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Enhancing our understanding of drinking in later life: qualitative data refreshes parts that other data cannot reach
- Author:
- FUDGE Nina
- Journal article citation:
- Age and Ageing, 48(1), 2019, pp.3-5.
- Publisher:
- Oxford University Press
This article considers how older people can be at risk of alcohol-related harm. It points out that qualitative studies on drinking in older age provide nuanced detail on the routines and practices behind drinking in later life. For example: most adults consider themselves responsible drinkers; ‘othering’ differentiates themselves from heavier and riskier drinkers and drinking alcohol in later life can be pleasurable, helping to ease social interactions and structure post-retirement day. It concludes that qualitative evidence can be used to develop public health interventions that speak to the people they are intended for. (Original abstract)
Effective treatments for older adult baby boomers with alcohol-use disorders: a literature review
- Authors:
- QUINN Adam, MOWBRAY Orion
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 18(4), 2018, pp.389-410.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Research on patterns of alcohol use among the older adult baby boomer birth cohort suggests considerable challenges to the health care system in the coming decades. This review contributes to the growing knowledge base by summarizing and categorizing the most effective alcohol-use treatments for use with the baby boomer cohort. Following a manual search of more than 7,000 articles published between 1990 and 2015, a review of 19 relevant articles was performed based on guidelines set by the U.S. Preventive Services Task Force. Five articles were rated as good, 11 were rated as fair, and 3 were rated as poor. The publications were divided into 4 interpretive categories consisting of clinic-based interventions, mail-based interventions, primary care physician feedback, and day treatment. Overall, the results suggest that cognitive behaviour-based treatments for alcohol-use disorders, both clinic-based and mail-based, might be effective in reducing drinking among baby boomers. Implications and future research are discussed. (Edited publisher abstract)
Squalor, chaos and feelings of disgust: care workers talk about older people with alcohol problems
- Authors:
- KARLSSON Lis Bodil, GUNNARSSON Evy
- Journal article citation:
- Ageing and Society, 38(8), 2018, pp.1624-1644.
- Publisher:
- Cambridge University Press
Older persons with alcohol problems have today become an all too common part of everyday elder care, but research in this area is still scarce. This article has a Swedish context with the aim of describing and analysing home care workers’ narratives about older people who can be characterised as heavy drinkers, i.e. people with severe alcohol problems who need considerable care for extended periods. Limited knowledge is available concerning this age group. This article therefore fills a knowledge gap about home care workers’ perspective about body work and the abject, and breaches the myth that older individuals should be able to drink as they prefer and/or notions of drinking alcohol as a last enjoyment in life. The care workers talked about how they got drawn into the daily lives of the care recipients and how they ended up in situations where they, on the one hand, removed the consequences of drinking, and on the other, felt that they sustained the drinking by cleaning out dirt and washing the care recipients’ bodies. (Edited publisher abstract)
Alcohol consumption in midlife and old age and risk of frailty: alcohol paradox in a 30-year follow-up study
- Authors:
- STRANDBERG Arto Y, et al
- Journal article citation:
- Age and Ageing, 47(2), 2018, pp.248-254.
- Publisher:
- Oxford University Press
Background: alcohol consumption has many harmful health effects, but also benefits of moderate consumption on frailty have been reported. We examined this relationship longitudinally from midlife to old age. Methods: data of reported alcohol consumption in midlife (year 1974) and in old age (years 2000 and 2003) were available of a socioeconomically homogenous sample of 2360 men (born 1919–34, the Helsinki Businessmen Study). Alcohol consumption was divided into zero (N = 131 at baseline), light (1–98 g/week, N = 920), moderate (99–196, N = 593), and high consumption (>196, n = 716). Incidence of phenotypic frailty and prefrailty was assessed in 2000 and 2003. Alcohol consumption (reference 1–98 g/week, adjusted for age, body mass index and smoking) was related to frailty both longitudinally (from 1974 to 2000, and from 2000 to 2003) and cross-sectionally in 2000 and 2003. Results: during a 30-year follow-up, high consumption clearly decreased whereas lighter consumption remained stable. High consumption in midlife predicted both frailty (odds ratio = 1.61, 95% confidence interval = 1.01–2.56) and prefrailty (1.42; 1.06–1.92) in 2000, association with zero and moderate consumption was insignificant. Cross-sectionally in 2000, both zero (2.08; 1.17–3.68) and high consumption (1.83; 1.07–3.13) were associated with frailty, while in 2003 only zero consumption showed this association (2.47; 1.25–4.88). Conclusion: the relationship between alcohol and frailty is a paradox during the life course. High, not zero, consumption in midlife predicts old age frailty, while zero consumption in old age is associated with frailty, probably reflecting reverse causality. (Publisher abstract)
Interventions to prevent and reduce excessive alcohol consumption in older people: a systematic review and meta-analysis
- Authors:
- KELLY Sarah, et al
- Journal article citation:
- Age and Ageing, 47(2), 2018, pp.175-184.
