Trends in alcohol-related liver disease mortality in Australia: An age–period–cohort perspective

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2023-06-22 DOI:10.1111/add.16275

Michael Livingston, Robin Room, Tanya Chikritzhs, Nicholas Taylor, Wing See Yuen, Paul Dietze

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Abstract

Background and Aims

There have been few systematic attempts to examine how alcohol-related mortality has changed in Australia, and no studies that have explored cohort effects in alcohol-related mortality. This study uses more than 50 years of data to measure age, period and cohort trends in alcohol-related liver disease (ALD) mortality.

Design, Setting and Cases

This was a retrospective age–period–cohort analysis of total Australian ALD mortality data from 1968 to 2020 in Australia. There was a total of 35 822 deaths—27 208 men (76%) and 8614 women (24%).

Measurements

Deaths from ALD were grouped into 5-year age groups and periods (e.g. deaths for 20–24-year-olds between 1968 and 1972 were combined).

Findings

ALD mortality peaked in the late 1970s and early 1980s for both men and women. In age–period–cohort models, mortality was highest for cohorts born 1915–30. For example, men born between 1923 and 1927 had a relative risk of 1.58 [95% confidence interval (CI) = 1.52, 1.64] compared with men born between 1948 and 1952. For women, there was an increase in risk for cohorts born in the 1960s [e.g. the 1963–67 cohort had a relative risk (RR) of 1.16 (95% CI = 1.07, 1.25) compared with women born in 1948–52]. For men, there was a broad decline in mortality over time [e.g. in 2020, the RR was 0.87 (95% CI = 0.82, 0.92) compared with the reference year of 2000]. For women, mortality declined until 2000 and has been stable since.

Conclusions

Alcohol-related liver disease mortality has declined across the Australian population since the 1970s and 1980s partly due to cohort-specific shifts as the highest-risk birth cohorts age. For women, this decline had stalled by the year 2000, and cohorts of women born during the 1960s were at higher risk than earlier cohorts, suggesting the need for thoughtful interventions as this population enters its highest-risk years for ALD mortality.

Abstract Image

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澳大利亚酒精相关肝病死亡率趋势：年龄-时期-队列视角

背景和目的很少有系统的尝试来研究澳大利亚与酒精相关的死亡率是如何变化的，也没有研究探讨酒精相关死亡率的队列效应。这项研究使用了50多个多年的数据来测量酒精相关肝病（ALD）死亡率的年龄、时期和队列趋势。设计、设置和病例这是对1968年至2020年澳大利亚ALD总死亡率数据的回顾性年龄段队列分析。总共有35个 822人死亡——27人 208名男性（76%）和8614名女性（24%）。测量ALD死亡人数分为5年年龄组和5个时期（例如，将1968年至1972年间20-24岁的死亡人数合并）。研究结果男性和女性的ALD死亡率在20世纪70年代末和80年代初达到峰值。在年龄-时期-队列模型中，1915-30年出生的队列死亡率最高。例如，1923年至1927年出生的男性的相对风险为1.58[95%置信区间（CI） = 1.52，1.64]与1948年至1952年间出生的男性相比。对于女性来说，20世纪60年代出生的队列的风险增加[例如，1963-67年的队列的相对风险（RR）为1.16（95%CI = 1.07.1.25）与1948–52年出生的女性相比。对于男性来说，随着时间的推移，死亡率普遍下降[例如，2020年，RR为0.87（95%CI = 0.82、0.92）。妇女死亡率在2000年之前一直在下降，此后一直保持稳定。结论自20世纪70年代和80年代以来，澳大利亚人群中与酒精相关的肝病死亡率有所下降，部分原因是随着高危出生队列年龄的增长，队列发生了特定的变化。对于女性来说，这种下降在2000年已经停滞，20世纪60年代出生的女性群体比早期群体的风险更高，这表明随着这一人群进入ALD死亡率最高的年份，需要采取深思熟虑的干预措施。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.