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- Ahlner, Felicia, 1987
(författare)
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Alcohol use among older adults: Population perspectives on prevalence, correlates, and consequences of drinking in Swedish 70-year-olds
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Alcohol consumption is a major contributor to global morbidity and mortality, as well as accidents and intentional injuries. Older adults may be particularly susceptible to these negative consequences due to age-related factors that increase vulnerability to the adverse effects of alcohol. The overall aim of this thesis was to investigate alcohol consumption patterns in population-based samples of older adults by examining the prevalence, time trends, associated factors across specific levels of consumption, and the influence of alcohol on all-cause mortality. Method: Data were obtained from the Gothenburg H70 Birth Cohort studies, and study samples (≥70 years of age) included Birth cohorts 1906-07, 1922, 1930, and 1944, with a particular focus on Birth cohort 1944. Results: Paper I outlined the methodology employed during the baseline examination of Birth cohort 1944 conducted between 2014 and 2016, serving as the foundation for all papers in this thesis. Paper II examined changes in alcohol consumption among four birth cohorts of 70-year-olds examined across four decades, showing a significant upward trend in consumption rates, especially among women. Risk consumption increased from 7.4% (16.1% in men, 0.5% in women) in 1976-77 to 34.0% (45.3% in men, 24.3% in women) in 2014-16. In Paper III, substantial discrepancies in sociodemographic, social and health-related factors across different levels of consumption were revealed, with former drinking associated with the most unfavorable set of factors. Further, characteristics varied significantly among 70-year-olds who exceeded low-risk drinking guidelines for older adults. Paper IV investigated the impact of alcohol on all-cause mortality in individuals with a baseline age of 70 years over an 8-year follow-up period. The study also evaluated the combined effect of lifestyle factors on mortality risk using a 7-item risk score. The findings suggested that alcohol consumption has no independent effect on all-cause mortality, but its impact was moderated by physical activity. Moreover, individuals fulfilling criteria for at least five lifestyle risk factors had up to four times higher risk of all-cause mortality. Conclusion: Recent generations of 70-year-olds exhibited higher alcohol consumption rates, yet with few negative consequences, both cross-sectionally and longitudinally. However, consuming alcohol at rates approximately 2.5 times higher than current age-specific guidelines was associated with traditional alcohol-attributable consequences. In addition, a combination of alcohol overconsumption and several unhealthy lifestyle risk factors increased the risk of mortality. The knowledge gained from this thesis could be used to inform public health policies and interventions aimed at reducing harmful alcohol consumption in this particular age group.
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| 2. |
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| 3. |
- Ahlner, Felicia, 1987, et al.
(författare)
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Increased Alcohol Consumption Among Swedish 70-Year-Olds 1976 to 2016: Analysis of Data from The Gothenburg H70 Birth Cohort Studies, Sweden
- 2018
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Ingår i: Alcoholism: Clinical and Experimental Research. - : Wiley. - 0145-6008. ; 42:12, s. 2403-2412
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Tidskriftsartikel (refereegranskat)abstract
- © 2018 by the Research Society on Alcoholism Background: The older adult population is increasing worldwide, as is the number of older adults who consume alcohol. Although there is a growing body of research on alcohol consumption among older people, few studies focus on changes in at-risk consumption over time across well-defined birth cohorts of older adults. Methods: This study used a serial cross-sectional design in order to compare alcohol consumption patterns among birth cohorts of Swedish 70-year-olds (total n=2,268) examined in 1976 to 1977 (n=393), 1992 to 1993 (n=248), 2000 to 2002 (n=458), and 2014 to 2016 (n=1,169). Participants took part in a multidisciplinary study on health and aging. Face-to-face interviews were conducted by healthcare professionals. Protocols regarding alcohol consumption were similar for all cohorts. The volume of weekly alcohol consumption was estimated during the past month. At-risk consumption was defined as ≥100g alcohol/wk corresponding roughly to the National Institute on Alcohol Abuse and Alcoholism definition of heavy consumption. Results: The proportion of at-risk consumers among men increased from 16.1% in 1976 to 1977 to 29.9% in 2000 to 2002 (p=0.001) and 45.3% in 2014 to 2016 (p<0.001). In women, proportions were low in 1976 to 1977 (0.5%) and 1992 to 1993 (2.0%; p=0.134), but increased to 9.5% in 2000 to 2002 (p<0.001) and 24.3% in 2014 to 2016 (p<0.001). The male:female ratio regarding consumption of ≥100g/wk decreased from 32.2:1 in 1976 to 1977 to 3.1:1 in 2000 to 2002 to 1.9:1 in 2014 to 2016. Spirit consumption decreased dramatically among men during the study period, while women reported very low spirit consumption at all examinations. Wine consumption increased in both sexes between 2000 to 2002 and 2014 to 2016. Beer consumption increased among men between 2000 to 2002 and 2014 to 2016. Conclusions: Recent cohorts of 70-year-olds in Sweden report significantly higher levels of alcohol consumption than previous cohorts. There was a dramatic increase in at-risk consumption among 70-year-olds from the 1970s to the mid-2010s, and this was particularly pronounced among women.
