Lifestyle

Alcohol use


LASA153
LASA353

Contact: Hannie Comijs

Background
Alcohol is one of the most widely consumed psychoactive substances. In 1999, the consumption of pure alcohol per capita in The Netherlands was 8.2 liters.(1) Alcohol consumption is both positively and negatively associated with the health and well-being of older persons. Excess use of alcohol may lead to the development of cirrhosis of the liver, breast cancer, and neurological damage such as Wernicke Korsakoff syndrome. (2) Moderate alcohol consumption is associated with a decreased risk of a.o. coronary heart disease and ischaemic stroke, and also has beneficial psychosocial consequences.(3,4)

Measurement instruments in LASA
At each LASA examination, alcohol consumption is assessed during the face-to-face medical interview with a questionnaire developed by Statistics Netherlands.(5)

The file LASA153 contains the following variables. Alcohol consumption (variable name= alcohu) is assessed by asking the respondents whether they drink alcohol (yes/no). If a respondent currently consumes alcohol, they are asked how many days a week they consume alcoholic beverages (variable name= alcohd). Response categories are 1) every day, 2) 5-6 days per week, 3) 3-4 days per week, 4) 1-2 days per week, 5) 1-3 days per months, 6) less than 1 day per months. In addition, they are asked how many glasses they usually consume each time (variable name= alcohn). Response categories are 1) 11 consumptions or more, 2) 8-10 consumptions, 3) 6-7 consumptions, 4) 4-5 consumptions, 5) 2-3 consumptions and 6) 1 consumption.

To assess excessive alcohol consumption (variable name= alcoh6), respondents were asked how often he/she consumes six or more consumptions on one day during the last six months.

Only at baseline (LASA-B), current drinkers are asked which type of alcoholic beverages (beer, wine, liquors, strong alcohol drinks, and light alcoholic drinks) they usually consume, and at which time of the day he/she usually consume alcohol. Moreover, ex-drinkers were asked how many glasses they were used to consume each time, and at what age they stopped.

The file LASA353 contains the following composite variables: number of alcohol consumptions per week (variable name= alconw), alcohol consumption index (Garretsen, 1983) (variable name= garret), problem drinking (variable name= alcohpp) and the standardized alcohol use corrected for sex (Netherlands Economic Institute; NEI) (variable name =alcnei).

Number of alcohol consumptions per week
A continuous variable was computed that indicated the number of alcohol consumptions per week. “How many days per week do you drink alcohol?” and “How many consumptions do you drink each time?” were multiplied. Because these response categories were categorical, the upper boundary is included to compute a continuous variable. The upper boundary was chosen because persons are more likely to underestimate as opposed to overestimate their alcohol consumption. By multiplying these two variables, the number of alcohol consumptions per week varies from 0 to 77 (or more). Respondent who indicate they drink less than 1 glass a week are fixed at 0.5 glasses a week.

“How many days per week do you drink alcohol?”
1. (every day) =7 days per week
2. (5-6 days per week) =6 days per week
3. (3–4 days per week) =4 days per week
4. (1-2 days per week) =2 days per week
5. (1-3 days per month) =1 day per week
6. (less than 1 day per month) =0 days per week

“How many consumptions do you drink each time?”
1. (11 consumptions or more) =11 consumptions
2. (8-10 consumptions) =10 consumptions
3. (6-7 consumptions) =7 consumptions
4. (4-5 consumptions) =5 consumptions
5. (2-3 consumptions) =3 consumptions
6. (1 consumption) =1 consumption

Alcohol consumption index (Garretsen, 1983)
The alcohol consumption index developed by Garretsen (1983) classifies alcohol drinkers into four categories (very excessive, excessive, moderate, light) based on the number of days drinking alcohol per month and the number of alcohol consumptions each time (see Table 1).

Because in LASA we asked how many days per week a respondent drinks alcohol instead of how many days per month, the following classification shown in Table 2 can be used:

Problem drinking
Garretsen and Knibbe (7) introduced and defined the concept of problem drinking. This is defined as drinking at least once a week six or more glasses of alcohol, or 21 days per month drinking four or more glasses. For LASA, the question on how often the respondent drank six or more consumptions on one day during the last six months can be used to define problem drinking.

