Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective

Abstract Research on the prospective relationship between older adults’ alcohol consumption and their subsequent risk of dementia and cognitive impairment, no dementia (CIND) has been limited by inconsistent definitions of “moderate” drinking, use of short follow-ups, and an exclusive focus on either amounts of alcohol, or history of drinking problems, as predictors. To overcome these limitations we analyzed a longitudinal, 18-year Health and Retirement Study cohort (n=4,421) to determine how older adults’ baseline membership in one of six drinking categories (Non-Drinker, Without and With a History of Drinking Problems (HDP); Within-Guideline Drinker, Without and With a HDP; and Outside-Guideline Drinker, Without and With a HDP) predicted dementia and CIND 18 years later. Among participants with No HDP, 12.6% of Non-Drinkers, 5.2% of Within-Guideline Drinkers, and 8.8% of Outside-Guideline Drinkers were classified as having dementia at the 18-year follow-up; among participants With HDP, 14.1% of Non-Drinkers, 8.9 % of Within-Guideline Drinkers, and 6.9% of Outside-Guideline Drinkers were classified with dementia. Being a baseline Within-Guideline Drinker with No HDP reduced the likelihood of dementia 18 years later by 45%, independent of baseline demographic and health characteristics; being a baseline Within-Guideline Drinker With a HDP reduced the likelihood of dementia by only 13% (n.s.). Similar patterns obtained for the effects of baseline drinking group membership on likelihood of CIND at follow-up. These findings suggest that consuming alcohol at levels within validated guidelines for low-risk drinking may protect against dementia and CIND, but only among older adults who have no history of drinking problems.

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Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽

10.1024/1662-9647/a000127 ◽

2015 ◽

Vol 28 (2) ◽

pp. 67-76

Author(s):

Grace C. Niu ◽

Patricia A. Arean

Keyword(s):

Older Adults ◽

Mental Illness ◽

Brain Plasticity ◽

Late Life ◽

Aging Population ◽

The United States ◽

Future Research ◽

Evidence Based ◽

Late Life Depression ◽

Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

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Understanding the Critical Role of Alcohol Consumption in the Linkages Among Older Adults' Depressive Symptoms, Leisure Activities, and Physical Health Outcomes

PsycEXTRA Dataset ◽

10.1037/e625482009-001 ◽

2009 ◽

Author(s):

Rebecca Rueggeberg ◽

Carsten Wrosch ◽

Fatima Amari

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Alcohol Consumption ◽

Health Outcomes ◽

Physical Health ◽

Leisure Activities ◽

Critical Role ◽

Physical Health Outcomes

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Sex in Late Life: Assessing Adults’ Expectations and the Role of Healthcare Professionals

Innovation in Aging ◽

10.1093/geroni/igaa057.1003 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 313-313

Author(s):

Jill Naar ◽

Raven Weaver ◽

Shelbie Turner

Keyword(s):

Older Adults ◽

Sexual Health ◽

Health Behaviors ◽

Healthcare Professionals ◽

Late Life ◽

Sexual History ◽

Growth Curve Models ◽

The Us ◽

Sexual Health Behaviors ◽

The Life Course

Abstract Sexual activity contributes to quality of life throughout the lifespan. However, stigma about sex in late life influences older adults’ perceptions and healthcare professionals’ perceptions of older adults’ sexual health/behaviors. Using a multi-methods approach, we examined attitudes and knowledge about sexual health/behaviors in late life. Using longitudinal data from the Midlife in the US Study (Wave 1-3; N=7049), we ran age-based growth curve models to analyze changes in levels of optimism about sex in their future. We also piloted a survey with healthcare professionals assessing attitudes, knowledge, and awareness of policy about sexual health/behaviors among older adults. Adults’ expectations became less optimistic with increased age (β = -0.1, SE = 0.003, p < .0001). Men were more optimistic than women at age 20 (p = 0.016), but men’s optimism decreased over the life course at a faster rate than did women’s (p < .0001), so that from ages 40-93, men were less optimistic than women. Among healthcare professionals (N=21), the majority indicated never or rarely asking their clients about sexual history or health/behaviors; however, they indicated some knowledge about issues relevant to older adults (e.g., safe-sex practices, sexual dysfunction). Few indicated awareness about policies related to sexual behavior among residents (i.e., issues of consent, STIs). Among adults, there is a need to address declining optimism for expectations about sex in late life. Health professionals are well-situated to raise awareness and normalize discussions about sexual health, thus countering negative stigma and contributing to increasing optimism for expectations to remain sexually active.

