The effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care (AESOPS) – A randomised control trial protocol

Coulton, Simon; Watson, Judith; Bland, Martin; Drummond, Colin; Kaner, Eileen; Godfrey, Christine; Hassey, Alan; Morton, Veronica; Parrott, Steve; Phillips, Tom; Raistrick, Duncan; Rumball, Daphne; Tober, Gillian

doi:10.1186/1472-6963-8-129

Cited by 24 publications

(16 citation statements)

References 38 publications

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“…Recent literature suggests that 11–33% of older people misuse alcohol and the physical, cognitive and psychological effects are greater than in younger people 3 4. Due to the physiological changes of aging, older people may experience alcohol related problems at lower consumption levels 5. Excessive alcohol consumption is associated with a higher risk of dementia,6 and around 10% of dementias are directly related to alcohol 7 8…”

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confidence: 99%

Alcohol in moderation, premorbid intelligence and cognition in older adults: results from the Psychiatric Morbidity Survey

Cooper

Bebbington

Meltzer

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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Aims: To test the hypothesis that the association previously reported between moderate alcohol use and better cognition, is an artefact of confounding by (a) higher premorbid education and socioeconomic status; (b) a lifestyle of moderation (using smoking as a risk marker); and (c) decreased alcohol consumption in people with physical illnesses. Method Results:The relationship between current cognition and alcohol use was reduced and no longer significant after considering premorbid intelligence or physical health. In our final model, the significant predictors of current cognition amongst non-problem drinkers were: age (B=-.13,-.18--.08, p<0.001) and crystallised intelligence (B=0.14,.12-.17,p<0.001).Smoking was not associated with cognition. Conclusions:In people who were not problem drinkers, higher alcohol intake was not associated with improved current cognition after controlling for premorbid intelligence and physical health. Our findings suggest that, despite previous suggestions, moderate alcohol consumption does not protect older people from cognitive decline.3

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confidence: 99%

Alcohol in moderation, premorbid intelligence and cognition in older adults: results from the Psychiatric Morbidity Survey

Cooper

Bebbington

Meltzer

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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“…14 An ongoing study being conducted in primary care in the UK estimates the prevalence of AUD, using the Alcohol Use Disorders Identification Test (AUDIT), as between 8 and 10% in those aged 55 years or more. 15 Studies on older populations, those aged 75 years or more, indicate a reduction in prevalence of AUD of 5% for males and 2.5% for females. 16 In-patient studies tend to indicate a higher prevalence of AUD than communitydwelling populations, 18% for hospital in-patients and 23-44% for psychiatric in-patients.…”

Section: Prevalencementioning

confidence: 98%

“…Stepped care interventions for older alcohol users, aged 55 years or more, are currently being evaluated in the United Kingdom. 15 In this study, older people who score positive for AUD using the AUDIT questionnaire, are randomized to receive either a minimal intervention or stepped care. The stepped care approach involves three consecutive steps of increasing intensity.…”

Section: Treatmentmentioning

confidence: 99%

Alcohol use disorders in older people

Coulton

2009

Rev. Clin. Gerontol.

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The number of people aged 65 years or more is increasing worldwide. Alcohol use disorders (AUD) are a common condition in the older population, and this combined with the changing age demographic in the population means that AUD in this population is a significant public health concern. AUD has a major impact upon the physical, psychological and social health of the older population. There is evidence that older people do benefit from interventions to reduce alcohol consumption as much as, if not more than, younger populations. There is evidence that AUD in the older population often goes undetected and the potential for beneficial behavioural health change is not realized.

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“…Older adults are at particular risk for negative health outcomes from SUDs including falls, hypertension, cancer, early onset dementia, cognitive deficits, and a host of chronic medical health conditions (Coulton et al, 2008; Rosen, Hunsaker, Albert, Cornelius,& Reynolds, 2011). The additional burden of comorbid mental health disorders associated with SUDs further complicates effective diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

Rosen

Engel

Hunsaker

et al. 2013

Social Work in Public Health

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This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.

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The effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care (AESOPS) – A randomised control trial protocol

Cited by 24 publications

References 38 publications

Alcohol in moderation, premorbid intelligence and cognition in older adults: results from the Psychiatric Morbidity Survey

Alcohol in moderation, premorbid intelligence and cognition in older adults: results from the Psychiatric Morbidity Survey

Alcohol use disorders in older people

Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

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