scholarly journals Alcohol screening for older adults in an acute general hospital: FAST v. MAST-G assessments

2016 ◽  
Vol 40 (2) ◽  
pp. 72-76 ◽  
Author(s):  
Rachel Knightly ◽  
George Tadros ◽  
Juhi Sharma ◽  
Peter Duffield ◽  
Emma Carnall ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Screening Test ◽  
Alcohol Misuse ◽  
Alcohol Screening ◽  
Alcohol Problems ◽  
Fast Screening ◽  
Accident And Emergency ◽  
Screening Protocol ◽  
History Of

Aims and methodDocumented prevalence of alcohol misuse among older adult patients at Birmingham Heartlands Hospital is significantly lower than the national prevalence. We aimed to evaluate our alcohol misuse screening protocol for older adults to identify possible shortcomings. Hospital protocol is to screen all adults for alcohol misuse in the accident and emergency (A&E) department using the Fast Alcohol Screening Test (FAST). One hundred consecutive consenting in-patients aged 65–94 admitted via A&E subsequently undertook an additional alcohol screening test (Michigan Alcoholism Screening Test-Geriatric version; MAST-G). Results of the two tests were compared.ResultsFAST screening was completed for 71 patients and none were FAST-positive for alcohol misuse, yet using MAST-G, 18 patients scored positively for alcohol misuse. FAST screening failed to identify 8 patients with a documented history of alcohol misuse.Clinical implicationsOlder adult alcohol misuse prevalence is significantly underreported using FAST. Screening older adults for alcohol problems requires a different approach to screening the general population.

scholarly journals The Experience and Perception of Physiotherapists in Nigeria re: Fall Prevention in Recurrent-Faller Older Adults

2019 ◽  
Author(s):  
Perpetua Obi ◽  
Henrietha Nwankwo ◽  
Diaemeta Emofe ◽  
Isreal Adandom ◽  
Michael Kalu
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Fall Prevention ◽  
Developing World ◽  
Phenomenological Approach ◽  
Developing Nations ◽  
Prevention Strategies ◽  
Face To Face ◽  
Rehabilitation Professionals ◽  
History Of

Background: Effective fall prevention practices are essential for reducing falls among older adults. Rehabilitation professionals like physiotherapists are essential members of the fall prevention team, yet little is known about the experiences of physiotherapists practicing fall prevention in developing nations. Objective: To explore the experiences of physiotherapists in Nigeria who practice fall prevention among older adults. Method: We adopted a phenomenological approach to the traditional qualitative design in this study. We purposefully selected and conducted face-to-face interview with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data was analyzed using thematic analysis. Results: Four themes emerged from our participants: characteristics of recurrent fallers, fall prevention practices, hindrances to fall prevention, and strategies to promote fall prevention practices. In practice, understanding the characteristics (risk factors) of older adults with a history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls. Conclusion: This study adds to the sparse amount of literature concerning the experience of physiotherapist in fall prevention practices in the developing world. More importantly, the findings of this study will strengthen or stimulate discussion around development of fall prevention strategies specific to the developing world context.

scholarly journals Substance misuse in life and death in a 2-year cohort of suicides

2016 ◽  
Vol 208 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Karen Galway ◽  
Diana Gossrau-Breen ◽  
Sharon Mallon ◽  
Lynette Hughes ◽  
Michael Rosato ◽  
...  
Keyword(s):  
Substance Misuse ◽  
Alcohol Misuse ◽  
Alcohol Problems ◽  
Drug Misuse ◽  
Therapeutic Dosage ◽  
Life And Death ◽  
Other Substances ◽  
History Of ◽  
Toxicology Screening ◽  
The Relationship

BackgroundAlthough substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide.AimsTo examine the relationship between substance misuse and subsequent suicide.MethodLinkage of coroners' reports to primary care records for 403 suicides occurring over 2 years.ResultsWith alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse.ConclusionsA deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a ‘cause of death’.

Alcohol use and misuse in older adults

1999 ◽  
Vol 9 (2) ◽  
pp. 151-162 ◽  
Author(s):  
Lawrence Schonfeld ◽  
Larry W Dupree
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Misuse ◽  
Specific Treatment ◽  
Alcohol Problems ◽  
Drinking Behaviour ◽  
Problem Drinkers ◽  
Medical Settings ◽  
The Usa ◽  
Screening Assessment

Alcohol misuse among older people has now been investigated for over 30 years. Schonfeld and Dupree previously described studies of alcohol use and abuse in the USA and UK, categories of older problem drinkers, age-inappropriate assessments, and examples of age-specific treatment. This review addresses more recent studies on drinking behaviour across several countries, screening assessment for older adults, alcohol problems in primary care medical settings, current age-specific treatment programmes, and treatment recommendations by expert panels, as well as in-home detoxification and use of the medication naltrexone as adjuncts to treatment.

scholarly journals The motor repertoire of older adult fallers may constrain their response to balance perturbations

2018 ◽  
Vol 120 (5) ◽  
pp. 2368-2378 ◽  
Author(s):  
Jessica L. Allen ◽  
Jason R. Franz
Keyword(s):  
Older Adults ◽  
Visual Perception ◽  
Older Adult ◽  
Balance Control ◽  
Lateral Instability ◽  
Increased Risk ◽  
Motor Module ◽  
Risk Of Falls ◽  
History Of ◽  
Walking Balance

