Older People at Greater Risk for Alcohol Impairment

Older People May Be at Greater Risk for Alcohol Impairment than Teens, According to Baylor Study

An acute dose of alcohol may cause greater impairment in coordination, learning and memory in the elderly than in young people, according to a study by Baylor University.

Researchers said the findings have profound significance for older people –a population that is aging worldwide at an unprecedented rate and that includes Baby Boomers as they become senior citizens.

“Health implications such as falls, accidents and poor medicine-taking are pretty easy to conclude,” said Douglas B. Matthews, Ph.D., senior author of the paper, published online in the journal Alcoholism: Clinical and Experimental Research. April is Alcohol Awareness Month.

In the United States, as many as 13 percent of men and 8 percent of women over age 65 engage in risky drinking behavior, with an estimated 1 to 3 percent of those afflicted with an alcohol use disorder, according to prior research. Because of improvements in medicine and public health, nutrition and education, people 65 and older will account for 20 percent of the U.S. population by the year 2030, according to U.S. Census Bureau estimates.

While previous data have indicated that aged people show significantly greater impairments than younger adults when alcohol is consumed, understanding the neurobiology underlying that increased sensitivity in the aged has been hampered by the lack of an adequate animal model, said Matthews, a research scientist in psychology and neuroscience in Baylor’s College of Arts & Sciences and head of psychology at Nanyang Technological University in Singapore.

The Baylor research, the first of its kind, established a baseline of the acute effects of alcohol in aged populations, which can aid future research into neurobiology and in determining the effect of prolonged alcohol abuse.

The experiment included adult and aged rats (at least 18 months old), Matthews said. It showed a dramatic increase in ethanol-induced ataxia.

“We know a lot of neurobiological changes occur during aging which underlie age-related cognitive and behavioral deficits. It’s reasonable to suspect a significant interaction exists between age-related and alcohol-induced effects in the brain,” said Jim Diaz-Granados, Ph.D., a study co-author, chair of Baylor’s department of psychology and neuroscience, and chair of the Council of Graduate Departments of Psychology, a national organization.

“Our hope would be that further findings in this area will serve as a basis to educate the public regarding the risks and provide insights in the clinic,” Diaz-Granados said.

Findings were presented at the Research Society of Alcoholism conference in San Francisco. Also conducting research in the study was Adelle Novier, a doctoral student in psychology and neuroscience at Baylor.

The Genetics of Alcoholism

Is Alcoholism due to Nature or Nurture

Why can some people have a glass of wine or beer with their meal without feeling compelled to drink more, whereas others can’t seem to stop drinking? Can some people “hold” their liquor better than others? Does alcoholism tend to run in families? Does genetics hold the key to developing medications to treat alcoholism and its effects on the body? Researchers have been trying to find answers to questions such as these for several decades, seeking to identify the factors that influence a person’s risk of becoming alcohol dependent.

Research, to date, indicates that both your genetic makeup (i.e., the information stored in the DNA that you inherited from your parents) and your environment (i.e., how you live) influence your risk for alcohol abuse and alcoholism.

Your genes certainly play an important role, influencing how your body responds to alcohol, how sensitive you are to its effects, and how likely you are to have a problem with alcohol. However, environmental factors—such as being surrounded by people who are heavy drinkers and who encourage you to drink—also can raise your risk for drinking too much.

The next question then becomes just how much of this risk is determined by our genes—that is, how much can be attributed to factors beyond our control. By studying large families with alcoholic and non-alcoholic members, comparing identical and fraternal twins, and studying adopted children and their biological and adoptive families, researchers found that about half of our risk for alcoholism is influenced by genetics. The remaining risk is related to the influence of environment—where and how we live. The two factors also work together in complex ways.


Unlike for some other diseases, there is no single gene that determines whether you will develop a problem with alcohol; instead, many genes influence your risk for developing alcoholism, each of which only has a small impact.

Understanding how genetics influences alcoholism also is important for another reason. Knowing the genes involved in this disease could help researchers and clinicians identify those who are most at risk of becoming alcoholic and understand how alcohol affects the body. These individuals then could be targeted more effectively for prevention and treatment efforts.