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| 4. |
- Ahlner, Felicia, 1987, et al.
(författare)
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Patterns of Alcohol Consumption and Associated Factors in a Population-Based Sample of 70-Year-Olds: Data from the Gothenburg H70 Birth Cohort Study 2014-16
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 19:14
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Tidskriftsartikel (refereegranskat)abstract
- Older adults of today consume more alcohol, yet knowledge about the factors associated with different consumption levels is limited in this age group. Based on the data from a population-based sample (n = 1156, 539 men and 617 women) in The Gothenburg H70 Birth Cohort Study 2014-16, we examined sociodemographic, social, and health-related factors associated with alcohol consumption levels in 70-year-olds, using logistic regression. Total weekly alcohol intake was calculated based on the self-reported amount of alcohol consumed. Alcohol consumption was categorized as lifetime abstention, former drinking, moderate consumption (<= 98 g/week), and at-risk consumption (>98 g/week). At-risk consumption was further categorized into lower at-risk (98-196 g/week), medium at-risk (196-350 g/week), and higher at-risk (>= 350 g/week). We found that among the 1156 participants, 3% were lifetime abstainers, 3% were former drinkers, 64% were moderate drinkers, and 30% were at-risk drinkers (20% lower, 8% medium, 2% higher). Among several factors, former drinking was associated with worse general self-rated health (OR 1.65, 95% CI 1.08-2.51) and lower health-related quality of life (measured by physical component score) (OR 0.94, 95% CI 0.91-0.97), higher illness burden (OR 1.16, 95% CI 1.07-1.27), and weaker grip strength (OR 0.96, 95% CI 0.94-0.98). Higher at-risk drinkers more often had liver disease (OR 11.41, 95% CI 3.48-37.37) and minor depression (OR 4.57, 95% CI 1.40-14.95), but less contacts with health care (OR 0.32, 95% CI 0.11-0.92). Our findings demonstrate the importance of classifications beyond abstinence and at-risk consumption, with implications for both the prevention and clinical management of unhealthy consumption patterns in older adults.
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| 5. |
- Ahlner, Felicia, 1987, et al.
(författare)
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The effect of alcohol consumption on all-cause mortality in 70-year-olds in the context of other lifestyle risk factors: results from the Gothenburg H70 birth cohort study
- 2023
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Ingår i: BMC Geriatrics. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn this study, we examined the effect of alcohol, as well as the combined effect of seven lifestyle factors, on all-cause mortality in older adults (baseline age 70 years).MethodsData was derived from the population-based Gothenburg H70 Birth Cohort study, including 1124 participants from the 2014-16 examination. Risk consumption was defined as > 98 g alcohol per week, and hazardous drinking was based on the Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Cox regression models were used to examine the individual effect of alcohol consumption, as well as the combined effect of seven lifestyle risk factors (high alcohol consumption, lifetime smoking, unhealthy Body Mass Index, insufficient physical activity, sedentary behavior, insufficient/prolonged sleep, unhealthy dietary pattern) on all-cause mortality.ResultsDuring a mean follow-up of 7.7 years, 81 (7.2%) participants died. Neither risk consumption nor hazardous drinking were associated with elevated mortality, but hazardous drinking was associated with an increased risk of mortality in those with insufficient physical activity. Those with at least five lifestyle risk factors had an increased all-cause mortality compared to those fulfilling criteria for a maximum of one lifestyle risk factor. High alcohol consumption showed a relatively minor impact on this risk, while physical activity and unhealthy dietary pattern had an independent effect on mortality.ConclusionsIn this particular sample, there was no independent effect of alcohol on the risk of 8-year all-cause mortality. However, an interaction effect of physical activity was observed. It may be that high alcohol consumption per se is less important for mortality among older adults. However, a combination of several unhealthy lifestyle behaviors was linked to a substantial increase in the risk of mortality in Swedish older adults. Also, it has to be emphasized that high alcohol consumption may have other adverse health effects apart from mortality among older adults.
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| 6. |
- Falk Erhag, Hanna, et al.
