S Malyutina

Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations

Objectives: To examine, on empirical data, whether drinking patterns, in addition to overall alcohol consumption, contribute to differences in rates of alcohol related problems between populations. Design: Cross sectional survey. Settings: One Russian, one Polish, and one Czech city. Participants: 1118 men and 1125 women randomly selected from population registers. Main outcome measures: Problem drinking; negative social consequences of drinking; alcohol consumption and drinking pattern. Results: Rates of problem drinking and of negative consequences of drinking were much higher in Russian men (35% and 18%, respectively) than in Czechs (19% and 10%) or Poles (14% and 8%). This contrasts with substantially lower mean annual intake of alcohol reported by Russian men (4.6 litres) than by Czech men (8.5 litres), and with low mean drinking frequency in Russia (67 drinking sessions per year, compared with 179 sessions among Czech men). However, Russians consumed the highest dose of alcohol per drinking session (means 71 g in Russians, 46 g in Czechs, and 45 g in Poles), and had the highest prevalence of binge drinking. In women, the levels of alcohol related problems and of drinking were low in all countries. In ecological and individual level analyses, indicators of binge drinking explained a substantial part of differences in rates of problem drinking and negative consequences of drinking between the three countries. Conclusions: These empirical data confirm high levels of alcohol related problems in Russia despite low volume of drinking. The binge drinking pattern partly explains this paradoxical finding. Overall alcohol consumption does not suffice as an estimate of alcohol related problems at the population level.

Childhood socioeconomic circumstances and adult height and leg length in central and eastern Europe

Background: Adult height and leg length have been shown to be positively associated with childhood socioeconomic circumstances in several studies in western populations. This study will determine whether similar associations are observable in settings with different social histories, and will assess whether adult leg length is more strongly associated than adult height. Methods: Random samples of men and women aged 45–69 years were taken from population registers in Novosibirsk (Russia), Krakow (Poland) and six towns of the Czech Republic, recruiting nearly 29 000 people. Participants completed a questionnaire that included questions regarding their mother’s and father’s education (not available in the Czech Republic) and ownership of several household items when they were 10 years old. Participants’ standing and sitting heights were measured and from these an estimate of leg length was derived. Associations between indicators of childhood socioeconomic circumstances and anthropometric measures were analysed using linear regression. Results: Russian individuals were shorter and reported fewer household assets at the age of 10 years than Czech and Polish individuals. Parental education and household assets were strongly associated with each other and both were independently associated with height, leg length and trunk length. Height was associated with childhood circumstances more strongly than leg length. The associations of childhood circumstances with the leg/trunk ratio were weak and inconsistent. Conclusion: In these urban populations in eastern Europe, adult height is associated with childhood conditions at least as strongly as leg length.

The association between psychosocial characteristics at work and problem drinking: a cross-sectional study of men in three Eastern European urban populations

Background: Psychosocial factors at work are thought to influence health partly through health behaviours. Aims: To examine the association between effort-reward imbalance and job control and several alcohol related measures in three eastern European populations. Methods: A cross-sectional study was conducted in Novosibirsk (Russia), Krakow (Poland), and Karvina (Czech Republic). The participants completed a questionnaire that included effort-reward at work, job control, and a number of sociodemographic variables. Annual alcohol intake, annual number of drinking sessions, the mean dose of alcohol per drinking session, and binge drinking (⩾80 g of ethanol in one session at least once a week) were based on graduated frequencies in the questionnaire. Data were also available on problem drinking (⩾2 positive answers on CAGE questionnaire) and negative social consequences of drinking. All male participants in full employment (n = 694) were included in the present analyses. Results: After controlling for age and centre, all indices of alcohol consumption and problem drinking were associated with the effort-reward ratio. Adjustment for material deprivation did not change the results but adjustment for depressive symptoms reduced the estimated effects. Job control was not associated with any of the alcohol related outcomes. Conclusions: The imbalance of effort-reward at work is associated with increased alcohol intake and problem drinking. The association appears to be partly mediated by depressive symptoms, which might be either an antecedent or a consequence of men’s drinking behaviour.

