Thursday, 21 August 2003
This presentation is part of : Thursday Poster Sessions

PD-017 Alcohol Consumption in Primary Care Elderly Patients: Demographic Characteristics and Comorbidities

U. Nalla Banu Durai1, John S. McIntyre2, Karen Lynn Cheal3, Elizabeth Catherine McDonel Herr4, and Sue Ellen Levkoff3. (1) Psychiatry, VA Chicago Health Care System, Chicago, IL, USA, (2) Psychiatry, Unity Health system, Rochester, NY, USA, (3) Psychiatry, Brigham and Women's Hospital, Boston, MA, USA, (4) US Dept of Health and Human Services, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA

Objective: Existing data indicate that moderate alcohol consumption is associated with positive physical health and better performance on cognitive tests, but little is known about the effects of alcohol consumption in the elderly. Also, very little information is available with regard to the effects of alcohol consumption on mental health in the elderly population. In order to determine whether there is an association between alcohol consumption and physical and mental health effects in the elderly, we analyzed data on a large sample of primary care elderly subjects.

Design: Analysis of cross-sectional data obtained through a screening questionnaire.

Materials and Methods: As part of the PRISMe study to compare two models of mental health care, integrated vs. referral, approximately 27000 patients 65 years and older from 34 primary care clinics in six VA medical centers, three community health centers, and two hospital-based networks were screened for depression, anxiety and alcohol use. Alcohol use was defined as in excess of seven drinks or more per week (the NIAAA guideline) or three or more episodes of binge drinking (four or more standard drinks on a drinking occasion) per quarter. Over 3000 patients screened positive and underwent further assessment to be randomized into the study for at-risk drinking (12 or more drinks per week for women and 14 or more for men or 4 or more binges in the past three months), depressive and/or anxiety disorders. Approximately 600 patients were enrolled in the study for at-risk drinking. The health and lifestyle factors of persons categorized as light (1-11 drinks/week), medium (12-20 drinks/week), and heavy (21 or more drinks/week) drinkers were compared using Chi-square and ANOVA techniques.

Results: Preliminary findings indicate that moderate drinkers are more likely to be married (p<0.001), better educated (p<0.02), and to have better perceived health (p<0.001) and fewer hospitalizations (p<0.05). Moderate drinkers are less likely to smoke (p<0.001). In general, the risk profile of this group is better, compared to lighter or heavier drinkers.

Conclusion: Preliminary results indicate a non-linear relationship between alcohol consumption and other health and lifestyle factors, in this sample of older adults. Additional planned analyses include an examination of cognitive function, depression status, and control for potential confounders. We did ascertain whether patients had a drink in the past year; however, we did not ascertain whether they were lifetime abstainers. Other published studies indicate that moderate levels of alcohol consumption tend to be beneficial when compared to both light drinkers and life-time abstainers. Longitudinal prospective studies are needed to determine safe levels of alcohol consumption in the elderly population.

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