摘要:

This study describes mortality rates and predictors of mortality among late‐middle‐aged and older (55+) substance abuse inpatients (n= 21, 139) in Department of Veterans Affairs (VA) Medical Centers in the 4 years after an index episode of care. A total of 24% of the patients died; this mortality rate was 2.64 times higher than expected. Predictors of earlier mortality included older age and nonmarried status, alcohol psychosis and organic brain disorder diagnoses, and several medical diagnoses, including neoplasms, liver cirrhosis, respiratory, endocrine and metabolic, and blood system disorders. Three proxy indicators of illness severity also predicted mortality: more prior inpatient and outpatient medical care and an index episode in an extended care unit. In contrast, more prior outpatient mental health care and remitted status predicted lower mortality. These diagnostic and treatment indicators can be used to identify patients at heightened risk for premature mortality. Moreover, they show that intensive mental health aftercare and remission of substance abuse may delay mortality, even among older patients who have longstanding substance abuse probl

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb00902.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We conducted a retrospective chart review of older (n= 48; mean age = 69) and younger (n= 36; mean age = 30) patients who were admitted to residential/inpatient treatment for alcohol withdrawal and dependence. Although the two age groups did not differ in terms of recent drinking history, the elderly group had significantly more withdrawal symptoms for a longer duration than the younger group. The elderly group also had more symptoms of cognitive impairment, daytime sleepiness, weakness, and high blood pressure. Finally, no significant differences were found between age groups in either the dosage or number of days of detoxification medication, although a trend was found for more days of medication in the elderly. We conclude that alcohol withdrawal may be more severe in elderly than in younger persons. Accordingly, treatment may take longer and should target the specific profile of symptoms that characterize alcohol withdrawal in the elderly.

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb00903.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A large and compelling experimental literature has documented the adverse impact of prenatal alcohol exposure on the developing brain of the offspring. This is the first report of adolescent attention/ memory performance and its relationship with prenatal alcohol exposure in a population‐based, longitudinal, prospective study (n= 462) involving substantial covariate control and “blind” examiners. Prenatal alcohol exposure was significantly related to attention/memory deficits in a dose‐dependent fashion. A latent variable reflecting 13 measures of maternal drinking was correlated 0.26 with a latent variable representing 52 scores from 6 tests measuring various components of attention and short‐term memory performance. The number of drinks/occasion was the strongest alcohol predictor. Fluctuating attentional states, problems with response inhibition, and spatial learning showed the strongest association with prenatal alcohol exposure. A latent variable reflecting the pattern of attention/memory deficits observed at 14 years correlated 0.67 with a composite pattern of deficits previously detected on neurobehavioral tests administered during the first 7 years of life. The 14‐year attention/memory deficits observed in the present study appear to be the adolescent sequelae of deficits observed earlier in development. As is usual in such studies, not all exposed offspring show

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1994.tb00904.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY