Cohort and age trends in age 35–45 prevalence of alcohol use disorder symptomology, by severity, sex, race, and education. (1st September 2021)

• Record Type: Journal Article
• Authors: Jager, Justin; Keyes, Katherine M.; Son, Daye; Kloska, Deb; Patrick, Megan E.; Schulenberg, John E.
• Is Part Of: Drug and alcohol dependence. Volume 226(2021)
• Publication Date: 2021-09-01
• Subjects: Alcohol use disorder -- Middle-aged adults -- Sex -- Cohort; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108820
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Prevalence of overall alcohol use disorder decreased by 19 % across ages 35–45. Decreases were more pronounced between ages 35 and 40 compared to ages 40 and 45. Cohort differences in AUD prevalence were found at age 35 but not at age 45. Age and cohort effects did not differ by AUD severity (mild, moderate, severe). Age declines in AUD prevalence were slower for females and for college graduates. Abstract: Aims: To present national trends by age and cohort among middle-aged adults in the prevalence of AUD symptomology, by severity, sex, race, and education. Design: National, multi-cohort longitudinal probability samples of US adults, with data collected at ages 35, 40, and 45 among 14 cohorts who reached age 45 between 2003 and 2016. Setting: Data were collected via self-administered questionnaires to adults in the United States. Participants: The sample consisted of 20, 634 individuals. Measurements: 5-year prevalence of symptoms consistent with a DSM-5 AUD. Findings: Between ages 35–45 prevalence of any AUD symptoms decreased 19 %; decreases were most evident between ages 35–40. From 2003 to 2016, AUD symptoms were steady across cohort. However, because the pace of decrease across ages 35–45 slowed across cohort, cohort differences emerged at specific ages: age 35 prevalence decreased 18 % across cohort, but age 45 prevalence was equivalent across cohort. Age and cohort effects, and their interaction, did not vary by AUD severity level. Declines in AUD symptoms across age were 17 % slower for women, and declines in AUD symptoms across age and cohort were 11 % and 29 % slower, respectively, for those with a college degree. The protection afforded by a college degree was reversed among mild AUD and most pronounced for severe AUD. Conclusions: AUDs may be more plastic and responsive to intervention during early mid-life than later. Despite progress in reducing the burden of AUD in the US population among younger middle-aged adults, an increased focus remains necessary as they continue to age.