摘要：Objectives. We examined demographic predictors of longitudinal patterns in alcohol consumption. Methods. We used mixed-effects models to describe individual alcohol consumption and change in consumption with age, as well as the associations between consumption and birth year, national alcohol consumption, and demographic factors, among 14 105 adults from the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study. Results. Alcohol consumption declined with increasing age, and individual consumption mirrored national consumption. Higher consumption was associated with male gender, being White, being married, having a higher educational level, having a higher income, being employed, and being a smoker. Faster age-related decline in consumption was associated with earlier cohorts, being male, being married, having a lower educational level, and being a smoker. Conclusions. Compared with alcohol consumption among earlier cohorts, that among recent cohorts declined more slowly with increasing age, suggesting that negative health effects of alcohol could increase in the future. Alcohol consumption has substantial positive and negative effects on physical, mental, and social health. 1 Older adults and women (who constitute the majority of the older population) have increased health risks associated with alcohol use because of age-related physiological changes and gender-related metabolic differences that increase sensitivity to alcohol. 2– 4 Given the progressive aging of the US population, 5 researchers need to understand how drinking behavior changes with age to better predict the effect of alcohol on public health. US cross-sectional surveys reveal that compared with younger adults, older adults more often are nondrinkers and less often are heavy drinkers. 6– 12 Furthermore, after early adulthood, there is an association between older age and lower alcohol consumption. 8 However, an apparent association between age and alcohol use observed in cross-sectional data may be an artifact of cohort or period effects. 7 Longitudinal data allow age, cohort, and period effects to be separated, but few studies have examined such data for drinking trends. 7, 9– 11, 13, 18– 21 Those studies have yielded conflicting findings about whether and how age, cohort, and period influence drinking over time. Furthermore, the studies have been limited by small sample sizes, narrow age ranges, small geographic areas, failure to consider period effects, nonrandom selection of respondents, or data from as few as 2 time points. 7– 11, 13, 18– 21 We used data from the first National Health and Nutrition Examination Survey (NHANES I), conducted in 1971–1975, 22, 23 and its follow-up surveys, conducted between 1982 and 1992, 24– 27 to answer the following questions regarding alcohol consumption among US adults: (1) How does drinking behavior (drinking vs abstention) change over time? (2) What are the differences in demographic characteristics among people with different longitudinal drinking patterns? (3) How do age, period, and cohort influence alcohol consumption over time? (4) What demographic factors predict level of alcohol consumption and rate of change in alcohol consumption with increasing age? Answers to these questions will inform estimates of the effect of alcohol on the health of the aging US population.
