Risky drinking and dual diagnosis in older people under a UK community old age psychiatry service

Abstract

Purpose The assessment of patterns in risky drinking and its association with dual diagnosis in community services for older people remains under-explored. The paper aims to discuss this issue. Design/methodology/approach Drinking risk using the Alcohol Use Disorders Identification Test (AUDIT) and the presence of co-existing mental disorders was examined in 190 people aged 65 and over. Findings In total, 24 per cent of drinkers drank above lower risk levels and 22 per cent reported binge drinking over the past 12 months. Those scoring 1 or more on the AUDIT were more likely to be male and to have greater cognitive impairment than non-drinkers and those reporting no past problems with alcohol. Research limitations/implications Given the limitations of the Mini Mental State Examination in the detection of alcohol related cognitive impairment (ARCI), the use of other cognitive screening instruments in larger study populations is also warranted. Practical implications Greater attention needs to be paid to the assessment of risky drinking in older male drinkers and those with cognitive impairment. Originality/value There is considerable scope for the routine detection of cognitive impairment and dementia in older people with alcohol use within mainstream mental health services, particularly in those with binge drinking. As ARCI is associated with loss of function and independence, early detection and intervention can improve health and social outcomes.

Characteristics of people who have received treatment for late-onset problem drinking and alcohol use disorder: A systematic review and narrative synthesis

“…The high prevalence of psychiatric co-morbidity found in this population (e.g., Charzynska et al, 2011 ; Rao, 2019 ; Rao et al., 2021 ; RCPSYCH, 2018 ; Searby et al, 2015 ) points to a complex relationship between the psychosocial characteristics of late-onset problem drinkers and poor mental health ( Bruce, 2002 ; Emiliussen et al, 2017d ; Shaw & Palattiyil, 2008 ; Ward et al, 2008 ; WHO, 2020 ). Indeed, 12 of the papers in the current review (almost half) reported psychiatric co-morbidity in their participants (see Table 9 ).…”