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      The eyes have it: Alcohol‐induced eye movement impairment and perceived impairment in older adults with and without alcohol use disorder

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          Abstract

          Background

          While alcohol has been shown to impair eye movements in young adults, little is known about alcohol‐induced oculomotor impairment in older adults with longer histories of alcohol use. Here, we examined whether older adults with chronic alcohol use disorder (AUD) exhibit more acute tolerance than age‐matched light drinkers (LD), evidenced by less alcohol‐induced oculomotor impairment and perceived impairment.

          Method

          Two random‐order, double‐blinded laboratory sessions with administration of alcohol (0.8 g/kg) or placebo. Participants ( n = 117; 55 AUD, 62 LD) were 40–65 years of age. Eye tracking outcomes (pupil size, smooth pursuit gain, pro‐ and anti‐saccadic velocity, latency, and accuracy) were measured at baseline and repeated at peak and declining breath alcohol intervals. Participants rated their perceived impairment during rising and declining intervals.

          Results

          Following alcohol consumption, older adults with AUD (vs. LD) showed less impairment on smooth pursuit gain and reported lower perceived impairment, but both groups showed similar pupil dilation and impairment on saccadic measures.

          Conclusions

          While alcohol impaired older adults with AUD less than LD in terms of their ability to track a predictably moving object (i.e., smooth pursuit), both drinking groups were equally sensitive to alcohol‐induced delays in reaction time, reductions in velocity, and deficits in accuracy to randomly appearing objects (i.e., saccade tasks). Thus, despite decades of chronic excessive drinking, older adults with AUD exhibited similar oculomotor tolerance on pro‐ and anti‐saccade eye movements relative to their light‐drinking counterparts. Given that these individuals also perceived less impairment during intoxication, they may be at risk for injury and harm when they engage in real‐life drinking bouts.

          Abstract

          While chronic alcohol consumption may produce tolerance (less impairment) for certain behaviors, alcohol's effects on eye movements are unclear. In our comparison of older adults with chronic alcohol use disorder (AUD) and age‐matched light drinkers, the AUD group was less impaired in tracking a predictably moving object (smooth pursuit) but equally impaired in responding to randomly appearing targets (saccades), despite perceiving lower impairment. During real‐life drinking, impairment of saccadic movements may hinder their ability to mitigate dangers and threats.

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          Most cited references47

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          Predicting basal metabolic rate, new standards and review of previous work.

          After reviewing the literature on basal metabolism, this paper discusses and reviews recent attempts to predict BMR from age, sex and anthropometric measurements. Criticism is made of the scientific and statistical integrity of a widely used table of standard metabolic rates for weight. The statistical screening of data from the literature of the past 50 years is described and equations computed from these screened data are presented. In these equations, BMR is predicted simply from weight or from weight and height with sex and age taken into account. Information is given on error, and tables estimating error for predictions on new data both for individuals and for means of groups of subjects are included. A table of BMRs for weights from 3 to 84 kg for males and females separately is also included. Cross-validation techniques are used to estimate possible threats to validity from various sources including, for example, different procedures of early workers. It was found that in the data available subjects from developing countries not only were smaller and had lower metabolic rates (as was expected) but also had lower rates per unit body weight than European or North American subjects. It is argued that at an individual level the error of prediction must be high since the global operationalisation of BMR confounds separate effects known to participate in complex relations with sex, age and anthropometric indices. The work reported is aimed at meeting a practical need for equations which are simple to apply. However, it was found that little was gained by the use of more complex equations, although they remain of scientific interest.
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            The Risks Associated With Alcohol Use and Alcoholism

            Alcohol consumption, particularly heavier drinking, is an important risk factor for many health problems and, thus, is a major contributor to the global burden of disease. In fact, alcohol is a necessary underlying cause for more than 30 conditions and a contributing factor to many more. The most common disease categories that are entirely or partly caused by alcohol consumption include infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiovascular disease, liver and pancreas disease, and unintentional and intentional injury. Knowledge of these disease risks has helped in the development of low-risk drinking guidelines. In addition to these disease risks that affect the drinker, alcohol consumption also can affect the health of others and cause social harm both to the drinker and to others, adding to the overall cost associated with alcohol consumption. These findings underscore the need to develop effective prevention efforts to reduce the pain and suffering, and the associated costs, resulting from excessive alcohol use.
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              High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism.

              After consuming comparable amounts of ethanol, women have higher blood ethanol concentrations than men, even with allowance for differences in size, and are more susceptible to alcoholic liver disease. Recently, we documented significant "first-pass metabolism" of ethanol due to its oxidation by gastric tissue. We report a study of the possible contribution of this metabolism to the sex-related difference in blood alcohol concentrations in 20 men and 23 women. Six in each group were alcoholics. The first-pass metabolism was determined on the basis of the difference in areas under the curves of blood alcohol concentrations after intravenous and oral administration of ethanol (0.3 g per kilogram of body weight). Alcohol dehydrogenase activity was also measured in endoscopic gastric biopsies. In nonalcoholic subjects, the first-pass metabolism and gastric alcohol dehydrogenase activity of the women were 23 and 59 percent, respectively, of those in the men, and there was a significant correlation (rs = 0.659) between first-pass metabolism and gastric mucosal alcohol dehydrogenase activity. In the alcoholic men, the first-pass metabolism and gastric alcohol dehydrogenase activity were about half those in the nonalcoholic men; in the alcoholic women, the gastric mucosal alcohol dehydrogenase activity was even lower than in the alcoholic men, and first-pass metabolism was virtually abolished. We conclude that the increased bioavailability of ethanol resulting from decreased gastric oxidation of ethanol may contribute to the enhanced vulnerability of women to acute and chronic complications of alcoholism.

                Author and article information

                Contributors
                aking@bsd.uchicago.edu
                Journal
                Alcohol Clin Exp Res (Hoboken)
                Alcohol Clin Exp Res (Hoboken)
                10.1111/(ISSN)2993-7175
                ACER
                Alcohol, Clinical & Experimental Research
                John Wiley and Sons Inc. (Hoboken )
                2993-7175
                29 January 2025
                February 2025
                : 49
                : 2 ( doiID: 10.1111/acer.v49.2 )
                : 437-447
                Affiliations
                [ 1 ] Department of Psychiatry & Behavioral Neuroscience University of Chicago Chicago Illinois USA
                [ 2 ] Department of Behavioral and Social Sciences Brown University School of Public Health Providence Rhode Island USA
                [ 3 ] Department of Ophthalmology and Visual Sciences University of Illinois at Chicago Chicago Illinois USA
                Author notes
                [*] [* ] Correspondence

                Andrea C. King, Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Avenue (MC‐3077), Chicago, IL 60637, USA.

                Email: aking@ 123456bsd.uchicago.edu

                Author information
                https://orcid.org/0009-0002-0279-9314
                https://orcid.org/0000-0001-5943-7109
                Article
                ACER15509 ACER-24-6147.R1
                10.1111/acer.15509
                11828972
                39878623
                963dd752-0723-4c9a-9cc6-b17023041010
                © 2024 The Author(s). Alcohol, Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 July 2024
                : 22 November 2024
                Page count
                Figures: 5, Tables: 2, Pages: 11, Words: 7600
                Funding
                Funded by: National Institute on Alcohol Abuse and Alcoholism , doi 10.13039/100000027;
                Award ID: R01‐AA013746
                Categories
                Research Article
                Behavior, Treatment and Prevention
                Custom metadata
                2.0
                February 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.3 mode:remove_FC converted:14.02.2025

                alcohol use disorder,eye movement,older adults,saccade,smooth pursuit,tolerance

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