This Alcohol Alert describes how research is helping to identify the genes involved in alcoholism. In examining this research, one thing becomes clear: Unlike for some other diseases, there is no single gene that determines whether you will develop a problem with alcohol; instead, many genes influence your risk for developing alcoholism, each of which only has a small impact. Further, environmental influences may override or blunt the effects of the genes that increase risk. This overview describes how researchers are trying to tease apart which of the thousands of genes and millions of gene variants that make up your DNA play a role in alcoholism, how some of these genes act, and how these genes interact with your environment to determine how you and your body respond to alcohol.

Genes v’s Environment

As described above, researchers are learning more and more about how your genetic makeup can influence your drinking behavior and its consequences and which genes may put you at increased risk of alcoholism. But does this mean that if you inherit a certain combination of genes from your parents, you are destined to become an alcoholic? The answer to this is a clear “no” because how you live also plays an important role. People with the same genetic makeup may be more or less likely to develop alcoholism depending on their environment and life circumstances.

Researchers can study the interactions between genes and the environment and the relative impact of each through a variety of direct and indirect approaches.38 These approaches have helped identify several environmental factors that either protect us from or place us at increased risk for alcoholism; for example, marital status and religiosity have been found to be protective factors, lessening the impact of genetic risk factors on drinking in women. For adolescents in particular, drinking seems to be influenced strongly by environmental factors in addition to genetic makeup. Adolescents who carry high-risk genes and whose parents do not monitor their activities and/or who have friends that use alcohol and other drugs are more likely to develop alcohol problems than those with a similar genetic makeup whose behavior is monitored more closely. Modifying the environment also can help adolescents avoid risky drinking behavior. Participants in one prevention program designed for youth were less likely to engage in high-risk behavior, such as drinking, even though they had a high-risk genetic background.

The bottom line is that genes alone do not determine our destiny—lifestyle choices and other environmental factors have a substantial impact. In addition, many other individual and psychosocial variables influence when and how much we drink, both in the short and long term, and how this influences our risk of alcoholism.

Full story at; http://pubs.niaaa.nih.gov/publications/AA84/AA84.htm

Alcohol and Pregnancy

Prenant mother drinking 2Alcohol and Pregnancy: The Long-Term Consequences

Now, there’s more evidence of the dangers of heavy drinking while pregnant. New research shows that children whose mothers drank while pregnant had abnormal brain development patterns years after being exposed to alcohol in the womb.

The study is the first to follow children over time using magnetic resonance imaging technology to look at how heavy alcohol exposure before birth interferes with brain growth in childhood and adolescence.

The findings suggest that children with heavy alcohol exposure may have decreased brain plasticity—the brain’s ability to grow and remodel itself based on experience with the outside world.

Such adaptation continues throughout tone’s life and is crucial to learning new skills and adapting to the environment.

During normal development, brain volume increases rapidly at a young age as new neural connections form and then decrease in certain regions during adolescence as underused brain connections are cleared away to increase efficiency. While children whose mothers didn’t drink showed this pattern of robust brain growth and reduction, children with heavy exposure to alcohol showed patterns of static growth.

Among the 70 children in the study who had been heavily exposed to alcohol in utero (13 drinks per week throughout the pregnancy, on average), lack of growth was most obvious in the rear portions of the brain—particularly in the parietal cortex, which is thought to be involved in selective attention and the production of planned movement.

From; NIAAA Spectrum Volume 5, Issue 1 | February 2013. American National Institutes of Health • National Institute on Alcohol Abuse and Alcoholism

| http://www.spectrum.niaaa.nih.gov

Deaths Fall When Alcohol Price Increases

Drop in alcohol related deaths by nearly a third follows minimum alcohol price increase of 10%

A new study made available online today in ‘Addiction’ shows that, between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia, Canada dropped more than expected when minimum alcohol price was increased, while alcohol-related deaths increased when more private alcohol stores were opened. The paper has significant implications for international alcohol policy.

The study was carried out by researchers from British Columbia, the westernmost province in Canada, using three categories of death associated with alcohol – wholly alcohol attributable (AA), acute, and chronic*, analysing death rates across the time period against increases in government set minimum prices of alcohol drinks.

