Late-life alcohol consumption and 20-year mortality

Background: Growing epidemiological evidence indicates that moderate alcohol consumption is associated with reduced total mortality among middle-aged and older adults. However, the salutary effect of moderate drinking may be overestimated owing to confounding factors. Abstainers may include former problem drinkers with existing health problems and may be atypical compared to drinkers in terms of sociodemographic and social-behavioral factors. The purpose of this study was to examine the association between alcohol consumption and all-cause mortality over 20 years among 1,824 older adults, controlling for a wide range of potential confounding factors associated with abstention. Methods: The sample at baseline included 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social-behavioral factors. Abstention was defined as abstaining from alcohol at baseline. Death across a 20-year follow-up period was confirmed primarily by death certificate. Results: Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers. Conclusions: Findings are consistent with an interpretation that the survival effect for moderate drinking compared to abstention among older adults reflects 2 processes. First, the effect of confounding factors associated with alcohol abstention is considerable. However, even after taking account of traditional and nontraditional covariates, moderate alcohol consumption continued to show a beneficial effect in predicting mortality risk

Human Adaptation

NULL447

Evaluating educational environments

xvi, 334 p.; 23 cm

Situational analysis of a therapeutic community milieu

The reactions of patients and staff were investigated in a representative sample of daily settings in a psychiatric inpatient ward in order to assess the relative amounts of variance accounted for by settings, individual differences, modes of response, and their interactions. The results indicated that, for patients, individual differences accounted for more variance than setting differences, whereas, for staff, individual differences generally accounted for less variance than setting differences. Most importantly, the Individuals X Settings interactions generally accounted for approximately 20 % of the total variance. It was concluded that individuals, settings, modes of response, and their interactions each contribute practically important proportions of total variance, and that each of these sources of variation must be sampled in attempts to measure and predict individual behavior. The research reported here deals with one facet of the generality-specificity problem, that is, the problem of the consistency of differen

Evaluating educational environments /

xvi, 334 p.; 23 cm