Correlates of and relationship among lifetime alcohol abuse and alcohol dependence in older community residents in Brazil.

Misinterpretation in major surveys of alcohol use disorder as described by DSM-IV (American Psychiatric Association, 1994; Hasin et al., 2007) has raised serious question regarding the extent of alcohol use disorder, and the relationship between alcohol abuse and alcohol dependence. While the adverse social, physical and mental effects of alcohol misuse are well known (Council on Scientific Affairs, 1996), there is little information on the determinants of alcohol abuse (the societal impact of adverse alcohol use), alcohol dependence (the physiologic impact), and the combined presence of alcohol abuse and dependence. We therefore examined their separate associations with demographic, social, and health characteristics in a representative community-resident sample ≥60 years of age. We hypothesized that, while each of the three groups would be associated with demographic characteristics, abuse would be more closely associated with social characteristics, dependence with health characteristics, and the combined presence of abuse and dependence with both.