DSM-5 Latent Classes of Alcohol Users among Treatment Seeking Older Adults

Abstract

Objective: Understanding the variation of alcohol use disorder (AUD) among a clinical sample of patients aged 60 and older, by identifying latent classes of AUD and exploring risk factors and outcomes of treatment associated with the class. Method: We used the Danish subsample (n = 341) from the Elderly Study. Latent class analysis was used to identify classes based on the 11 symptoms of DSM-5 AUD. We analyzed the associations between class membership and sociodemographic variables, alcohol consumption, and drinking-related outcome of treatment. Results: Three latent classes were identified. Individuals in the low-symptomatic class (34.85%) displayed low endorsement of DSM-5 criteria “Withdrawal”, “Time Spent”, “Less activities” compared to the other classes, and had fewest drinks per drinking day. Individuals in the moderate-symptomatic class (32.69%) were most likely to be intoxicated in hazardous situations, and those in the high-symptomatic class (32.47%) displayed, with a few exceptions, the highest probabilities of all DSM-5 criteria. Female gender, living alone and prior AUD treatment was associated with increased risk of being in the high-symptomatic class. No difference between classes was found with respect to years with AUD and frequency of drinking days, and latent class membership had no effect on drinking outcome after treatment, when controlling for baseline. Conclusions: Three classes of DSM-5 AUD among older adults in treatment emerged, displaying a low-moderate-high distribution, advocating for a unidimensional construct of DSM-5 AUD. Although different with respect to baseline risk factors, no strong connection between DSM-5 latent class and alcohol consumption after AUD treatment was found.

Highlights

• Among 341 older alcohol use disorder (AUD) outpatients, three latent classes of DSM-5 AUD emerged.

• The classes of DSM-5 AUD displayed a low-moderate-high endorsement of DSM-5 AUD characteristics.

• The three classes had similar alcohol-related treatment outcomes.

Keywords:

• DSM-5
• alcohol use disorder
• older adults
• latent class analysis

Acknowledgements

We acknowledge the contribution of all study participants, therapists, interviewers, and student helpers.

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the Lundbeck Foundation, Denmark, which had no role in study design, collection, analysis and interpretation of data, writing of the report, and decision to submit the article for publication.