(författare)
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Alcohol use and drinking patterns in Swedish 85 year olds born three decades apart - findings from the Gothenburg H70 study
- 2023
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 52:3
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about alcohol consumption among the oldest old. Objective To compare alcohol use and drinking patterns among 85 year olds born three decades apart. Design Cross-sectional. Setting The Gothenburg H70 Birth Cohort Studies. Subjects About 1,160 85 year olds born in 1901-02, 1923-24, and 1930. Methods Self-reported questions about alcohol included how often study participants drank beer, wine, and spirits and how many centilitres in total/week. Risk consumption was defined as >= 100 g alcohol/week. Descriptive statistics and logistic regression were used to explore cohort characteristics, differences in proportions, factors associated with risk consumption and 3-year mortality. Results The proportion of at-risk drinkers increased from 4.3 to 14.9% (9.6-24.7% in men and 2.1-9.0% in women). The proportion of abstainers decreased from 27.7 to 12.9%, with the largest decrease observed among women (29.3-14.1%). Controlling for sex, education and marital status, 85 year olds in the later-born cohorts were more likely to be risk consumers than those in the earlier-born cohort [odds ratio (OR) 3.1, 95% confidence nterval (CI) 1.8-5.6]. The only factor associated with an increased likelihood was male sex (OR 3.7, 95% CI 1.0-12.7 and OR 3.2, 95% CI 2.0-5.1). There were no associations between risk consumption of alcohol and 3-year mortality in any of the cohorts. Conclusion Alcohol consumption and the number of risk consumers among 85 year olds have increased considerably. This could have large public health consequences since older adults are more sensitive to alcohol's adverse health effects. Our findings show the importance of detecting risk drinkers also in the oldest old.
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| 7. |
- Falk, Hanna, 1977, et al.
(författare)
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Internet use and self-rated health among Swedish 70-year-olds: a cross-sectional study
- 2019
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: The Internet is increasingly becoming an infrastructure for a number of services, both commercial, public (including health related) and personal. Using the internet have the potential to promote social interaction and social connectedness by upholding social networks and social contacts. However, Internet use is lower in older adults compared to other age groups. This digital divide is considered a risk to the health of older adults since it limits their participation in society, access and use of relevant health related information and services. This study focuses on whether there is an association between Internet use and self-rated health. Method: A cross-sectional population-based sample of 70-year-olds from The Gothenburg H70 Birth Cohort Study (n=1136) was examined in 2014–16. All data was collected using structured interviews and questionnaires. Differences in proportions were tested with chi-square test and ordinary least square regression analysis was used to estimate the relationship between Internet use and self-rated health controlling for health factors, hearing and visual impairment, and social contacts. Results: There is a relationship between more frequent Internet use and good self-rated health (unstandardized β 0.101 p<0.001), and the effect remained after adjusting for all covariates (unstandardized β 0.082 p<0.001). Our results also show that, in comparison to health factors, Internet use is of minor importance to the SRH of older adults, since adding these improved the explanatory power of the model by approximately 400% (from 0.04 to 0.18). Conclusion: Although the direction of the relationship between more frequent interne use and better self-rated health is undetermined in the present study, it can be suggested that using the Internet informs and educates older adults, strengthening their position as active and engaged participants of society. It can also be suggested that those using the Internet report less loneliness and a possibility to establish new computer-mediated relationships within online communities. Further research needs to examine what aspects of Internet use, and in what contexts such positive perceptions arise.
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| 8. |
- Havstam Johansson, Lena, 1963, et al.
(författare)
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Vision-related quality of life and visual function in a 70-year-old Swedish population
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:5, s. 521-529
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate vision-related quality of life (VRQoL), visual function and predictors of poor vision in a population of 70-year-olds. Methods Self-reported ocular morbidity and responses to the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) in a cross-sectional population study (N = 1203) in Gothenburg, Sweden, were compared with results from ophthalmic examination (N = 560). Results The most common self-reported ophthalmic morbidities were cataract (23.4%), age-related macular degeneration (AMD; 4.7%), glaucoma (4.3%) and diabetic retinopathy (1.4%). Cataract was more prevalent in women (p = 0.001). The composite score from NEI VFQ-25 for the entire cohort was 91.4 (standard deviation: 27.5). When comparing composite score for different eye diseases, persons with cataract or AMD exhibited lower scores (p = 0.029 and 0.018, respectively). Best-corrected visual acuity (BCVA) was normal (>= 0.5 decimal) in 98.9%; two individuals had low vision (<0.3). Men exhibited better BCVA (median: -0.08 logMAR) than women (-0.06; p = 0.005). Visual field defects were observed in 16.3% and uncorrected refractive errors in 61.5%. Poor vision was reported by 7.4% of participants with presenting visual acuity (PVA) >= 0.5 (decimal), while 66.7% with PVA PVA <0.5, 55.6% obtained a BCVA of >= 1.0 with the right correction. Low contrast sensitivity was a significant predictor of experiencing poor vision (p = 0.008), while PVA and visual field defects were not. Conclusions Low contrast sensitivity is a predictor of experiencing poor vision. There is a discrepancy between subjective/objective visual function and a high prevalence of uncorrected refractive errors. Women have more cataract, and men demonstrate slightly better visual acuity.