Alcohol consumption and cognitive performance: a Mendelian randomization study

Aims To use Mendelian randomization to assess whether alcohol intake was causally associated with cognitive function. Design Mendelian randomization using a genetic variant related to alcohol intake (ADH1B rs1229984) was used to obtain unbiased estimates of the association between alcohol intake and cognitive performance. Setting Europe. Participants More than 34 000 adults. Measurements Any versus no alcohol intake and units of intake in the previous week was measured by questionnaire. Cognitive function was assessed in terms of immediate and delayed word recall, verbal fluency and processing speed. Findings Having consumed any versus no alcohol was associated with higher scores by 0.17 standard deviations (SD) [95% confidence interval (CI) = 0.15, 0.20] for immediate recall, 0.17 SD (95% CI = 0.14, 0.19) for delayed recall, 0.17 SD (95% CI = 0.14, 0.19) for verbal fluency and 0.12 SD (95% CI = 0.09, 0.15) for processing speed. The minor allele of rs1229984 was associated with reduced odds of consuming any alcohol (odds ratio = 0.87; 95% CI = 0.80, 0.95; P = 0.001; R2 = 0.1%; F-statistic = 47). In Mendelian randomization analysis, the minor allele was not associated with any cognitive test score, and instrumental variable analysis suggested no causal association between alcohol consumption and cognition: −0.74 SD (95% CI = −1.88, 0.41) for immediate recall, −1.09 SD (95% CI = −2.38, 0.21) for delayed recall, −0.63 SD (95% CI = −1.78, 0.53) for verbal fluency and −0.16 SD (95% CI = −1.29, 0.97) for processing speed. Conclusions The Mendelian randomization analysis did not provide strong evidence of a causal association between alcohol consumption and cognitive ability.

The Relationship between Body Mass Index and 10-Year Trajectories of Physical Functioning in Middle-Aged and Older Russians: Prospective Results of the Russian HAPIEE Study.

ObjectiveTo investigate the associations of overweight and obesity with longitudinal decline in physical functioning (PF) among middle-aged and older Russians.DesignProspective cohort study.SettingFour rounds of data collection in the Russian Health, Alcohol and Psychosocial factors In Eastern Europe study with up to 10 years of follow-up.Participants9,222 men and women aged 45-69 years randomly selected from the population of two districts of Novosibirsk, Russia.MeasurementsPF score (range 0-100) was measured by the Physical Functioning Subscale (PF-10) of the 36-item Short Form Health Survey (SF-36) at baseline and three subsequent occasions. Body mass index (BMI), derived from objectively measured body height and weight at baseline, was classified into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obesity class I (BMI 30.0-34.9), and obesity class II+ (BMI≥35.0).ResultsThe mean annual decline in the PF score during the follow-up was -1.92 (95% confidence interval -2.17; -1.68) in men and -1.91 (-2.13; -1.68) in women. At baseline, compared with normal weight, obesity classes I and II+ (but not overweight) were associated with significantly lower PF in both sexes. In prospective analyses, the decline in PF was faster in overweight men (difference from normal weight subjects -0.38 [-0.63; -0.14]), class I obese men and women (-0.49 [-0.82; -0.17] and -0.44 [-0.73; -0.15] respectively) and class II+ obese men and women (-1.13 [-1.73; -0.53] and -0.43 [-0.77; -0.09] respectively). Adjustment for physical activity and other covariates did not materially change the results.ConclusionsPF decreased more rapidly in obese men and women than among those with normal weight. The adverse effect of high BMI on PF trajectories appeared to be more pronounced in men than in women, making more extremely obese Russian men an important target population to prevent/slow down the process of decline in PF.

OP19 Social Networks and Depressive Symptoms in Russia, Poland and the Czech Republic: Evidence from the Hapiee Study

Background In countries of Central and Eastern Europe, prevalence rates of depressive symptoms are as high as 20% in men and 40% in women. Inclusion in social networks has been found to be a strong predictor of depressive symptoms in other countries, but little research on this association has been carried out in Central and Eastern Europe. This study aims to examine this association in the adult urban population in Russia, Poland and the Czech Republic. Methods Cross-sectional analysis was performed on baseline data (2002–2005) from the Health Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study, involving men and women aged 45–69 from the adult urban population of the three countries of interest (Total N=25,674). Depressive symptoms were measured by the Centre for Epidemiological Studies Depression (CESD–20) scale. Inclusion in social networks was measured in terms of trust in informal or formal networks, and frequency of contacts with friends and distant relatives. Results In Russia and the Czech Republic, odds of depressive symptoms were higher for men (Russia, OR 3.94, 95%CI 2.37–6.54; Czech Republic OR 2.04, 95%CI 1.18–3.52) and women (Russia, OR 2.19, 95%CI 1.47–2.99; Czech Republic OR 1.87, 95%CI 1.10–3.16) who had nobody to rely upon, compared with those who relied on friends or family. The pattern of association between frequency of contact with distant relatives or friends and depressive symptoms varied according to gender and country of origin of participants. Not having relatives outside the household was predictive of depressive symptoms among Polish men (OR 1.54, 95% C.I. 1.10–2.15) and women (OR 2.01, 95% C.I. 1.36–2.97); and not having any friends was associated with higher odds of depressives symptoms among Russian women (OR 1.54, 95% C.I. 1.09–2.19), and Polish men (OR 1.60, 95% C.I. 1.15–2.22). Conclusion The results presented here suggest that exclusion from social networks is a strong predictor of depressive symptoms and that there is a country specific pattern of variation in how frequency of contact with social networks affects the risk of depressive symptoms. We argue that this variation could be due to differences in economic development and social capital of Russia, Poland and the Czech Republic.