Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs.

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The extent of alcohol education and GPs' attitudes towards alcohol were associated with the reported number of patients managed. Thus, it is worth exploring the extent to which improved education, using pharmacotherapy in primary health care and a shift to personalized health care in which individual patients are facilitated to undertake their own assessment and management (individual responsibility) might increase the number of heavy drinkers who receive feedback on their drinking and support to reduce their drinking.

Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on allcause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65-84 years old. Participants received identical baseline evaluation at the 1st survey (1992)(1993) and were followed at 2nd (1995)(1996) and 3rd survey (2000)(2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this populationbased study was 7.6% (95% confidence interval (CI) 6.55-8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the cooccurrence among these conditions. Frailty was associated with a significantly increased risk of allcause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52-2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44-2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06-1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88-1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3-(HR 3.33, 95% CI 1.28-8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10-3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short-and long-term predictor of all-cause mortality in nondemented and demented patients.

BackgroundPublic health policies aim to improve and maintain the health of citizens. Relevant data and indicators are needed for a health policy that is based on factual information. After 14 years of work (1998–2012), the multi-phase action on European Community Health Indicators (ECHI) has created a health monitoring and reporting system. It has generated EU added value by defining the ECHI shortlist with 88 common and comparable key health indicators for Europe.MethodsIn the 2009-2012 Joint Action for ECHIM project the ECHI shortlist was updated through consultation with Member State representatives. Guidelines for implementation of the ECHI Indicators at national level were developed and a pilot data collection was carried out.Results67 of the ECHI Indicators are already part of regular international data collections and thus available for a majority of Member States, 14 are close to ready and 13 still need development work. By mid-2012 half of the countries have incorporated ECHI indicators in their national health information systems and the process is ongoing in the majority of the countries. Twenty-five countries were able to provide data in a Pilot Data Collection for 20 ECHI Indicators that were not yet (fully) available in the international databases.ConclusionsThe EU needs a permanent health monitoring and reporting system. The Joint Action for ECHIM has set an example for the implementation of a system that can develop and maintain the ECHI indicators,, and promote and encourage the use of ECHI in health reporting and health policy making. The aim for sustainable public health monitoring is also supported by a Eurostat regulation on public health statistics requiring that health statistics shall be provided according to the ECHI methodology. Further efforts at DG SANCO and Eurostat are needed towards a permanent health monitoring system.

Abstract.Introduction. There is a lack of information about initiatives aimed at preventing the harmful effects of alcohol amongst the elderly. Objectives. One of the objectives of the VINTAGE study was to collect the initiatives carried out in Europe and review the published grey literature about this topic. Methods. Email-based survey addressed to researchers, professionals and policymakers, and internet search of grey literature. Results. Three hundred nine contacts were finally made, and 21 of the 36 collected initiatives were considered as useful in preventing the harmful use of alcohol amongst the elderly. Out of the about 2900 references identified 96 were classified as relevant. Conclusions. Despite a growing interest, alcohol use in the elderly is not yet perceived as a major issue for prevention.Key words: aged, alcohol drinking, promotion, prevention, Europe.Riassunto (Esempi di buona pratica per la prevenzione del consumo dannoso di alcol negli anziani in Europa, il progetto VINTaGE). Introduzione. c'è carenza di informazioni sulle iniziative volte a prevenire gli effetti dannosi del consumo di alcol tra gli anziani. Obiettivi. Uno degli obiettivi dello studio VINTAGE è stato quello di raccogliere esempi di intervento condotti in Europa ed eseguire una revisione della letteratura grigia sull'argomento. Metodi. Indagine via e-mail, rivolta a ricercatori, professionisti e decisori politici, e revisione della letteratura grigia disponibile in Internet. Risultati. Su 309 contatti effettuati, 21 delle 36 iniziative raccolte sono state ritenute utili per la prevenzione del consumo dannoso di alcol tra gli anziani. Novantasei dei circa 2900 riferimenti bibliografici individuati sono stati classificati rilevanti. Conclusioni. Nonostante un crescente interesse, il consumo di alcol tra gli anziani non è ancora percepito come obiettivo prioritario di prevenzione.Parole chiave: anziano, assunzioni di alcoolici, promozione, prevenzione, Europa.

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IntroductionFrailty is a critical intermediate status of the aging process including physical, cognitive, and psychosocial phenotypes. We operationalized a biopsychosocial frailty construct, estimating its association with mild cognitive impairment (MCI) and its subtypes.MethodsIn 1980, older individuals from the population‐based Italian PRoject on the Epidemiology of Alzheimer's disease (IPREA), we investigated cross‐sectional associations among biopsychosocial frailty, MCI, and its subtypes.ResultsParticipants with biopsychosocial frailty showed an increased odds ratio (OR) of MCI [OR: 4.36; 95% confidence interval (CI): 2.60‐7.29; Fisher's exact p < 0.01], particularly for nonamnestic MCI single domain (naMCI‐SD, OR:3.28; 95% CI: 1.35‐7.97; Fisher's exact p = 0.02) and for nonamnestic MCI multiple domain (naMCI‐MD, OR:6.92; 95% CI: 3.37‐14.21; Fisher's exact p < 0.01). No statistically significant associations between amnestic MCI single or multiple domain and biopsychosocial frailty were observed.DiscussionIn a large, older Italian cohort, a biopsychosocial frailty phenotype was associated with MCI, in particular, could be associated with some of its subtypes, that is, naMCI‐SD, and naMCI‐MD.