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| 9. |
- Lindberg, Olle R, et al.
(författare)
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Effects of current alcohol use on brain volume among older adults in the Gothenburg H70 Birth Cohort study 2014-16
- 2024
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Ingår i: European Archives of Psychiatry and Clinical Neuroscience. - 0940-1334. ; 274:2, s. 363-373
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Tidskriftsartikel (refereegranskat)abstract
- Brain gray- and white matter changes is well described in alcohol-dependent elderly subjects; however, the effect of lower levels of alcohol consumption on the brain is poorly understood. We investigated the impact of different amounts of weekly alcohol consumption on brain structure in a population-based sample of 70-year-olds living in Gothenburg, Sweden. Cross-sectional data from 676 participants from The Gothenburg H70 Birth Cohort Study 2014-16 were included. Current alcohol consumers were divided into seven groups based on self-reported weekly amounts of alcohol consumption in grams (g) (0-50 g/week, used as reference group, 51-100 g/week, 101-150 g/week, 151-200 g/week, 201-250 g/week, 251-300 g/week, and > 300 g/week). Subcortical volumes and cortical thickness were assessed on T1-weighted structural magnetic resonance images using FreeSurfer 5.3, and white matter integrity assessed on diffusion tensor images, using tract-based statistics in FSL. General linear models were carried out to estimate associations between alcohol consumption and gray- and white matter changes in the brain. Self-reported consumption above 250 g/week was associated with thinning in the bilateral superior frontal gyrus, the right precentral gyrus, and the right lateral occipital cortex, in addition to reduced fractional anisotropy (FA) and increased mean diffusivity (MD) diffusively spread in many tracts all over the brain. No changes were found in subcortical gray matter structures. These results suggest that there is a non-linear relationship between alcohol consumption and structural brain changes, in which loss of cortical thickness only occur in non-demented 70-year-olds who consume more than 250 g/week.
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| 10. |
- Mellqvist Fässberg, Madeleine, et al.
(författare)
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Epidemiology of suicidal feelings in an ageing Swedish population: From old to very old age in the Gothenburg H70 Birth Cohort Studies
- 2020
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Ingår i: Epidemiology and Psychiatric Sciences. - 2045-7960. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- AimsThe first aim of this study was to provide prevalence suicidal feelings over time (past week, past month, past year and lifetime) in a population-based sample of old to very old adults without dementia. Does prevalence change with rising age? The second aim was to examine the fluctuation of suicidal feelings over time. How does this coincide with depression status?MethodsData were derived from the Gothenburg H70 Birth Cohort Studies (the H70 studies) which are multidisciplinary longitudinal studies on ageing. A representative sample of adults in Gothenburg, Sweden with birth years 1901-1944 were invited to take part in a longitudinal health study on ageing and participated at one or more occasions during 1986-2014. The sample consisted of 6668 observations originating from 3972 participants without dementia between the ages of 70 and 108, including 1604 participants with multiple examination times. Suicidal feelings were examined during a psychiatric interview using the Paykel questions (life not worth living, death wishes, thoughts of taking own life, seriously considered taking life, attempted suicide).ResultsPrevalence figures for suicidal feelings of any severity were as follows: past week 4.8%, past month 6.7%, past year 11.2% and lifetime 25.2%. Prevalence rates increased with age in the total group and in women but not in men. Suicidal feelings were common in participants with concurrent major or minor depression, but over a third of the participants who reported suicidal feelings did not fulfil criteria for these diagnoses nor did they present elevated mean depressive symptom scores. The majority of participants consistently reported no experience of suicidal feelings over multiple examination times, but fluctuation was more common in women compared with men.ConclusionSuicidal feelings in late-life are uncommon in individuals without depression indicating that such behaviour is not a widespread, normative phenomenon. However, such feelings may occur outside the context of depression. © Cambridge University Press 2019.
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