What do elderly problem drinkers aim for? Choice of goal for treatment among elderly treatment-seeking alcohol-dependent patients

Objective: The patient’s free choice of treatment goals for alcohol use disorder (AUD) is predictive for treatment outcome. Presently there is limited knowledge of whether the age at onset of AUD influences the choice of goal for treatment. The present study investigates whether there are differences in choice of treatment goal between patients with very late onset alcohol use disorder (VLO AUD ≥ 60 years) and those having early or mid-age onset of AUD (EMO AUD < 60 years). Method: Participants were 341 persons, voluntarily enrolled in the Elderly Study, who were seeking treatment for AUD in outpatient centres for alcohol treatment in Denmark. Data regarding thoughts about abstinence, alcohol use in the last 90 days, motivation for treatment and psychiatric diagnosis were collected via questionnaires. A logistics regression was used to analyse the data. Results: 32.1% of the participants with VLO AUD chose temporary abstinence goals, compared to 18.2% of the patients with earlier-onset AUD ( p = 0.024). Further, 10.7% of participants with VLO AUD chose total abstinence goals compared to 31.3% of participants with early or mid-age onset AUD ( p = 0.002). Conclusion: There are significant differences in choice of goal between participants with very late onset AUD and early or mid-age onset AUD. Individuals with very late onset alcohol use disorder tend to choose temporary abstinence over any other treatment goal whereas, in general, individuals with early onset alcohol use disorder choose permanent abstinence over other treatment goals.

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DSM-5 alcohol use disorder features among treatment-seeking older adults

SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice ◽

10.1024/0939-5911/a000550 ◽

2018 ◽

Vol 64 (4) ◽

pp. 185-196 ◽

Cited By ~ 2

Author(s):

Silke Behrendt ◽

Barbara Braun ◽

Randi Bilberg ◽

Gerhard Bühringer ◽

Michael Bogenschutz ◽

...

Keyword(s):

Older Adults ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

The Elderly ◽

Treatment Seeking ◽

Controlled Clinical Trial ◽

Dsm 5 ◽

Wide Range ◽

And Gender ◽

International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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Relationship between alcohol use disorder and cognition in the elderly

European Neuropsychopharmacology ◽

10.1016/s0924-977x(16)31793-x ◽

2016 ◽

Vol 26 ◽

pp. S675

Author(s):

D. Kim ◽

K.J. Jang ◽

C.H. Hong ◽

J.S. Noh ◽

S.J. Son

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

The Elderly

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The Validity of the Alcohol-Use-Disorder-Identification-Test and a Novel Proxy Test in the Assessment of Alcohol Consumption in the Cognitively Impaired Elderly

Journal of Addiction Research ◽

10.33140/jar.02.01.06 ◽

2018 ◽

Vol 2 (1) ◽

Keyword(s):

Cognitive Impairment ◽

Alcohol Use ◽

Alcohol Use Disorder ◽

Alcohol Intake ◽

Elderly Population ◽

Screening Tool ◽

Alcohol Misuse ◽

The Elderly ◽

Identification Test ◽

Disorder Identification

Aims: Alcohol is consumed excessively by almost a quarter of the population. A report by highlighted underdiagnosis of alcohol misuse in the elderly [1]. There is a lack of research focusing on assessment of alcohol use and its impact in older people. This study aimed to assess the validity of the Alcohol-Use-Disorder-Identification-Test (AUDIT) in an elderly population with cognitive impairment and to establish the validity of a novel adaption of the AUDIT used as a proxy measure. Methods: Opportunistic observational study examining the assessment of alcohol consumption in an elderly population with mild cognitive impairment or mild dementia. The study aimed to evaluate the self-report AUDIT versus a “proxy” AUDIT compared to a plasma Carbohydrate-deficientTransferrin (CDT) level. Findings: Scores were comparable between the “proxy” AUDIT and the AUDIT. Neither measure of alcohol intake correlated significantly with CDT levels. There was no association between alcohol intake and cognition or quality of life ratings. Conclusions: We suggest the AUDIT could be a useful screening tool in detecting alcohol misuse in the elderly with cognitive impairment. The “proxy” AUDIT was also found to be a valid screening tool, however further work is needed to confirm these findings.

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Substance Use Disorders in the Elderly

10.1093/med/9780199374656.003.0030 ◽

2017 ◽

Author(s):

Michael Burgard ◽

Robert Kohn

Keyword(s):

Older Adults ◽

Substance Use ◽

Alcohol Use ◽

Substance Use Disorders ◽

Alcohol Use Disorder ◽

Illicit Drugs ◽

Nursing Home Residents ◽

The Elderly ◽

The United States ◽

Driving Under The Influence

Substance use disorders in older adults remains lower than in younger adults; however, the prevalence is rising in the elderly population. In the United States, the lifetime prevalence of an alcohol use disorder among persons age 65 and older is 16.1%. Studies of Veteran’s Administration nursing home residents have found that 29% to 49% of those admitted have a lifetime diagnosis of alcohol use disorder. A sizable proportion of the elderly acknowledge driving under the influence. In 2013, 1.5% of the elderly had used illicit drugs. The number requiring treatment for substance abuse is expected to double by 2020. The populations with the fastest increase in opiate mortality are those age 55 and older, including those 65 and older. This chapter presents the epidemiology of substance use among older adults and discusses issues related to elders’ substance use, including use in nursing homes, impaired driving and arrests, use of non-prescription medications, screening for substance use, and treatment.