The study was complicated by another provincial policy which allowed partial privatisation of alcohol retail sales, resulting in a substantial expansion of alcohol stores.  Previously, alcohol could only be sold directly to the public in government owned stores, unlike in Europe where it is widely available in supermarkets, off-licences and petrol stations.  The researchers therefore had to both control for the effects of the wider availability of alcohol, and assess what effect this measure had on mortality rates.

The major finding was that increased minimum alcohol prices were associated with immediate, substantial and significant reductions in wholly AA deaths:

A 10% increase in the average minimum price for all alcoholic beverages was associated with a 32% reduction in wholly AA deaths

Some of the effect was also detected up to a year after minimum price increases

Significant reductions in chronic and total AA deaths were detected between two and three years after minimum price increases

A 10% increase in private liquor stores was associated with a 2% increase in acute, chronic, and total AA mortality rates

This overall drop in deaths was more than expected, and disproportionate to the size of the minimum price increase – a minimum price increase of 1% was associated with a mortality decline of more than 3%.

The authors suggest that the reason for the reduction in mortality is that increasing the price of cheaper drinks reduces the consumption of heavier drinkers who prefer these drinks. They note that other research has also suggested that impacts on some types of mortality may be delayed by one or two years after price increases.

Dr Tim Stockwell, director of the University of Victoria’s Centre for Addictions Research of British Columbia and a lead author, said “This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia.”

Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, and Buxton J. (2013) The relationship between changes to minimum alcohol prices, outlet densities and alcohol attributable deaths in British Columbia in 2002-2009. Addiction, 108: doi:  10.1111/add.12139

* Wholly alcohol attributable deaths included the following: poisonings due to alcohol, alcoholic psychoses, alcohol dependence, alcohol abuse, alcoholic cardiomyopathy, alcoholic gastritis, chronic pancreatitis (alcohol induced), fetal alcohol syndrome and excess alcohol blood level; acute alcohol attributable deaths comprised mainly injuries whether caused intentionally or unintentionally while chronic alcohol attributable deaths were those caused by alcohol-related illnesses such as liver cirrhosis and various cancers (e.g. cancers of the mouth, oesophagus, stomach, colon and breast). These types of diagnosis were determined from the underlying cause of death identified on the death certificates.

Drug-addicted anesthesiologists pose danger

Anesthesiologists – the doctors who keep patients alive during surgery, who essentially take over our breathing – make up just three per cent of all doctors, but account for 20 to 30 per cent of drug-addicted MDs. Experts say anesthesiologists are overrepresented in addiction treatment programs by a ratio of three to one, compared with any other physician group, an occupational hazard that could pose catastrophic risks to their patients.

Their drugs of choice are most frequently fentanyl and sufentanil, opioids that are 100 and 1,000 times more potent than morphine. They “divert” a portion of the doses meant for their patients to themselves, slipping syringes into their pockets.

And later, alone in the bathroom or the call room, when the drug hits their own bloodstream, the relief, the sense that all is well in the world, the mild euphoria, is immediate.

See full story via Drug-addicted anesthesiologists pose danger.

Alcohol Related Brain Injury

Brain - parts vulnerable to damage by alcoholWhat is Acquired Brain Injury (ABI)?

An Acquired Brain Injury (ABI) is an injury to the brain that has been sustained at some time after birth. It can result in a variety of ways including:

  • Traumatic brain injury (e.g. through a traffic accident, assault or fall);
  • Through an illness (e.g. infection, stroke, brain tumour, degenerative condition);
  • Hypoxia (lack of oxygen to the brain) (e.g. drug overdose, loss of blood);
  • Substance abuse (e.g. drugs including alcohol).

The effects of an ABI vary from one person to another and can depend on the nature and severity of the brain injury sustained. An ABI can result in deterioration in function in various ways including:

  • Cognitive/thinking skills (e.g. reduced memory, concentration, planning);
  • Communication or speech (e.g. slurred speech, trouble finding the right word);
  • Physical and sensory limitations (e.g. movement, fatigue, vision, smell);
  • Emotional or behavioural difficulties (e.g. reduced motivation, impulsivity);

These difficulties can have negative effects on key areas of people’s lives, such as occupation, relationships and independent living. The pattern of recovery from an ABI varies and impairments can be temporary (i.e. improving over time) or permanent.