- Publisher:
- Oxford University Press
Background: harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified. Methods: two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA. Results: thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) −0.18 (95% CI −0.28, −0.07) and 12 months (6 studies; 2,788 participants SMD −0.16 (95% CI −0.32, −0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect. Conclusions: alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes. (Publisher abstract)
Social networks and alcohol use among older adults: a comparison with middle-aged adults
- Authors:
- KIM Seungyoun, et al
- Journal article citation:
- Aging and Mental Health, 22(4), 2018, pp.550-557.
- Publisher:
- Taylor and Francis
Objectives: This study compared the association between social networks and alcohol consumption among middle-aged (MA) and older adults (OA) to better understand the nature of the relationship between those two factors among OA and MA. Method: We examined Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Current drinkers aged over 50 were subdivided into two age groups: MA (50–64, n = 5214) and OA (65 and older, n = 3070). Each age group was stratified into drinking levels (low-risk vs. at-risk) based on alcohol consumption. The size and diversity of social networks were measured. Logistic regression models were used to examine age differences in the association between the social networks (size and diversity) and the probability of at-risk drinking among two age groups. Results: A significant association between the social networks diversity and lower odds of at-risk drinking was found among MA and OA. However, the relationship between the diversity of social networks and the likelihood of at-risk drinking was weaker for OA than for MA. The association between social networks size and at-risk drinking was not significant among MA and OA. Conclusion: The current study suggests that the association between social networks diversity and alcohol use among OA differs from the association among MA, and few social networks were associated with alcohol use among OA. In the future, research should consider an in-depth exploration of the nature of social networks and alcohol consumption by using longitudinal designs and advanced methods of exploring drinking networks. (Publisher abstract)
Satisfaction and difficulties of French professional home caregivers in supporting older people with Alzheimer's disease or alcohol misuse
- Authors:
- MOSCATO Alba, VARESCON Isabelle
- Journal article citation:
- Health and Social Care in the Community, 26(1), 2018, pp.27-34.
- Publisher:
- Wiley
In France, few studies have examined home care when it comes to ageing support and even fewer have considered alcohol misuse in this context. The studies also show that being old and having alcohol use disorders are two unfavourable conditions for receiving help, whereas for the Alzheimer's disease, there is a clear need for optimal care. In this article, the authors study professional home caregiver's perceptions of their job along with their difficulties and satisfactions in supporting older people with Alzheimer's disease or alcohol misuse. Out of the 23 professionals approached, 17 took part in a research interview from October 2013 to January 2014. All interviews were recorded, fully transcribed and lexically analysed with Alceste® software. Among the five classes that were identified from 63% of the initial data, the main themes that emerged illustrate the nature of the associated pathologies, the perceptions and satisfactions related to the profession, their adaptive skills, the difficulties related to the life context of the older person, and the wine consumption of the latter. The lexical discourse analysis shows that the professional home caregivers are involved in looking after not only people with Alzheimer's disease but also those with alcohol misuse. However, despite the difficulties and satisfactions encountered, adaptation to the older people seems to be their priority and one of the many skills that they have acquired during their professionalisation. Most of the older people who are helped are women and the difficulties mentioned by their caregivers usually arise at the time of their death. Lastly, when caring for alcohol misusers, they describe negative attitudes in their support. Although research in this area is rare while home care for the older person, whatever the pathology, is increasing, professionals need to be supported by the associations or companies that employ them and should be trained to help them provide the appropriate care. (Edited publisher abstract)
Drinking in later life: a systematic review and thematic synthesis of qualitative studies exploring older people’s perceptions and experiences
- Authors:
- BAREHAM Bethany Kate, et al
- Journal article citation:
- Age and Ageing, 48(1), 2019, pp.134-146.