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Early Versus Late Onset Alcohol Use Disorder Among Alcohol Dependent Women in Treatment

PsycEXTRA Dataset ◽

10.1037/e560672014-001 ◽

2014 ◽

Author(s):

Alexander A. Puhalla ◽

Elizabeth E. Epstein ◽

Ayorkor Gaba ◽

Barbara S. McCrady ◽

David Eddie

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Late Onset ◽

Alcohol Dependent

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Relationship between alcohol use disorder and cognition in the elderly

10.26226/morressier.5785edd1d462b80296c9a0bd ◽

2016 ◽

Author(s):

Dongsoo Kim

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

The Elderly

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Elderly-study – treatment for alcohol problems among 60+

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.992 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S291-S292

Author(s):

K. Andersen ◽

M. Bogenschutz ◽

G. Bühringer ◽

S. Behrendt ◽

B. Braun ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Randomized Study ◽

Alcohol Use Disorders ◽

The Elderly ◽

Alcohol Problems ◽

Motivational Enhancement Therapy ◽

Therapy Program ◽

Community Reinforcement Approach ◽

Competing Interest

IntroductionThe western societies have a rapidly aging population and an increasing number of elderly with alcohol use disorders.ObjectiveThe purpose of the elderly study is to develop and test an outpatient behavior therapy program for people with an alcohol use disorders.Aim of this abstractTo investigate the association between ages, gender, drinking pattern and psychology distress.MethodThe study is a randomized study expected to enroll and treat 1000 participants aged 60+ years before April 2017; 200 in USA; 400 in Germany and 400 in Denmark. To be included in the study the participants have to fulfil the DSM-5 criteria for alcohol use disorder. All participants are examined at baseline, and at four follow up interviews. After the baseline interview all participants are randomized to Motivational Enhancement Therapy (MET); or MET followed by 8 weeks of counseling based on the Community Reinforcement Approach (CRA) with a module added to address problems relevants to elderly people.ResultsThe presentation will include baseline characteristics of the Danish participants including demographics, expectations to treatment, history of drinking in the last 90 days before baseline and their psychological distress. We have now enrolled 259 participants in the Danish database. We expect to present results from 320 patients.ConclusionThe data will present information about the profile of 60+ years’ individuals seeking treatment for alcohol use disorder, and thereby provide knowledge about which characteristics that may be important when planning treatment for this age group.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The impact of sex, age at onset, recurrence, mode of ascertainment and medical complications on the family genetic risk score profiles for alcohol use disorder

Psychological Medicine ◽

10.1017/s0033291721003317 ◽

2021 ◽

pp. 1-9

Author(s):

Kenneth S. Kendler ◽

Henrik Ohlsson ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Alcohol Use ◽

Genetic Risk ◽

Criminal Behavior ◽

Alcohol Use Disorder ◽

Genetic Risk Score ◽

Age At Onset ◽

Risk Scores ◽

Medical Complications ◽

The Family ◽

The Impact

Abstract Background Alcohol use disorder (AUD) is clinically heterogeneous. We examine its potential genetic heterogeneity as a function of sex, age, clinical features and mode of ascertainment. Methods In the Swedish population born 1932–1995 (n = 5 829 952), we examined the genetic risk profiles for AUD, major depression (MD), anxiety disorders, bipolar disorder, drug use disorder (DUD), attention deficit-hyperactivity disorder (ADHD) and criminal behavior (CB) in 361 124 cases of AUD subdivided by sex, age at onset (AAO), recurrence, mode of ascertainment and medical complications. Family genetic risk scores (FGRS), calculated from 1st to 5th-degree relatives controlling of cohabitation, assesses genetic risk from phenotypes in the family, not from DNA variants. Results FGRS profiles differed modestly across sex with all scores higher in females. Differences were more pronounced for AAO and recurrence with the FGRS for AUD, DUD, ADHD and CB substantially higher in cases with early AAO or high recurrence rates. Genetic profiles differed considerably by mode of ascertainment, with higher FGRS for AUD and most other disorders in patients seen in hospital v. primary care settings. Cases of AUD with medical complications had higher FGRS for AUD. AUD cases comorbid with MD and DUD had higher FGRS risk for AUD, but this genetic may be less specific given increases in FGRS for multiple other disorders. Conclusions From a genetic perspective, AUD differs substantially as a function of AAO, recurrence, mode of ascertainment and patterns of comorbidity, suggesting caution in cross-sample comparisons of AUD cohorts that differ in these features.

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