title: The association between alcohol use and long-term care placement among older Canadians: a 14-year population-based study.
abstract: Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors.
authors.affiliation: Portland State University, Portland, OR, USA. Electronic address: kaplanm@pdx.edu.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Kaplan
authors.forename: Nathalie
authors.initials: N
authors.lastname: Huguet
authors.forename: David
authors.initials: D
authors.lastname: Feeny
authors.forename: Bentson H
authors.initials: BH
authors.lastname: McFarland
authors.forename: Raul
authors.initials: R
authors.lastname: Caetano
authors.forename: Julie
authors.initials: J
authors.lastname: Bernier
authors.forename: Norman
authors.initials: N
authors.lastname: Giesbrecht
authors.forename: Lisa
authors.initials: L
authors.lastname: Oliver
authors.forename: Pamela
authors.initials: P
authors.lastname: Ramage-Morin
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Ross
mesh_terms: D000368:Aged; D064829:Alcohol Abstinence / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012112:Residential Facilities / Q000706:statistics & numerical data*; D013695:Temperance / Q000706:statistics & numerical data
keywords: Alcohol; HRQL; HUI3; Health Utilities Index Mark 3; Long-term care placement; NPHS; National Population Health Survey; Older adult; health-related quality of life