title: Late-life problem drinking: personal and environmental risk factors for 4-year functioning outcomes and treatment seeking.
abstract: Recent research emphasizes the importance of identifying older problem drinkers. However, very little is known about the longitudinal course and predictors of late-life problem drinking. This prospective study of late-life problem drinkers (N = 581) focused on predictors of alcohol consumption, drinking problems, depression, and treatment seeking over a 4-year interval. Heavier baseline alcohol use and being male independently predicted more alcohol consumption 4 years later; more baseline drinking problems and early-onset status independently predicted more drinking problems at follow-up. Independent of other factors, more initial depressive symptoms and chronic health stressors portended more depressive symptoms at follow-up. Individuals who initially sought more treatment, and who had more chronic health and spouse stressors at baseline, were more likely to seek help 4 years later. Heavier reliance on avoidance coping strategies heightened the risk that stressors and friends' approval of drinking would lead to more drinking problems at follow-up. However, for individuals who had more drinking problems at baseline, such environmental risk factors as negative health events and friend stressors predicted fewer subsequent drinking problems.
authors.affiliation: Center for Health Care Evaluation, Palo Alto VA Health Care System, CA 94304, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Brennan
authors.forename: R H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010555:Personality Inventory; D011340:Problem Solving; D012307:Risk Factors; D012931:Social Environment; D012932:Social Facilitation