Author
CUMMINGS Sherry M.; BRIDE Brian; RAWLINS-SHAW Ann M .;
Title
Alcohol abuse treatment for older adults: a review of recent empirical research.
Journal citation/publication details
Journal of Evidence-Based Social Work, 3(1), 2006, pp.79-99.
Summary
The seven outcome studies identified for the formal review reported in this paper reveal positive effects, especially when age-specific, cognitive-behavioural and less confrontational treatment approaches are used. However, the evidence base is extremely limited, and more research is needed on the nature of alcohol abuse among older people and the impact of treatment on specific sub-populations such as women and people from minority ethnic groups. All of the research reviewed appears to be from the USA .
Context
Social work practitioners will increasingly confront older people with alcohol disorders as the population ages and the aim of this paper is to enhance practitioners' understanding of these disorders and the availability of effective treatment strategies. It covers a considerable amount of literature in addition to the few studies that are formally reviewed, to provide an insight into the consequences of alcohol abuse for morbidity and mortality among older people, the prevalence of abuse and the kinds of treatment approaches that are in use.
Methods
What sources were used?
The following databases were searched: ETOH [the now archived Alcohol and Alcohol Problems Science Database, 1977-2003, produced by the US National Institute on Alcohol Abuse and Alcoholism]; PsycINFO; Sociofile [the former name of Sociological Abstracts]; PubMed; and AgeLine.
What search terms/strategies were used?
No details are given, apart from a date limitation to material from 1980 onwards.
What criteria were used to decide on which studies to include?
Eligible studies specifically addressed the outcomes of interventions for older adults with alcohol abuse or dependence disorders. No specific definition of 'older adult' was established, and studies that identified subjects as 'old' or 'older' were selected.
Who decided on their relevance and quality?
No details are given. The authors note that the vast majority of the studies they identified were descriptive and did not consider the outcomes of interventions.
How many studies were included and where were they from?
Seven studies were found, summarised in Table 2 which gives details of study populations, sample sizes (16-137 individuals), gender, race, treatment and outcomes. They all appear to be from the USA .
How were the study findings combined?
The synthesis is narrative in nature, with each study described in turn.
Findings of the review
On the basis of the very limited number of outcome studies identified, the authors find that interventions with older alcohol abusers produce positive outcomes including abstinence (four studies), a reduction in alcohol use (two studies) and improvements in general health (one study). Older people seem to do best when treated with a cognitive-behavioural approach (one study), are more likely to comply with treatment and have better outcomes when treated in an older person-specific programme (one study), and have better outcomes when treated in a more supportive, less confrontational environment (one study).
Authors' conclusions
While the number of studies identified in this review is very small, they 'offer important data suggesting the beneficial response of older persons to alcohol treatment programs'. More research, however, is needed to confirm the results of these studies, explore which components of interventions are essential to their success, and extend studies to cover women and those from minority ethnic groups. The adoption of clear definitions of 'abuse' and 'elderly' is also necessary. In the studies reviewed 'light' alcohol use was deemed acceptable by some researchers, while others defined any alcohol use as abuse. Participants ranged from 45 to 91, and people within this span of ages clearly have very different outlooks and face different kinds of challenge in their lives.
Implications for policy or practice
No specific implications are discussed.