Coping trajectories in later life: a 20-year predictive study.

OBJECTIVES AND METHOD: Information about aging-related change in coping is limited mainly to results of cross-sectional studies of age differences in coping, and no research has focused on predictors of aging-related change in coping behavior. To extend research in this area, we used longitudinal multilevel modeling to describe older adults' (n = 719; baseline M = 61 years) 20-year, intraindividual approach and avoidance coping trajectories, and to determine the influence of two sets of predictors (threat appraisal and stressor characteristics; gender and baseline personal and social resources) on level and rate of change in these trajectories. RESULTS: Over the 20-year study interval, participants declined in the use of approach coping and most avoidance coping strategies, but there was significant variation in this trend. In simultaneous predictive models, female gender, more threat appraisal, stressor severity, social resources, and depressive symptoms, and fewer financial resources were independently associated with higher initial levels of coping responses. Having more social resources, and fewer financial resources, at baseline in late-middle-age predicted faster decline over time in approach coping. Having more baseline depressive symptoms, and fewer baseline financial resources, hastened decline in use of avoidance coping. Independent of other variables in these models, decline over time in approach coping and avoidance coping remained statistically significant. CONCLUSION: Overall decline in coping may be a normative pattern of coping change in later life. However, it also is modifiable by older adults' stressor appraisals, their stressors, and the personal and social resources they possess at entry to later life, in late-middle-age.

Older adults' health and changes in late-life drinking patterns.

This study focused on the prospective associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 1,291 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption, and was followed one year, four years, and 10 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 10-year interval. Medical conditions, physical symptoms, medication use, and acute health events predicted a higher likelihood of abstinence and less frequent and lower alcohol consumption. However, overall health burden predicted more subsequent drinking problems, even after controlling for alcohol consumption and a history of heavy drinking and increased drinking in response to stressors. Among older adults, increased health problems predict reduced alcohol consumption but more drinking problems. Older adults with several health problems who consume more alcohol are at elevated risk for drinking problems and should be targeted for brief interventions to help them curtail their drinking.

A ten-year follow-up of older former problem drinkers: risk of relapse and implications of successfully sustained remission.

OBJECTIVE: This study examines the risk, predictors of relapse and the effects of successfully sustained remission on the drinking behavior, functioning, life context, coping and help seeking of older adults who were problem drinkers earlier in life. METHOD: Older former problem drinkers (n = 447) were prospectively followed for 10 years and compared to lifetime nonproblem drinkers. RESULTS: Of former problem drinkers, 31% (n = 141) died over the 10-year interval, a rate 1.6 times higher than that of lifetime nonproblem drinkers. Among surviving former problem drinkers, although relapse was relatively uncommon (11%), a less severe drinking history, heavier baseline alcohol consumption, and lower baseline income were associated with relapse. The majority (63%) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol, though at levels below those consumed by older lifetime nonproblem drinkers (n = 339). Stably remitted problem drinkers who were abstinent (SRAs) generally reported more severe drinking histories, greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent (SRNs). Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval, they continued to experience financial, health-related and life context deficits relative to older lifetime nonproblem drinkers. CONCLUSIONS: Results suggest there are long-term costs associated with earlier drinking problems, even when remission is maintained. Both current drinking behavior and drinking history are worth considering when making recommendations regarding older adults' alcohol consumption.

Successful remission of late-life drinking problems: a 10-year follow-up.

OBJECTIVE: This study sought to determine (1) the rate and predictors of long-term remission among a sample of untreated late-life problem drinkers and (2) whether successfully remitted older problem drinkers attain levels of functioning and life contexts comparable to those of lifetime nonproblem drinkers at a 10-year follow-up. METHOD: We compared 140 older baseline problem drinkers who were successful in achieving long-term remission to 184 baseline problem drinkers whose drinking problems did not remit over the course of 10 years and to 339 lifetime nonproblem drinkers, on functioning and life contexts at baseline and at 4- and 10-year follow-ups. RESULTS: Being female, having more recent onset of drinking problems, fewer and less severe drinking problems, friends who approved less of drinking, and drinking less and drinking less frequently at baseline predicted long-term remission. In many regards, long-term remitted problem drinkers attained levels of functioning and life context similar to those of lifetime nonproblem drinkers. However, remitted problem drinkers continued to report more incipient drinking problems, depressive symptoms, health and financial stressors, psychoactive medication use, reliance on avoidance coping strategies and less social support from friends than did lifetime nonproblem drinkers at the 10-year follow-up. CONCLUSIONS: About a third (30%) of an untreated sample of late-life problem drinkers succeeded in attaining stable, long-term remission. The functioning and life contexts of untreated remitted problem drinkers improved significantly over time; however, some deficits persisted at follow-up.

