Vaillant GE. A 60-year follow-up of alcoholic men. Addiction 2003 98:1043-1051
Dear Colleagues,
In a staggering feat, veteran alcohol researcher George Vaillant has followed the classic Boston study groups of Glueck & Glueck for up to 60 years from enrolment. These two groups included over 700 citizens either from poor inner city areas or from Harvard University undergraduates, most born in the 1920s. There are significant findings on the natural histories of alcohol abuse, dependence, abstinence and controlled drinking in relation to other medical problems, employment, self-help and mortality. Most importantly there is information on the onset of alcohol problems since the subjects were chosen young and at random. There is some bias since alcoholics are less likely to comply with such research but the differences in responses were not significant in this case.
There is more in this paper than could be included in a brief review. However, the main finding given by Vaillant in his abstract is that despite major differences in the groups in terms of IQ, social background and ethnicity, the main outcomes were very similar in four important domains by age 70. As also found by Drew, chronic alcohol dependence was rare in the older age groups. Controlled drinking was exceptional (1%). Just over half the subjects had died in both groups and around 10% were abusing alcohol (but not dependent) with most of the remainder abstinent.
‘Surprisingly, in both samples, alcohol abuse could persist for decades without remission, death or progression to dependency.’ [of 29 college alcohol abusers 13 surviv(ed) to age 80]. But there were some differences between the groups: ‘The average age of onset of alcohol abuse was a decade later for the college men (40 vs. 30) than it was for the core city men.’
I felt very proud when I completed a ten year follow-up of opiate dependent patients a few years ago. But my achievement is dwarfed by this monumental piece of work in the case of alcohol since Vaillant has now carefully examined outcomes over more than an average adult lifetime of three score years and ten.
comments by Andrew Byrne ..