- Publisher:
- Oxford University Press
Background: Alcohol presents risks to the health of older adults at levels that may have been ‘safer’ earlier in life. Moderate drinking is associated with some health benefits, and can play a positive role in older people’s social lives. To support healthy ageing, it is necessasrfy to understand older people’s views with regards to their drinking. This study aims to synthesise qualitative evidence exploring the perceptions and experiences of alcohol use by adults aged 50 years and over. Methods: A pre-specified search strategy was applied to Medline, PsychINFO, Scopus, Applied Social Sciences Index and Abstracts and Cumulative Index to Nursing and Allied Health Literature databases from starting dates. Grey literature, relevant journals, references and citations of included articles were searched. Two independent reviewers sifted articles and assessed study quality. Principles of thematic analysis were applied to synthesise the findings from included studies. Results: Of 2,056 unique articles identified, 25 articles met inclusion criteria. Four themes explained study findings: routines and rituals of older people’s drinking; self-image as a responsible drinker; perceptions of alcohol and the ageing body; and older people’s access to alcohol. Differences between gender, countries and social patterns are highlighted. Conclusions: Older people perceive themselves as controlled and responsible drinkers. They may not recognise risks associated with alcohol, but appreciate its role in sustaining social and leisure activities important to health and well-being in later life. These are important considerations for intervention development. Drinking is routinised across the life course and may be difficult to change in retirement. (Edited publisher abstract)
Psychiatric disorders among older prisoners: a systematic review and comparison study against older people in the community
- Authors:
- DI LORITO Claudio, VOLLM Birgit, DENING Tom
- Journal article citation:
- Aging and Mental Health, 22(1), 2018, pp.1-10.
- Publisher:
- Taylor and Francis
Objectives: Despite emerging evidence that older prisoners experience poor mental health, literature in this area is still limited. In the present systematic review and meta-analysis, the authors report on the prevalence of psychiatric disorders among older prisoners and compare their findings against community studies on older people. Methods: The authors searched on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. They carried out bias assessments, rated studies for quality and ran a heterogeneity test. They meta-analysed prevalence rates of psychiatric disorders through an aggregate weighted mean and calculated relative risk (RR) and statistical significance against community studies. Sensitivity analyses were further performed. Results: They reviewed nine studies and obtained the following prevalence: ‘Any psychiatric disorder’ 38.4%, depression 28.3%, schizophrenia/psychoses 5.5%, bipolar disorder 4.5%, dementia 3.3%, cognitive impairment 11.8%, personality disorder 22.9%, alcohol abuse 15.9%, anxiety disorders 14.2%, PTSD 6.2%. Older prisoners were found to have higher RR for every single psychiatric disorder against older people in the community, with the sole exception of alcohol abuse and dementia. The prevalence rates were statistically significantly higher among the prisoners for ‘Any psychiatric disorder’, depression and personality disorder. Overall, the sensitivity analyses confirmed the authors' original results. Conclusion: The findings point at a high prevalence of every single psychiatric disorder among older prisoners, who also experience rates of dementia and alcohol abuse comparable to those reported in the community. The results have relevant implications for policy and practice in this area. Further research is crucial to confirm findings from this study. (Edited publisher abstract)
Unit costs of health and social care 2018
- Authors:
- CURTIS Lesley, BURNS Amanda
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2018
- Pagination:
- 201
- Place of publication:
- Canterbury
Provides unit costs for a range of health and social care services, community based health and care staff and hospital based health care staff. The report details cost at the level of individual service users for: services for older people; services for people with mental health problems; services for people who misuse drugs or alcohol; services for people requiring learning disability support; services for adult requiring physical support; services for children and their families; hospital and related services; and care packages, including support for children, young adult, people with disabilities and older people. It also provides unit cost information for different grades of staff working in a range of settings, including community-based health care and social care staff, and hospital based staff. It also includes two guest articles, on of uses data collected as part of a study of clinical medication reviews in care homes for older people to see whether two different methods of collecting primary and social care resource use data produce similar costs. (Edited publisher abstract)