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Longitudinal Association Between Education and Disability in Older Adults Living in Iceland

Innovation in Aging ◽

10.1093/geroni/igaa057.1274 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 396-396

Author(s):

Milan Chang ◽

Olof Geirsdottir ◽

Lenore Launer ◽

Vilmundur Gudnasson ◽

Palmi Jonsson ◽

...

Keyword(s):

Older Adults ◽

Low Socioeconomic Status ◽

Late Life ◽

Mobility Disability ◽

College And University ◽

Disability Status ◽

Adl Disability ◽

And Gender ◽

Access To Medical Care ◽

Life Education

Abstract BACKGROUND: Disabilities among older adults are associated with cumulative adversities such as low socioeconomic status (SES), poor nutrition, and lack of access to medical care and education. However, there is little evidence on the long-term association between education and disability status among older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of disability in activities of daily living (ADL) and mobility disability in late-life using 25 years of longitudinal data. METHODS: A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with an average of 25 years of follow-up (N=5764, mean age 77±6 yrs, 57.7% of women) Mid-life education was categorized into 2 groups (primary and secondary versus college and university). Disability status in late life was defined with ADL and mobility disability with a binary outcome (no difficulty versus any difficulty). Logistic regression analysis was used to examine the association. RESULTS: After controlling for age and gender, and midlife health risk factors, those who had high education at mid-life were less likely to have ADL disability (Odds Ratio (OR) = 0.75, 95% Confidence Interval (CI): 0.64 ~ 0.88, P ≤ 0.001) and mobility disability (OR = 0.72, 95% CI: 0.61 ~ 0.86, P < 0.001) compared with those who had low education in mid-life. CONCLUSION: People with high mid-life education were less likely to have ADL and mobility disability after 25 years later.

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Genome-wide analysis suggests the importance of vascular processes and neuroinflammation in late-life antidepressant response

Translational Psychiatry ◽

10.1038/s41398-021-01248-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Victoria S. Marshe ◽

Malgorzata Maciukiewicz ◽

Anne-Christin Hauschild ◽

Farhana Islam ◽

Li Qin ◽

...

Keyword(s):

Older Adults ◽

Cerebrovascular Disease ◽

Protein Degradation ◽

Late Life ◽

Cardioembolic Stroke ◽

Symptom Improvement ◽

Antidepressant Response ◽

Polygenic Risk ◽

Remission Status ◽

Genome Wide

AbstractAntidepressant outcomes in older adults with depression is poor, possibly because of comorbidities such as cerebrovascular disease. Therefore, we leveraged multiple genome-wide approaches to understand the genetic architecture of antidepressant response. Our sample included 307 older adults (≥60 years) with current major depression, treated with venlafaxine extended-release for 12 weeks. A standard genome-wide association study (GWAS) was conducted for post-treatment remission status, followed by in silico biological characterization of associated genes, as well as polygenic risk scoring for depression, neurodegenerative and cerebrovascular disease. The top-associated variants for remission status and percentage symptom improvement were PIEZO1 rs12597726 (OR = 0.33 [0.21, 0.51], p = 1.42 × 10−6) and intergenic rs6916777 (Beta = 14.03 [8.47, 19.59], p = 1.25 × 10−6), respectively. Pathway analysis revealed significant contributions from genes involved in the ubiquitin-proteasome system, which regulates intracellular protein degradation with has implications for inflammation, as well as atherosclerotic cardiovascular disease (n = 25 of 190 genes, p = 8.03 × 10−6, FDR-corrected p = 0.01). Given the polygenicity of complex outcomes such as antidepressant response, we also explored 11 polygenic risk scores associated with risk for Alzheimer’s disease and stroke. Of the 11 scores, risk for cardioembolic stroke was the second-best predictor of non-remission, after being male (Accuracy = 0.70 [0.59, 0.79], Sensitivity = 0.72, Specificity = 0.67; p = 2.45 × 10−4). Although our findings did not reach genome-wide significance, they point to previously-implicated mechanisms and provide support for the roles of vascular and inflammatory pathways in LLD. Overall, significant enrichment of genes involved in protein degradation pathways that may be impaired, as well as the predictive capacity of risk for cardioembolic stroke, support a link between late-life depression remission and risk for vascular dysfunction.

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