
| Bobo, Janet Kay; Greek, April A (2011) Increasing and decreasing alcohol use trajectories among older women in the U.S. across a 10-year interval. Int J Environ Res Public Health 8:3263-76 |
| Bobo, Janet Kay; Greek, April A; Klepinger, Daniel H et al. (2010) Alcohol use trajectories in two cohorts of U.S. women aged 50 to 65 at baseline. J Am Geriatr Soc 58:2375-80 |
