A ten-year follow-up of older former problem drinkers: risk of relapse and implications of successfully sustained remission.
OBJECTIVE
This study examines the risk, predictors of relapse and the effects of successfully sustained remission on the drinking behavior, functioning, life context, coping and help seeking of older adults who were problem drinkers earlier in life.


METHODS
Older former problem drinkers (n = 447) were prospectively followed for 10 years and compared to lifetime nonproblem drinkers.


RESULTS
Of former problem drinkers, 31% (n = 141) died over the 10-year interval, a rate 1.6 times higher than that of lifetime nonproblem drinkers. Among surviving former problem drinkers, although relapse was relatively uncommon (11%), a less severe drinking history, heavier baseline alcohol consumption, and lower baseline income were associated with relapse. The majority (63%) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol, though at levels below those consumed by older lifetime nonproblem drinkers (n = 339). Stably remitted problem drinkers who were abstinent (SRAs) generally reported more severe drinking histories, greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent (SRNs). Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval, they continued to experience financial, health-related and life context deficits relative to older lifetime nonproblem drinkers.


CONCLUSIONS
Results suggest there are long-term costs associated with earlier drinking problems, even when remission is maintained. Both current drinking behavior and drinking history are worth considering when making recommendations regarding older adults' alcohol consumption.
Schutte
K K
KK
Center for Health Care Evaluation, Department of Veterans Affairs Health Care System & Stanford University Medical Center, Menlo Park California 94025, USA. Kathleen.Schutte@med.va.gov
Nichols
K A
KA
Brennan
P L
PL
Moos
R H
RH
D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D013695:Temperance / Q000523:psychology / Q000706:statistics & numerical data*