Social relationships and allostatic load in the MIDUS study.

OBJECTIVE: This study examines how the social environment is related to allostatic load (AL), a multisystem index of biological risk. METHOD: A national sample of adults (N = 949) aged 34-84 rated their relationships with spouse, family, and friends at 2 time points 10 years apart. At the second time point, participants completed a biological protocol in which indices of autonomic, hypothalamic-pituitary-adrenal axis, cardiovascular, inflammatory, and metabolic function were obtained and used to create an AL summary score. Generalized estimating equations were used to examine the associations among 3 aspects of social relationships-social support, social negativity, and frequency of social contact-and AL. RESULTS: Higher levels of spouse negativity, family negativity, friend contact, and network level contact were each associated with higher AL, and higher levels of spouse support were associated with lower AL, independent of age, sociodemographic factors, and health covariates. Tests for age interactions suggested that friend support and network support were each associated with higher AL among older adults, but at younger ages there appeared to be no association between friend support and AL and a negative association between network support and AL. For network negativity, there was a marginal interaction such that network negativity was associated with higher AL among younger adults but there was no association among older adults. CONCLUSIONS: These findings demonstrate that structural and functional aspects of the social environment are associated with AL, and extend previous work by demonstrating that these associations vary based on the type of relationship assessed and by age.

Alcohol, tobacco, and nonmedical drug use disorders in U.S. Adults aged 65 years and older: data from the 2001-2002 National Epidemiologic Survey of Alcohol and Related Conditions.

OBJECTIVES: To examine the prevalence, sociodemographic, and health-related correlates of substance use disorders, including alcohol, tobacco, and nonmedical drug use among adults aged 65 years and older. DESIGN: The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a cross-sectional survey of a population-based sample. SETTING: The United States. PARTICIPANTS: Eight thousand two hundred five adults aged 65 years and older. MEASUREMENTS: Prevalence of lifetime and past 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, determined alcohol, tobacco, and nonmedical drug use disorders. RESULTS: Prevalence of any substance use disorder was 21.1% during the lifetime and 5.4% in the past 12 months. Lifetime and past 12-month alcohol use disorders were 16.1% and 1.5%; tobacco use disorders were 8.7% and 4.0%; and nonmedical drug use disorders were 0.6% and 0.2%, respectively. Younger age was associated with greater odds of any lifetime or past 12-month substance use disorders. Men and those who were divorced or separated had greater odds of both lifetime alcohol and tobacco use disorders. Very good or excellent self-rated health was associated with lower odds of lifetime and past 12-month tobacco use disorders. Younger age and being divorced or separated were associated with greater odds of lifetime nonmedical drug use disorder. CONCLUSIONS: More than one in five older adults ever had a substance use disorder, and more than 1 in 20 had a disorder in the past 12 months, primarily involving alcohol or tobacco. Older adults have increased comorbidities and use of medications, which can increase risks associated with substance use.