Recurrent risk of hospitalization among older persons with problematic alcohol use: A multiple failure-time analysis with a discontinuous risk model
(2022) In Addiction 117(9). p.2415-2430- Abstract
- Background and Aims
Older persons with problematic alcohol use vary in psychosocial functioning, age of onset for problem drinking and use of other drugs. The study measured the differential risks of all-cause, alcohol, polydrug and psychiatric-related repeated hospitalizations among older persons with problematic alcohol use.
Design
A linked register-based cohort study with discontinuous multiple-failure (time-to-repeated-event) data. Hospitalization and mortality were considered as failure.
Setting
Sweden, March 2003-November 2017, using data from the Addiction Severity Index (ASI) register linked to National Inpatient Register and the Swedish Cause of Death Register.
Participants
50 years and... (More) - Background and Aims
Older persons with problematic alcohol use vary in psychosocial functioning, age of onset for problem drinking and use of other drugs. The study measured the differential risks of all-cause, alcohol, polydrug and psychiatric-related repeated hospitalizations among older persons with problematic alcohol use.
Design
A linked register-based cohort study with discontinuous multiple-failure (time-to-repeated-event) data. Hospitalization and mortality were considered as failure.
Setting
Sweden, March 2003-November 2017, using data from the Addiction Severity Index (ASI) register linked to National Inpatient Register and the Swedish Cause of Death Register.
Participants
50 years and older (n= 1741; 28% women), with one or more alcohol problem days in the 30 days before an ASI assessment.
Measurements
Five mutually exclusive latent classes of problematic alcohol use, identified with eleven ASI items, were the independent variables: “Late Onset with Fewer Consequence (LO:FC; reference group)”; “Early Onset/Prevalent Multi-Dimensional problems (EO:MD)”; “Late Onset with co-occurring Anxiety and Depression (LO:AD)”; “Early Onset with co-occurring Psychiatric Problems (EO:PP)”; and “Early Onset with major Alcohol Problem (EO:AP)”. Covariates included sociodemographic characteristics, previous hospitalization and Elixhauser comorbidity index. Outcome measurements included recurrent hospitalization, and/or mortality due to: (a) all-cause, (b) alcohol-related disorders and diseases (c) polydrug use (d) other psychiatric disorders.
Findings
During the study period, 73.2% were hospitalized at least once, 57.3% were alcohol-related, 8.5% polydrug use and 18.5% psychiatric-related diagnoses.
Compared with LO:FC, EO:PP had higher risk for all-cause (adjusted hazard ratio [aHR]= 1.27, 95% confidence interval [CI]= 1.02—1.59) and alcohol-related (aHR= 1.34, 95% CI= 1.02—1.75) hospitalizations. Adjusted risks for polydrug-related hospitalization were 2.55, 95%CI= 1.04—6.27 for EO:MD and 2.62, 95%CI= 1.07—6.40 for EO:PP. Adjusted risk for psychiatric-related hospitalization was higher for LO:AD (aHR= 1.78, 95%CI= 1.16—2.73 and EO:PP (aHR= 2.03, 95%CI= 1.22—3.38).
Conclusions
Older addiction service users in Sweden have varying risks of hospitalization due to alcohol use, polydrug use and psychiatric disorders. Older persons with problematic alcohol use who have multiple needs and are assessed in social services may benefit from earlier interventions with an integrated focus on substance use and mental health. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/06b9cf94-cfb5-4629-85c3-ce2fbab12540
- author
- Jemberie, Wossenseged LU ; Padyab, Mojgan ; Mccarty, Dennis and Lundgren, Lena
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Addiction
- volume
- 117
- issue
- 9
- pages
- 2415 - 2430
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:35470927
- scopus:85129627252
- ISSN
- 1360-0443
- DOI
- 10.1111/add.15907
- language
- English
- LU publication?
- yes
- id
- 06b9cf94-cfb5-4629-85c3-ce2fbab12540
- date added to LUP
- 2022-04-27 15:49:38
- date last changed
- 2023-04-26 15:16:33
@article{06b9cf94-cfb5-4629-85c3-ce2fbab12540,
abstract = {{Background and Aims<br/>Older persons with problematic alcohol use vary in psychosocial functioning, age of onset for problem drinking and use of other drugs. The study measured the differential risks of all-cause, alcohol, polydrug and psychiatric-related repeated hospitalizations among older persons with problematic alcohol use.<br/><br/>Design<br/>A linked register-based cohort study with discontinuous multiple-failure (time-to-repeated-event) data. Hospitalization and mortality were considered as failure.<br/><br/>Setting<br/>Sweden, March 2003-November 2017, using data from the Addiction Severity Index (ASI) register linked to National Inpatient Register and the Swedish Cause of Death Register.<br/><br/>Participants<br/>50 years and older (n= 1741; 28% women), with one or more alcohol problem days in the 30 days before an ASI assessment.<br/><br/>Measurements<br/>Five mutually exclusive latent classes of problematic alcohol use, identified with eleven ASI items, were the independent variables: “Late Onset with Fewer Consequence (LO:FC; reference group)”; “Early Onset/Prevalent Multi-Dimensional problems (EO:MD)”; “Late Onset with co-occurring Anxiety and Depression (LO:AD)”; “Early Onset with co-occurring Psychiatric Problems (EO:PP)”; and “Early Onset with major Alcohol Problem (EO:AP)”. Covariates included sociodemographic characteristics, previous hospitalization and Elixhauser comorbidity index. Outcome measurements included recurrent hospitalization, and/or mortality due to: (a) all-cause, (b) alcohol-related disorders and diseases (c) polydrug use (d) other psychiatric disorders.<br/><br/>Findings<br/>During the study period, 73.2% were hospitalized at least once, 57.3% were alcohol-related, 8.5% polydrug use and 18.5% psychiatric-related diagnoses.<br/><br/>Compared with LO:FC, EO:PP had higher risk for all-cause (adjusted hazard ratio [aHR]= 1.27, 95% confidence interval [CI]= 1.02—1.59) and alcohol-related (aHR= 1.34, 95% CI= 1.02—1.75) hospitalizations. Adjusted risks for polydrug-related hospitalization were 2.55, 95%CI= 1.04—6.27 for EO:MD and 2.62, 95%CI= 1.07—6.40 for EO:PP. Adjusted risk for psychiatric-related hospitalization was higher for LO:AD (aHR= 1.78, 95%CI= 1.16—2.73 and EO:PP (aHR= 2.03, 95%CI= 1.22—3.38).<br/><br/>Conclusions<br/>Older addiction service users in Sweden have varying risks of hospitalization due to alcohol use, polydrug use and psychiatric disorders. Older persons with problematic alcohol use who have multiple needs and are assessed in social services may benefit from earlier interventions with an integrated focus on substance use and mental health.}},
author = {{Jemberie, Wossenseged and Padyab, Mojgan and Mccarty, Dennis and Lundgren, Lena}},
issn = {{1360-0443}},
language = {{eng}},
number = {{9}},
pages = {{2415--2430}},
publisher = {{Wiley-Blackwell}},
series = {{Addiction}},
title = {{Recurrent risk of hospitalization among older persons with problematic alcohol use: A multiple failure-time analysis with a discontinuous risk model}},
url = {{http://dx.doi.org/10.1111/add.15907}},
doi = {{10.1111/add.15907}},
volume = {{117}},
year = {{2022}},
}