Friday, April 30, 2010

At Risk Drinking Common Among Older Primary Care Patients


Journal of General Internal Medicine

Online First
16 April 2010

Prevalence and Correlates of At-Risk Drinking Among Older Adults: The Project SHARE Study
Andrew J. Barnes, Alison A. Moore, Haiyong Xu, Alfonso Ang, Louise Tallen, Michelle Mirkin and Susan L. Ettner


ABSTRACT

BACKGROUND 
At-risk drinking, excessive or potentially harmful alcohol use in combination with select comorbidities or medication use, affects about 10% of elderly adults and is associated with higher mortality. Yet, our knowledge is incomplete regarding the prevalence of different categories of at-risk drinking and their associations with patient demographics.

OBJECTIVE 
To examine the prevalence and correlates of different categories of at-risk drinking among older adults.

DESIGN 
Cross-sectional analysis of survey data.

SUBJECTS 
Current drinkers ages 60 and older accessing primary care clinics around Santa Barbara, California (n=3,308).

MEASUREMENTS 
At-risk drinkers were identified using the Comorbidity Alcohol Risk Evaluation Tool (CARET). At-risk alcohol use was categorized as alcohol use in the setting of 1) high-risk comorbidities or 2) high-risk medication use, and 3) excessive alcohol use alone. Adjusted associations of participant characteristics with at-risk drinking in each of the three at-risk categories and with at-risk drinking of any kind were estimated using logistic regression.

RESULTS 
Over one-third of our sample (34.7%) was at risk. Among at-risk individuals, 61.9% had alcohol use in the context of high-risk comorbidities, 61.0% had high-risk medication use, and 64.3% had high-risk alcohol behaviors. The adjusted odds of at-risk drinking of any kind were decreased and significant for women (odds ratio, OR=0.41; 95% confidence interval: 0.35-0.48; p-value<0.001), adults over age 80 (OR=0.55; CI: 0.43-0.72; p<0.001 vs. ages 60-64), Asians (OR=0.40; CI: 0.20-0.80; p=0.01 vs. Caucasians) and individuals with higher education levels. Similar associations were observed in all three categories of at-risk drinking.

CONCLUSIONS 
High-risk alcohol use was common among older adults in this large sample of primary care patients, and male Caucasians, those ages 60-64, and those with lower levels of education were most likely to have high-risk alcohol use of any type. Our findings could help physicians identify older patients at increased risk for problems from alcohol consumption.

This project was funded by the National Institute of Alcohol Abuse and Alcoholism 1RO1AA013990 (PI: Ettner). Dr. Moore’s time was additionally supported by the National Institute on Alcoholism and Alcohol Abuse 1R01AA15957 (PI: Moore).

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