Advertisement

Journal of General Internal Medicine

, Volume 22, Issue 1, pp 92–97 | Cite as

Alcohol Consumption Among Older Adults in Primary Care

  • JoAnn E. Kirchner
  • Cynthia Zubritsky
  • Marisue Cody
  • Eugenie Coakley
  • Hongtu Chen
  • James H. Ware
  • David W. Oslin
  • Herman A. Sanchez
  • U. Nalla B. Durai
  • Keith M. Miles
  • Maria D. Llorente
  • Giuseppe Costantino
  • Sue Levkoff
Original Article

Background

Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients.

Objectives

To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients.

Design

Cross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers.

Participants

Patients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients.

Measurements

Quantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety.

Results

Of the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1–7 drinks/week), 4.1% were at-risk drinkers (8–14 drinks/week), and 4.5% were heavy (>14 drinks/week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR (95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR (95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables.

Conclusions

The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health.

Key words

elderly alcohol drinking patterns primary care 

Notes

Acknowledgement

The PRISM-E Study is sponsored jointly by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Veterans Affairs (VA), the Health Resources and Services Administration (HRSA), and the Centers for Medicare & Medicaid Services (CMS).

PRISM-E Study investigators (in alphabetical order): Carolyn Aoyama (HRSA), Pat Arean (Co-PI), Stephen Bartels (PI), Hongtu Chen (PI), Henry Chung (Co-PI), Marisue Cody (Co-PI), Giuseppe Costantino (PI), U. Nalla B. Durai (PI), Carroll Estes (PI), Susan Cooley (VA), Jack Fitzpatrick (Co-PI), Brian Goodman (Co-PI), Trevor Hadley (Co-PI), Tim Howell (Co-PI), Ira Katz (Co-PI), JoAnn Kirchner (PI), Dean Krahn (PI), Sue Levkoff (PI), Karen Linkins (Co-PI), Maria Llorente (PI), James Maxwell (Co-PI), Keith Miles (Co-PI), Robert Molokie (Co-PI), Jack McIntyre (PI), Betsy McDonel Herr (SAMHSA), Mike Nazar (Co-PI), Ed Olsen (PI), David Oslin (PI), Tom Oxman (Co-PI), Andy Pomerantz (Co-PI), Louise Quijano (Co-PI), Heidi Syropoulos (Co-PI), William Van Stone (VA), Paul Wohlford (SAMHSA), Cynthia Zubritsky (PI). Finally, we thank Richard Owen for his thoughtful comments and suggestions during the revision of the manuscript and Penny White for her administrative support.

Potential Financial Conflicts of Interest

None disclosed.