Looking Forward (Fourth Edition)

Looking Forward is a handbook for supporting people with acquired brain injury. It gives a basic introduction to brain injury and the challenges involved for people living with acquired brain injury.

It offers practical advice and strategies to enable practitioners to empower people to achieve their full potential.

To download an electronic copy of the latest edition of the arbias book “Looking Forward” click the link below:

"Looking Forward (Fourth Edition)” – Download Adobe PDF (4.7 Mb)

Other news at; Acquired Brain Injury

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Family History of Alcoholism May Affect Teens’ Decision-Making

Teenage girl A family history of alcoholism may affect teenagers’ decision-making, researchers at Oregon Health and Sciences University have found. They discovered these adolescents have a weaker brain response during risky decision-making compared with teens without such a family history.

The researchers studied 31 teens ages 13 to 15. Of these, 18 had a family history of alcoholism. All of the teens’ brains were scanned using functional magnetic resonance imaging, to examine responses during an activity that mimicked the TV show Wheel of Fortune. The game presented risky and safe probabilities of winning different sums of money.

In the teens with a family history of alcoholism, the researchers noted that two areas of the brain responded differently, UPIreports. These brain areas are important for executive functioning, which guide complex behavior through planning, decision-making and response control. This group of teens showed weaker brain responses during risky decision-making, compared with teens who did not have a family history of alcoholism.

The researchers conclude in the journal Alcoholism: Clinical & Experimental Research, “Atypical brain activity, in regions implicated in executive functioning could lead to reduced cognitive control, which may result in risky choices regarding alcohol use.”

From Join Together

Liver Disease and Coffee

Drinking Coffee Could Help Those With Liver Disease, Study Shows

Coffee gives more than a morning pick-me-up — about two cups daily could help sufferers of liver disease, according to a new joint study by Mason and Inova Health Systems.

“No one really knows how caffeine works on (fatty liver disease),” says Zobair Younossi, who led the study and is co-director of the George Mason University−Inova Health System Translational Research Institute. Perhaps there is a component in caffeine that reduces inflammation in the liver, he suggests. “Also, caffeine could have an antioxidant effect.”

Dubbed Non-Alcoholic Fatty Liver Disease (NAFLD), this type of ailment is mainly caused by fat, and not by drinking alcohol. And it’s a growing problem.

“As the rate of obesity is going up in this country, especially among children, the problems of NAFLD will continue to rise,” says Younossi, who is chairman of the Department of Medicine at Inova Fairfax Hospital as well as vice president for research for Inova Health System. “This is becoming a major cause of liver disease.”

About 25 percent of the U.S. population has fatty liver disease, he says. From that number, about 2 to 3 percent could progress to cirrhosis, which is scarring on the liver that can lead to liver cancer.

Fatty liver disease frequently comes with type 2 diabetes, says Younossi, who has researched liver disease for 16 years. Obesity and poor diet are underlying factors.

The Coffee Effect

lisapawloski2Lisa Pawloski, chair of Mason’s Department of Nutrition Studies. Creative Services photo

Younossi, Inova’s Maria Stepanova and Mason’s Lisa Pawloski and Aybike Birerdinc looked at four continuous cycles of the Centers for Disease and Control and Prevention’s National Health and Nutrition Examination Surveys from 2001 to 2008. Approximately 19,000 respondents were asked about 62 different dietary habits, including their intake of water, sodium, fiber, cholesterol, calcium and alcohol.

The surveys from 2007-08 revealed that 32.2 percent of American men and 35.5 percent of women are obese. If those rates continue, then 45 to 50 percent of American adults will be obese by 2025, according to the study, meaning that more than 25 million Americans could develop fatty liver disease.

Out of all the survey data about diet, only caffeine appeared to have any protective value, Younossi says.

“I was actually surprised,” says Pawloski of the “coffee effect.”  “But there are other studies that support it. To me, it’s exciting that this study follows what others have done.”