Older adults are at a high risk of falls, and most falls occur during locomotor activities like walking. This study aimed to improve our understanding of changes in neuromuscular control associated with increased risk of falls in older adults in the presence of dynamic balance challenges during walking. Motor module (also known as muscle synergy) analyses identified changes in the neuromuscular recruitment of leg muscles during walking with and without perturbations designed to elicit the visual perception of lateral instability. During normal walking we found that a history of falls (but not age) was associated with reduced motor module complexity and that age (but not a history of falls) was associated with increased step-to-step variability of module recruitment timing. Furthermore, motor module complexity was unaltered in the presence of optical flow perturbations. The specific effects of a history of falls on leg muscle recruitment included an absence and/or inability to independently recruit motor modules normally recruited to perform biomechanical functions important for walking balance control. These results suggest that fallers do not recruit the appropriate motor modules necessary for well-coordinated walking balance control even in the presence of perturbations. The identified changes in the modular control of walking balance in older fallers may either represent a neural deficit that leads to poor balance control or a prior history of falls that results in a compensatory motor adaptation. In either case, our study provides initial evidence that a reduced motor repertoire in older adult fallers may be a constraint on their ability to appropriately respond to balance challenges during walking. NEW & NOTEWORTHY This is the first study to demonstrate a reduced motor repertoire during walking in older adults with a history of falls but without any overt neurological deficits. Furthermore, using virtual reality during walking to elicit the visual perception of lateral instability, we provide initial evidence that a reduced motor repertoire in older adult fallers may be a constraint on their ability to appropriately respond to balance challenges during walking.

Sexual Abuse in People with Alcohol Problems

1996 ◽  
Vol 169 (3) ◽  
pp. 355-360 ◽  
Author(s):  
Joanna Moncrieff ◽  
D. Colin Drummond ◽  
Bridget Candy ◽  
Ken Checinski ◽  
Roger Farmer
Keyword(s):  
Sexual Abuse ◽  
Alcohol Dependence ◽  
Additional Data ◽  
Alcohol Misuse ◽  
Alcohol Problems ◽  
Drinking Behaviour ◽  
Increased Risk ◽  
History Of ◽  
Drug Problems ◽  
Alcohol Related Problems

BackgroundThere is evidence that people with a history of sexual abuse may have an increased risk of developing alcohol and drug problems.MethodA self-completion sexual abuse questionnaire was designed and administered to a sample of attenders at three London alcohol services. Drinking behaviour was assessed using the Severity of Alcohol Dependence Questionnaire and the Alcohol Problems Questionnaire, and additional data were derived from case notes.ResultsFifty-four per cent of women and 24% of men identified themselves as victims of sexual abuse or assault. For the majority this had started before the age of 16 and involved non-relatives. Subjects with a history of sexual abuse were younger, reached drinking milestones earlier, were more likely to have a family history of alcohol misuse and had more alcohol-related problems than non-abused subjects. Sexual abuse, age and alcohol dependence predicted level of problems in a regression analysis.ConclusionsThe high rates of sexual abuse and its association with indications of increased morbidity suggest it is an important issue for the management of alcohol problems. More use could be made of self-completion questionnaires for the investigation of sexual abuse.

Identifying and responding to alcohol misuse in memory clinics: current practice, barriers and facilitators

2015 ◽  
Vol 8 (2) ◽  
pp. 65-77
Author(s):  
Anna Thake ◽  
Sarah Wadd ◽  
Kim Edwards ◽  
James Randall-James
Keyword(s):  
Cognitive Impairment ◽  
Alcohol Use ◽  
Current Practice ◽  
Alcohol Misuse ◽  
Family Members ◽  
Alcohol Screening ◽  
Alcohol Problems ◽  
Barriers And Facilitators ◽  
Content Type ◽  
Memory Clinics

Purpose – The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics. Design/methodology/approach – A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England. Findings – Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers. Research limitations/implications – Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings. Practical implications – Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits. Originality/value – This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

Zusammenhang zwischen sportlicher Aktivität und alkoholbezo- genen Störungen bei Studierenden

2017 ◽  
Vol 63 (1) ◽  
pp. 33-41
Author(s):  
Arne Göring ◽  
Malte Jetzke ◽  
Sabrina Rudolph
Keyword(s):  
Young Adult ◽  
Screening Test ◽  
Alcohol Problems ◽  
Alkoholbezogene Störungen

Zusammenfassung. Hintergrund und Ziel: Gegenüber dem Bevölkerungsdurchschnitt liegen die Prävalenzraten alkoholbezogener Störungen von Studierenden deutlich über dem Durchschnitt der nichtstudentischen Bevölkerung. Bislang existieren in Deutschland keine Studien zur Frage, welchen Einfluss sportliche Aktivitäten auf die Ausprägung alkoholbezogener Störungen bei Studierenden besitzen. Die vorliegende Studie untersucht diesen Zusammenhang bei Studierenden einer deutschen Volluniversität. Methodik: Im Rahmen einer repräsentativen Onlinestudie wurden 1383 Studierende einer deutschen Universität zu ihrem Alkoholkonsum, den damit verbundenen sozialen Folgen und ihren sportlichen Aktivitäten befragt. Als Instrument kam der 27 Items umfassende Young Adult Alcohol Problems Screening Test sowie ein Erhebungsverfahren zur Erfassung der habituellen sportlichen Aktivität zum Einsatz. Ergebnisse: Studierende, die regelmäßig und intensiv sportlich aktiv sind, weisen eine höhere Screeningrate für alkoholbezogene Störungen auf als Studierende, die gar nicht oder nur unregelmäßig aktiv sind. Dieser Zusammenhang gilt insbesondere für Mannschaftssportarten, aber auch für Fitnessaktivitäten. Schlussfolgerungen: Die Ergebnisse der Studie bestätigen amerikanische Forschungsbeiträge, die sportliche Aktivitäten bei Studierenden als einen Treiber für den Alkoholkonsum identifizieren. Sportorganisationen im Umfeld von Hochschulen sollten in der Alkoholprävention an Hochschulen zukünftig eine größere Berücksichtigung finden.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

2017 ◽  
Vol 2 (5) ◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Prescription

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

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