References

  1. 1.
    Centers for Disease Control and Prevention and National Center for Health Statistics. National Health Interview Survey, family core and sample adult questionnaires, 2003. http://www.cdc.gov/nchs/data/hus/tables/2003/hus065.pdf.
  2. 2.
    Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug and Alcohol Dependence. 2004;74:223–34.PubMedCrossRefGoogle Scholar
  3. 3.
    Oslin DW. Alcohol use in late life: disability and comorbidity. Journal of Geriatric Psychiatry and Neurology. 2000;13:134–40.PubMedGoogle Scholar
  4. 4.
    Adams WL. Potential for adverse drug–alcohol interactions among retirement community residents. Journal of the American Geriatrics Society. 1995;43:1021–25.PubMedGoogle Scholar
  5. 5.
    Moore AA, Hays RD, Greendale GA, Damesyn M, Reuben DB. Drinking habits among older persons: Findings from the NHANES I Epidemiologic Followup Study (1982–1984). Journal of the American Geriatrics Society. 1999;47:412–16.PubMedGoogle Scholar
  6. 6.
    Colsher PL, Wallace RB. Elderly men with histories of heavy drinking: correlates and consequences. Journal of Studies on Alcohol. 1990; 51:528–35.PubMedGoogle Scholar
  7. 7.
    Adams WL, Barry KL, Fleming MF. Screening for problem drinking in older primary care patients. The Journal of the American Medical Association. 1996;276:1964–67.CrossRefGoogle Scholar
  8. 8.
    Council of Scientific Affairs AMA. Alcoholism in the elderly. The Journal of the American Medical Association. 1996;275:797–801.CrossRefGoogle Scholar
  9. 9.
    Levkoff SE, Chen H, Coakley E, et al. Design and sample characteristics of the PRISM-E multisite randomized trial to improve behavioral health care for the elderly. Journal of Aging and Health. 2004;16:3–27.PubMedCrossRefGoogle Scholar
  10. 10.
    Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H. Validation of a short orientation–memory–concentration test of cognitive impairment. American Journal of Psychiatry. 1983;140:734–39.PubMedGoogle Scholar
  11. 11.
    Bongers IMB, Van Oers JAM. Mode effects of self-reported alcohol use and problem drinking: mail questionnaires and personal interviewing compared. Journal of Studies on Alcohol. 1998;59:280–285.PubMedGoogle Scholar
  12. 12.
    Greenfield TK, Midanik LT, Rogers JD. Effects of telephone versus face-to-face interview modes on reports of alcohol consumption. Addiction. 2000;95:277–284.PubMedCrossRefGoogle Scholar
  13. 13.
    Goldberg DP, Oldehinkel T, Ormel J. Why GHQ threshold varies from one place to another. Psychological Medicine. 1998;28:915–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Goldberg DP, Williams P. A user’s guide to the general health questionnaire. Windsor, England: NFER-Nelson; 1998.Google Scholar
  15. 15.
    Ware JE, Snow K, Kosinski M, Gandek B. SF-36 Health Survey: Manual and interpretation guide. Boston, MA: The Health Institute: New England Medical Center; 1993.Google Scholar
  16. 16.
    NIAAA. Alcohol Alert 40. 1998.Google Scholar
  17. 17.
    Blow FC, Walton MA, Barry KL, Coyne JC, Mudd SA, Copeland LA. The relationship between alcohol problems and health functioning of older adults in primary care settings. Journal of the American Geriatrics Society. 2000;48:769–74.PubMedGoogle Scholar
  18. 18.
    Moore AA, Endo JO, Carter K. Is there a relationship between excessive drinking and functional impairment in older persons? Journal of the American Geriatrics Society. 2003;51:44–49.PubMedCrossRefGoogle Scholar
  19. 19.
    Ostermann J, Sloan FA. Effects of alcohol consumption on disability among the near elderly: a longitudinal analysis. The Milbank Quarterly. 2001;79:487–515.PubMedCrossRefGoogle Scholar
  20. 20.
    Kahana E, Lawrence RH, Kahana B, et al. Long-term impact of preventive proactivity on quality of life of the old-old. Psychosomatic Medicine. 2002;64:382–94.PubMedGoogle Scholar
  21. 21.
    Klatsky AL. Moderate drinking and reduced risk of heart disease. Alcohol Research and Health. 1999;23:15–23.PubMedGoogle Scholar
  22. 22.
    Bridevaux IP, Bradley KA, Bryson CL, McDonell MB, Fihn SD. Alcohol screening results in elderly male veterans: association with health status and mortality. Journal of the American Geriatrics Society. 2004;52: 1510–1517.PubMedCrossRefGoogle Scholar
  23. 23.
    Thomas VS, Rockwood KJ. Alcohol abuse, cognitive impairment, and mortality among older people. Journal of the American Geriatrics Society. 2001;49:415–20.PubMedCrossRefGoogle Scholar
  24. 24.
    Caetano R, Clark CL. Trends in alcohol-related problems among white, blacks, and hispanics: 1984–1995. Alcoholism: Clinical and Experimental Research. 1998;22:534–538.Google Scholar
  25. 25.
    Liberto JG, Oslin DW, Ruskin PE. Alcoholism in older persons: a review of the literature. Hospital and Community Psychiatry. 1992;43:975–84.PubMedGoogle Scholar
  26. 26.
    Barnes GM. Alcohol use among older persons: findings from a Western New York State General Population Survey. Journal of the American Geriatrics Society. 1979;27:244–50.PubMedGoogle Scholar
  27. 27.
    Kua EH. Drinking habits of elderly Chinese. British Journal of Addiction. 1990;85:571–73.PubMedCrossRefGoogle Scholar
  28. 28.
    Bachman JG, Wallace JM, O’Malley PM, Johnston LD, Kurth CL, Neighbors HW. Racial/ethnic differences in smoking, drinking, and illicit drug use among American high school seniors, 1976–1989. American Journal of Public Health. 1991;81:372–77.PubMedCrossRefGoogle Scholar
  29. 29.
    Chermack ST, Blow FC, Hill EM, Mudd SA. The relationship between alcohol symptoms and consumption among older drinkers. Alcoholism: Clinical and Experimental Research. 1996;20:1153–58.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • JoAnn E. Kirchner
    • 1
    • 2
    • 15
  • Cynthia Zubritsky
    • 4
  • Marisue Cody
    • 3
  • Eugenie Coakley
    • 5
  • Hongtu Chen
    • 6
  • James H. Ware
    • 7
  • David W. Oslin
    • 11
    • 12
  • Herman A. Sanchez
    • 14
  • U. Nalla B. Durai
    • 8
  • Keith M. Miles
    • 9
  • Maria D. Llorente
    • 10
  • Giuseppe Costantino
    • 13
  • Sue Levkoff
    • 6
  1. 1.VA South Central Mental Illness Research Education and Clinic CenterLittle RockUSA
  2. 2.University of Arkansas for Medical SciencesLittle RockUSA
  3. 3.VA HSR&D Center for Mental Health and Outcomes ResearchLittle RockUSA
  4. 4.Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.John Snow, Inc.BostonUSA
  6. 6.Department of PsychiatryHarvard Medical SchoolBostonUSA
  7. 7.Harvard School of Public HealthBostonUSA
  8. 8.Chicago VA Health Care SystemChicagoUSA
  9. 9.Department of PsychiatryDartmouth Medical SchoolLebanonUSA
  10. 10.Miami VA Medical CenterUniversity of Miami School of MedicineMiami BeachUSA
  11. 11.Philadelphia VA Medical CenterPhiladelphiaUSA
  12. 12.Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaUSA
  13. 13.Sunset Park Family Health Center Network/Lutheran Medical CenterBrooklynUSA
  14. 14.Trinity Partners, Inc.WalthamUSA
  15. 15.HSR&D Center for Mental Health and Outcomes ResearchLittle RockUSA

Personalised recommendations