AGE OF ONSET AFFECTS RELAPSE OF ALCOHOL USE DISORDER: A 7- YEAR RETROSPECTIVE COHORT STUDY

Abstract Background Age of onset(AOO) influences the prognosis of many diseases and even serves as potential driver. But in Alcohol Use Disorders(AUD), there is no consensus regarding the effect of AOO on the course. Objectives We thus retrospectively investigated a large-scale cohort to explore the effect of AOO on the course of AUD. Method In this study, a total of 14,357 inpatients with alcohol use disorders were recruited over a 7- year time span, and after applying rigorous data criteria, 2,176 inpatients were ultimately included in the statistical analysis. Patients were divided into three age subgroups according to their age of onset, which were early adult onset(EAO), middle adult onset(MAO) and late adult onset(LAO). Results The proportion of recurrence was statistically different in the subgroups with different age of onset (X2=9.819, df=3, P=0.007), the Bonferroni post hoc test suggested a higher proportion of recurrence in the EAO than that in the MAO subgroup (66.1% vs 59.5%, P<0.05). We then performed a Binary logistic regression. Taking patients in the EAO subgroup as a reference, patients with MAO had a lower risk of recurrence (OR=0.75, 95%CI=0.63-0.90, P=0.002), however, the risk of recurrence in the LAO subgroup was not statistically different from the EAO (OR=0.78, 95%CI=0.54-1.11, P=0.17). Subsequently, a survival analysis for recurrence within one year was performed. There were statistically differences in Kaplan-Meier method estimates of the probability of disease-free survival (DFS) at day 365 between the three age of onset subgroups (33.9%, 40.5%, 39.7%, respectively; P=0.03). Specifically, post hoc tests suggested that DFS was lower in the EAO subgroup than in the other two groups (median DFS=197, 95%CI=172.10-221.90, P=0.012). Finally, we follow-up all patients for 5 years for cerebral atrophy onset, and the results suggest that the incidence of cerebral atrophy during the follow-up period was lower in the EAO subgroup than that in the other two subgroups (OR=1.42, 95%CI=1.19-1.70, P<0.001; OR=1.62, 95%CI=1.14-2.31, P=0.007, respectively), but this difference was no longer statistically significant after controlling for the age factor (both P>0.05). Conclusion This is the first large sample size study to explore the influence of age of onset on alcohol use disorders in a Chinese population. Our study found that alcohol use disorders with onset in early adult are associated with more recurrences. These findings will help explore risk factors for alcohol use disorders and provide preliminary evidence for clinical development of prevention strategies.