Aims-To examine whether a multifaceted intervention among older at-risk drinking primary care patients reduced at-risk drinking and alcohol consumption at 3 and 12 months. Design-Randomized controlled trial.Setting-Three primary care sites in southern California.Participants-Six hundred thirty-one adults aged ≥ 55 years who were at-risk drinkers identified by the Comorbidity Alcohol Risk Evaluation Tool (CARET) were randomly assigned between October 2004 and April 2007 during an office visit to receive a booklet on healthy behaviors or an intervention including a personalized report, booklet on alcohol and aging, drinking diary, advice from the primary care provider and telephone counseling from a health educator at 2, 4 and 8 weeks.Measurements-The primary outcome was the proportion of participants meeting at-risk criteria, and secondary outcomes were number of drinks in past 7 days, heavy drinking (4 or more drinks in a day) in the past 7 days and risk score.. Conclusions-A multifaceted intervention among older at-risk drinkers in primary care does not reduce the proportions of at-risk or heavy drinkers, but does reduce amount of drinking at 12 months.

Objectives To examine the prevalence and sociodemographic and health-related correlates of substance use, including alcohol, tobacco and non-medical drug use, among adults aged 65 years and older. Design Cross-sectional, retrospective survey of a population-based sample, the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Setting United States Participants Eight thousand two hundred and five US adults aged 65 years of age and older. Measurements Prevalence of lifetime and past 12-month alcohol use, tobacco use, and non-medical drug use and associations among substance use and sociodemographic and health-related factors. Findings Almost 80% of older adults had used any of the three substances over their lifetimes and more than 50% reported such use over the past 12-months. Alcohol was the most commonly used substance both over the lifetime (74%) and in the past 12-months (45%), followed by tobacco (52% lifetime and 14% past 12-month use); far fewer reported non-medical use of drugs (5% lifetime and 1% past 12-month use). In general, being younger, male, and divorced or separated were factors consistently associated with use of any of the three substances compared to being older, female, and married. Conclusions Most older adults use substances both over their lifetimes and in the past 12-months. Alcohol is the substance of choice for this age group, followed by tobacco; few report non-medical drug use.

No abstract

Background: Accelerometers are being used to assess postural control in adults, but there is little to support their reliability and validity. Objective: To estimate the test-retest reliability of the balance accelerometry measure (BAM) and to describe the known-groups validity of the BAM composite score. Methods: Two measures of standing postural sway were taken across six sensory (vision/stance surface) and motor stance (feet together or tandem) positions from eighteen patients with vestibular disorders and 84 healthy subjects. Test-retest reliability for postural sway was estimated across all conditions using intraclass correlation coefficient (ICC). A composite measure of sway standardized to young healthy subjects on eyes open firm surface stance was compared between groups. Results: Test-retest reliability of postural sway was good (ICC ⩾ 0.74) under all sensory conditions except eyes closed/tandem stance, which was slight to poor. Analysis of the receiver operating characteristic curve for composite scores indicated significant accuracy at identification of subjects in the vestibular/balance disorder groups. Composite standard scores equal or greater than 21.1 identified subjects with vestibular disorders with an accuracy of 72% sensitivity and 68% specificity. Conclusion: The BAM displays good-excellent reliability for five of six sensory-motor conditions. The composite score appears to differentiate healthy from subjects with vestibular disorders.