Up to 40 percent of older persons who drink may be at-risk for harm. This risk is due to age-related physiological changes that increase the effects of a given dose of alcohol and age-associated increases in comorbidity and medication use that may cause adverse effects when even small amounts of alcohol are consumed. Most trials of brief advice to reduce drinking among primarily younger populations have reduced subjects' alcohol use by 10-20 percent. These trials have focused on drinkers who are at risk because of the amount they drink, or because they have symptoms of alcohol abuse or dependence. No trials have yet focused on older drinkers who are at risk because of the interaction of alcohol use and co-morbidity (e.g., diabetes, hypertension) and medication use (e.g., anticoagulants, nonprescription antihistamines). To test whether a screening and brief advice preventive intervention targeted to older persons may reduce such at-risk drinking and prevent subsequent harm, we propose a 12-month, randomized, controlled trial involving 880 subjects attending primary care clinics at two non-academic sites. Our intervention will consist of advice given to both at-risk drinkers and their physicians personalized to address the particular reasons a subject is identified as an at-risk drinker. We will identify at-risk drinkers using a new screening measure, the Short Alcohol-Related Problems Survey (shARPS). Respondents may be identified as at-risk drinkers because they have a single risk (e.g., drinking and using benzodiazepines) or multiple risks (e.g., drinking and using narcotics, drinking and having depression). At-risk drinkers will be randomized to either receive brief advice about at-risk drinking (intervention) or a booklet on healthy behaviors (control). To assess the efficacy of the intervention, subjects will undergo assessments of their alcohol-associated risks at recruitment, and 3 and 12 months later. Our analyses will assess the effect of the intervention on the prevalence of at-risk drinking, the amount of drinking, and the numbers of risks identifying those subjects still considered at-risk drinkers. This study will be the first to assess a preventive intervention to reduce risks of alcohol use, alone or in conjunction with comorbidity and medication use among older adults in primary care. If such an intervention is successful, potentially hundreds of thousands of older persons may benefit from a reduction in their risks associated with alcohol use and prevention of harm.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA013937-04
Application #
7106387
Study Section
Social Sciences, Nursing, Epidemiology and Methods 4 (SNEM)
Program Officer
Scott, Marcia S
Project Start
2003-08-15
Project End
2009-07-31
Budget Start
2006-08-01
Budget End
2009-07-31
Support Year
4
Fiscal Year
2006
Total Cost
$390,884
Indirect Cost
Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Barnes, Andrew J; Xu, Haiyong; Tseng, Chi-Hong et al. (2016) The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study. J Subst Abuse Treat 60:14-20
Mosqueda, Laura; Burnight, Kerry; Gironda, Melanie W et al. (2016) The Abuse Intervention Model: A Pragmatic Approach to Intervention for Elder Mistreatment. J Am Geriatr Soc 64:1879-83
Sanna, Maija B; Tuqan, Alia T; Goldsmith, Jeff S et al. (2015) Characteristics of older at-risk drinkers who drive after drinking and those who do not drive after drinking. Traffic Inj Prev 16:104-8
Ettner, Susan L; Xu, Haiyong; Duru, O Kenrik et al. (2014) The effect of an educational intervention on alcohol consumption, at-risk drinking, and health care utilization in older adults: the Project SHARE study. J Stud Alcohol Drugs 75:447-57
Borok, Jenna; Galier, Peter; Dinolfo, Matteo et al. (2013) Why do older unhealthy drinkers decide to make changes or not in their alcohol consumption? Data from the Healthy Living as You Age study. J Am Geriatr Soc 61:1296-302
Lin, James C; Guerrieri, Joy Gioia; Moore, Alison A (2011) Drinking patterns and the development of functional limitations in older adults: longitudinal analyses of the health and retirement survey. J Aging Health 23:806-21
Moore, Alison A; Blow, Fred C; Hoffing, Marc et al. (2011) Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial. Addiction 106:111-20
Lin, James C; Karno, Mitchell P; Tang, Lingqi et al. (2010) Do health educator telephone calls reduce at-risk drinking among older adults in primary care? J Gen Intern Med 25:334-9
Lin, James C; Karno, Mitchell P; Barry, Kristen L et al. (2010) Determinants of early reductions in drinking in older at-risk drinkers participating in the intervention arm of a trial to reduce at-risk drinking in primary care. J Am Geriatr Soc 58:227-33
Karlamangla, Arun S; Sarkisian, Catherine A; Kado, Deborah M et al. (2009) Light to moderate alcohol consumption and disability: variable benefits by health status. Am J Epidemiol 169:96-104

Showing the most recent 10 out of 12 publications