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Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO Study.

Berg, J.F. van den, Kok, R.M., Marwijk, H.W.J. van, Mast, R.C. van der, Naarding, P., Oude Voshaar, R.C., Stek, M.L., Verhaak, P.F.M., Waal, M.W.M. de, Comijs, H.C. Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO Study. American Journal of Geriatric Psychiatry: 2014, 22(9), p. 886-874.
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Objectives
To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults.

Design
Cross-sectional study. Setting: Netherlands Study of Depression in Older Persons (NESDO).

Participants
A total of 373 participants (mean [standard deviation] age: 70.6 [7.3] years; 66% women) diagnosed with a depressive disorder, and 128 nondepressed participants.

Measurements
Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT). Participants were categorized into abstainers (AUDIT score: 0), moderate drinkers (AUDIT score: 1–4), and at-risk drinkers (AUDIT score: ≥5). Multinomial logistic regression analysis was performed with AUDIT categories as outcome, and demographic, social, somatic, and psychological variables as determinants.

Results
The depressed group consisted of 40.2% abstainers, 40.8% moderate drinkers, and 19.0% at-risk drinkers. The depressed participants were more often abstinent and less often moderate drinkers than the nondepressed participants; they did not differ in at-risk drinking. Depressed abstainers more often used benzodiazepines but less often used antidepressants, and they had a poorer cognitive function than depressed moderate drinkers. Depressed at-risk drinkers were more often smokers and had fewer functional limitations but more severe depressive symptoms than depressed moderate drinkers.

Conclusions
Although alcohol abstinence was more common in depressed than in nondepressed older adults, 19% of depressed persons were at-risk drinkers. Because at-risk drinking is associated with more severe depression and may have a negative impact on health and treatment outcome, it is important that physicians consider alcohol use in depressed older adults. (aut. ref.)