Reciprocal relations between stressors and drinking behavior: a three-wave panel study of late middle-aged and older women and men.

AIM: To examine reciprocal relations between stressors and drinking behavior among late-middle-aged and older women and men. DESIGN, SETTING, AND PARTICIPANTS: A community sample of 621 women and 941 men (mean age = 61) provided information about their life stressors and drinking behavior at three times: initial assessment, 1 year later and 4 years later. Structural equation modeling with manifest variables was used to examine cross-temporal relations between stressors and drinking behavior. FINDINGS: Stressors did not predict heavier or more frequent drinking. In fact, among women, increased health stressors predicted a reduction of alcohol consumption; among men, increased financial stressors suppressed alcohol consumption. Higher stressor levels in some life domains did foreshadow later drinking problems. More initial drinking problems resulted in more subsequent financial and spouse stressors for both women and men. Contrary to expectation, more frequent alcohol consumption presaged fewer negative life events, health stressors, and financial stressors for women, and fewer health stressors for men. CONCLUSIONS: The findings suggest that among older adults there may be a harmful feedback cycle whereby problematic drinking and life stressors exacerbate each other, but also a benign feedback cycle in which moderate alcohol consumption and life stressors reduce each other.

Predicting the development of late-life late-onset drinking problems: a 7-year prospective study.

There has been little empirical study of risk factors for the development of late-life late-onset drinking problems. In the current prospective study, we compare two groups of older adults who, at a baseline assessment, were nonproblem drinkers: individuals who developed drinking problems over the course of the next 7 years (n = 77) and those who did not (n = 197). Late-onset problem drinkers reported mild to moderate drinking problems and spontaneous remission rates were high. Compared with stable nonproblem drinkers, late-onset problem drinkers at baseline were more likely to report incipient problems, heavier alcohol consumption, greater friend approval of drinking, more reliance on avoidance coping strategies, were more likely to smoke, and were less likely to have acute medical conditions that could potentially be complicated by alcohol consumption. Contrary to expectation, life stressors did not predict drinking problem onset. However, compared with stable nonproblem drinkers, late-onset problem drinkers were more likely to have a history of responding to stressors and negative affect with increased alcohol consumption.

Gender differences in the relations between depressive symptoms and drinking behavior among problem drinkers: a three-wave study.

Prior research has suggested that the relation between depression and drinking behavior is stronger for women than for men. In a 3-wave study spanning 3 years, we examined the nature of reciprocal relations between depressive symptoms and drinking behavior among women (n = 207) and men (n = 207) seeking detoxification or referral services for their drinking problems. Latent variable structural equation modeling analyses revealed that more baseline depression was associated with less alcohol consumption 1 year later among women and men. However, later on, more depression predicted heavier alcohol consumption, but only among women. Among women and men, heavier alcohol consumption predicted more subsequent depression, although the timing of this effect differed by gender. Reciprocal effects between depression and drinking problems were found only among men.

Depression and drinking behavior among women and men: a three-wave longitudinal study of older adults.

This 3-wave longitudinal study analyzed latent variable cross-lagged models of the relation between depressive symptoms and drinking behavior separately for 621 late-middle-aged women and 951 late-middle-aged men. Time lags of 1 and 3 years were used. Among women, heavier alcohol consumption predicted less depressive symptomatology 1 and 3 years later, whereas among men, having more depressive symptoms predicted less alcohol consumption later on. Including cross-temporal paths in the women's depression-drinking problems model did not provide a significant improvement over hypothesizing no cross-temporal effects. Among men, however, having more drinking problems was associated with fewer depressive symptoms 3 years later. These findings were robust in follow-up analyses controlling for the effects of socioeconomic and health status.

Remission of late-life drinking problems: a 4-year follow-up.

This 4-year follow-up study compared stably remitted late-life problem drinkers to nonremitted problem drinkers and nonproblem drinkers. At time 1, to-be-remitted drinkers reported less alcohol consumption and fewer drinking problems, more depression and less self-confidence, less spousal support and approval of drinking from friends, and more help-seeking than did to-be-nonremitted drinkers. Remitted drinkers showed improvement in functioning and life context at the 4-year follow-up, but compared with nonproblem drinkers some deficits persisted. Stable remission and abstinence among late-onset drinkers were closely tied to receiving less spousal support and approval from friends for drinking at time 1, whereas help-seeking was a strong predictor of stable remission and abstinence among early-onset problem drinkers. For both late- and early-onset drinkers, abstinence was predicted by initially having more drinking problems, depression, and health stressors.