Netherlands Economic Institute (NEI) (8)
The Netherlands Economic Institute (NEI), has developed a standard to categorise alcohol use. This standard has been used to compare percentages of alcohol use across surveys (e.g. Central office of Statistics) in The Netherlands.

Men (women)
   no use= 0 glasses per day
   moderate use= 1-3 (1-2) glasses per day
   grey area= 4-7 (3 -5) glasses per day
   excessive use= 8 (6) or more glasses per day

In LASA, the numbers of glasses per day can be calculated by calculating the number of alcoholic drinks per week divided by 7. However, keep in mind that this is an extrapolation and not a precise estimate.

Alcohol use among former-drinkers
Because at LASA-B, ex-drinkers were only asked how many glasses they usually drink each time, this scale have to be used to categorise drinking behaviour for this group. Drinking 6 or more glasses might indicate problem drinking behaviour in the past (variable name = alcppp).

Questionnaires
LASAB153 / LASAC153 / LASAD153 / LASAE153 / LAS2B153 / LASAF153 / LASAG153 / LASAH153 / LAS3B153 / LASMB153 / LASAI153 (medical interview, in Dutch)

Variable information
LASAB153 / LASAC153 / LASAD153 / LASAE153 / LAS2B153 / LASAF153 / LASAG153 / LASAH153 / LAS3B153 / LASMB153 / LASAI153;
LASAB353 / LASAC353 / LASAD353 / LASAE353 / LAS2B353 / LASAF353 / LASAG353 / LASAH353 / LAS3B353 / LASMB353 / LASAI353
(pdf)

Availability of information per wave1:

 

B

C

D

E

 
2B*

F

G

H

 

3B*

MB*

I*

Drink alcohol?

Me

Me

Me

Me

Me

Me

Me

Me

Me

 Me

Me

Which type of alcoholic beverages

Me

 

 

 

Me

 

 

 

Me

 

 

Age stopped

Me

 

 

 

Me

 

 

 

Me

 

 

Number of days a week

Me

Me

Me

Me

Me

Me

Me

Me

Me

Me 

Me

Drank before

Me

 

 

 

Me

 

 

 

Me

 

 

Number of glasses

Me

Me

Me

Me

Me

Me

Me

Me

Me

 Me

Me

Number of times six glasses or more

Me

Me

Me

Me

Me

Me

Me

Me

Me

 

Me

Which time of day

Me

 

 

 

 

 

 

 

 

 

 

Other people worried about alcohol use

 

 

 

 

 

 

 

Me

Me

 

Me

1 More information about the LASA data collection waves is available on:
http://www.lasa-vu.nl/data/lasa/sampleLASAdatacollection.html

*  2B=baseline second cohort;
   
3B=baseline third cohort;
    MB=migrants: baseline first cohort (Under Construction);
    I=Under Construction

Me=data were collected in medical interview

Previous use in LASA
Several papers have used the number of alcohol consumptions per week (continuous) as a determinant or covariate in the statistical analyses (Pluijm et al., 2001; Pluijm et al., 2004; Stel et al., 2003; Pluijm et al., 2006). Dik et al.(2003) used the alcohol consumption index developed by Garretsen (6). Aartsen and Comijs (2012) investigate the association between alcohol use and depressive symptoms. Comijs et al. (2012) state that when people grow older, alcohol consumption decreases, which seems associated with a decline in physical or psychological health and/or cognitive decline.