Caffeine is showing some benefit for such diseases as Alzheimer’s disease, Parkinson’s disease and type 2 diabetes, says Pawloski, who is chair of the Department of Nutrition and Food Studies in Mason’s College of Health and Human Services.

“It used to be people would say they’re cutting back on caffeine,” Pawloski continues. “There is a change in the attitudes about coffee and caffeine consumption. I think this study is another piece to show that it’s not necessarily a bad thing to include in your diet.”

How Much to Consume?

How much coffee is enough is debatable, Younossi says. Don’t start drinking coffee tomorrow if you don’t already do so. “In fact, if you drink too much, you could do some harm,” he says.

There is some evidence that high caffeine intake can adversely affect bone density, Pawloski adds. Those with iron deficiency should be careful with caffeine because tannins contained in tea as well as in wine inhibit iron absorption.

Also, don’t take caffeine pills — go for the real thing, Pawloski advises. Coffee and tea contribute fluids as well as antioxidants, she says. And milk added to the drink provides beneficial calcium.

“I would encourage coffee and tea drinking, but I would not make a definite recommendation to start doing it to prevent liver disease,” Pawloski says.

And watch how many calories you pack into your caffeine perk, Pawloski adds. “Some people, like me, like to load it up with cream and sugar.”

Patients with liver disease can reverse the trajectory of the disease through diet and weight loss, Younossi says. They need to keep accurate dietary records and watch what they eat and drink, he says. Even though fatty liver disease isn’t caused by drinking alcohol, libations don’t help because processing alcohol is tough on the liver.

“Even social drinking can be harmful,” Younossi adds.

There’s no current evidence that caffeine could reverse scarring on the liver, but Younossi suspects it could have a beneficial effect. More studies are on the way, he says.

Pawloski currently is working on a study with Inova and Mason’s Department of Geography and Geoinformation Science to track the number and proximity of fast-food outlets in neighborhoods with high levels of obesity and poverty.

“This study, combined with other studies, may impact advice to people with liver disease,” Pawloski says.

From a press release of the George Mason University−Inova Health System Translational Research Institute.

‘Meow Meow’ Recreational Drugs

Bath salts emerging as new recreational drugs

A commonly available preparation is the new street drug for young people. Bath salts also known as “Meow Meow” and Mephedrone the drug can be very frightening and dangerous. These products, sometimes called plant food, are sold in powder or crystal form under names like Bliss, Purple Wave, Vanilla Sky and Ivory Wave. Though not approved by the Food and Drug Administration for consumption, they have become increasingly popular, especially among teenagers and young adults, the D.E.A. said.

The use of bath salts as recreational drugs has greatly escalated in recent years. Researchers from the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma describe an incident of a man experiencing significant agitation, paranoia, and hallucinations who also exhibited violent behavior upon his emergency department arrival.

His case is not unique. Despite disclaimers of “not for human consumption” package warnings, according to the American Association of Poison Control Centers, calls for bath salt poisoning incidents have skyrocketed, with 1,782 since January 2011 compared with 302 in all of 2010. The inexpensive powdery substances with benign names contain stimulants not detectable through drug screens. However, they can produce a “high” along with increased blood pressure, increased heart rate, agitation, hallucinations, extreme paranoia, and delusions, not unlike the Oklahoma patient.

Treatment for ingesting these bath salts is sedation until the side effects wear off, along with supportive care. Although currently federally unregulated, 26 states have made these substances illegal. This new research was presented at CHEST 2011, the 77th annual meeting of the American College of Chest Physicians (ACCP), in Honolulu, Hawaii.

Intervene Early To Prevent Smoking

Cigarette smoking is the leading cause of premature, preventable death in the United States. Each year smoking causes an average of 438,000 deaths from cancer, heart disease, stroke, and lung disease, according to the National Cancer Institute.

For years the conventional wisdom in smoking research was that smokers don’t show signs of daily cigarette addiction until adulthood. But at the School of Nursing, Professor Carla Storr, ScD, RN, is shedding light on the fact that nicotine addiction can start well before smokers are old enough to legally buy cigarettes.

Intervene Early To Prevent Smoking.