The elderly comprise the fastest growing segment of the population and are at increased risk for development of disabling illness. The number one disabling illness in the elderly is stroke. Emerging evidence suggests that problem drinking affects a larger portion of the elderly than previously thought. Problem drinking in the elderly frequently goes unrecognized because of its relationship with other conditions associated with the aging process. Early identification of problem drinking in the elderly has been a paramount concern, partly reflecting increased awareness of their increased susceptibility to adverse health consequences. Thus far, research has focused primarily on the causal connection between alcohol and incidence of stroke while ignoring the impact of alcohol on stroke recovery. The proposed study will address limitations of the current literature by examining the impact of current problem drinking on recovery following stroke. We will use prospective methods of investigation to examine correlates of problem drinking in elderly hospitalized patients with acute stroke to define the role of alcohol in impeding post-stroke recovery.
Our specific aims are as follows: 1) determine the relationship between current problem drinking and cognition, mood, functional abilities, and stroke severity, 2) determine the impact of current problem drinking on mood, cognition, and functional recovery in the hospital, 3) determine the relationship between problem drinking and outcome measures within the hospital; and 4) determine the relationship between post-stroke resumption of drinking and outcome measures, such as driving and return to work. My career goal is to be an alcohol researcher who draws upon the tools of analytic investigation and interventional science to understand and optimize functional recovery in patients after disabling illness. Therefore, I propose the following two areas of career enhancement training to prepare me for this task: 1) epidemiology and research methodology and 2) hospital-based alcohol treatment interventions. Results of this investigation will lead to development of a pilot project in year 04 and an RO1 proposal in year 05 of the proposal exploring the efficacy of brief hospital-based intervention strategies in this population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AA013898-03
Application #
6917894
Study Section
Special Emphasis Panel (ZAA1-FF (16))
Program Officer
Breslow, Rosalind
Project Start
2003-07-01
Project End
2008-06-30
Budget Start
2005-07-01
Budget End
2006-06-30
Support Year
3
Fiscal Year
2005
Total Cost
$141,813
Indirect Cost
Name
Johns Hopkins University
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Yantz, Christine L; Johnson-Greene, Doug; Higginson, Christopher et al. (2010) Functional cooking skills and neuropsychological functioning in patients with stroke: an ecological validity study. Neuropsychol Rehabil 20:725-38
Johnson-Greene, Doug; Touradji, Pegah; Emmerson, Lindsay C (2009) The Three Cities Test: preliminary validation of a short bedside memory test in persons with acute stroke. Top Stroke Rehabil 16:321-9
Johnson-Greene, Doug; McCaul, Mary E; Roger, Patricia (2009) Screening for hazardous drinking using the Michigan Alcohol Screening Test-Geriatric Version (MAST-G) in elderly persons with acute cerebrovascular accidents. Alcohol Clin Exp Res 33:1555-61
Spencer, Robert J; Johnson-Greene, Doug (2009) The Cognitive Estimation Test (CET): psychometric limitations in neurorehabilitation populations. J Clin Exp Neuropsychol 31:373-7