  • Aartsen, M.J., Comijs, H.C. (2012). Alcohol consumption and depressive symptoms among older adults: Results of the Longitudinal Aging Study Amsterdam.Tijdschrift voor Gerontologie en Geriatrie, 43, 127-136.
  • Comijs, H.C., Aartsen, M.J., Visser, M., Deeg, D.J.H. (2012). Alcohol consumption among persons aged 55+ in the Netherlands. Tijdschrift voor Gerontologie en Geriatrie, 43, 115-126.
  • Dik, M.G., Deeg, D.J.H., Visser, M., Jonker, C. (2003). Early life physical activity and cognition at old age. Journal of Clinical and Experimental Neuropsychology, 25, 643-653.
  • Pluijm SMF, Visser M, Smit JH, Popp-Snijders C, Roos JC, Lips P. (2001). Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res,  16: 2142-2151.
  • Pluijm, S.M.F., van Essen, H.W., Bravenboer, N., Uitterlinden, A.G., Smit, J.H., Pols, H.A.P., Lips, P.T.A. (2004). Collagen type I alpha1 Sp1 polymorphism, osteoporosis and intervertebral disc degeneration in older men and women. Annals of the Rheumatic Diseases, 63, 71-77.
  • Pluijm, S.M.F., Smit, J.H., Tromp, E.A.M., Stel, V.S., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporosis International, 17, 417-425.
  • Stel, V.S., Pluijm, S.M.F., Deeg, D.J.H., Smit, J.H., Bouter, L.M., Lips, P.T.A. (2003). A classification tree for predicting recurrent falling in community-dwelling older persons. Journal of the American Geriatrics Society, 51, 1356-1364.

References

  1. Productschap voor Gedistilleerde Dranken: World Drink Trends: International Beverage Alcohol consumption and Production Trends. Henley-on-Thames: NTC Publications Ltd, 2000.
  2. Ashworth M, Gerada C. (1997). ABC of mental health, Addiction and dependence-II: Alcohol. BMJ; 315: 358-360.
  3. Holman CDJ, English DR, Milne E, De Winter MG. (1996). Meta-analysis of alcohol and all-casue mortality: a validation of NHMRC recommendations. Med J Aust, 164: 141-145.
  4. Maclure M. (1993). Demonstration of deductive meta-analysis: ethanol intake and risk of myocardial infarction. Epidemiol Rev, 15: 328-351.
  5. Central Bureau of Statistics. Health Interview Questionnaire. The Hague: CBS, 1989.
  6. Garretsen, HFL. (1983). Probleemdrinken: Prevalentiebepaling, beinvloedende factoren en preventiemogelijkheden: Theoretische overwegingen en onderzoek in Rotterdam. Lisse, Swets & Zeitlinger (in Dutch).
  7. Garretsen HFL and Knibbe RA. (1983). Alkohol Prevalentie Onderzoek Rotterdam/ Limburg, Landelijk Eindrapport, Ministerie van Welzijn, Volksgezondheid en Cultuur, Leidschendam (in Dutch).
  8. Reinhard OPM, Rood-Bakker DS. (1998). Alcoholgebruik in beeld. Standaardmeetlat. Nederlands Economisch Instituut, Rotterdam(in Dutch).
  9. Pluijm SMF, Visser M, Smit JH, Popp-Snijders C, Roos JC, Lips P. (2001). Determinants of bone mineral density in older men and women: body composition as mediator. J Bone Miner Res, 16: 2142-2151.
  10. Pluijm, S.M.F., van Essen, H.W., Bravenboer, N., Uitterlinden, A.G., Smit, J.H., Pols, H.A.P., Lips, P.T.A. (2004). Collagen type I alpha1 Sp1 polymorphism, osteoporosis and intervertebral disc degeneration in older men and women. Annals of the Rheumatic Diseases, 63, 71-77.
  11. Stel, V.S., Pluijm, S.M.F., Deeg, D.J.H., Smit, J.H., Bouter, L.M., Lips, P.T.A. (2003). A classification tree for predicting recurrent falling in community-dwelling older persons. Journal of the American Geriatrics Society, 51, 1356-1364.
  12. Pluijm, S.M.F., Smit, J.H., Tromp, E.A.M., Stel, V.S., Deeg, D.J.H., Bouter, L.M., Lips, P.T.A. (2006). A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporosis International, 17, 417-425.
  13. Dik, M.G., Deeg, D.J.H., Visser, M., Jonker, C. (2003). Early life physical activity and cognition at old age. Journal of Clinical and Experimental Neuropsychology, 25, 643-653.