title: Functioning, problem behavior and health services use among nursing home residents with alcohol-use disorders: nationwide data from the VA minimum data set.
abstract: OBJECTIVE
  We examined (1) whether nursing home residents with alcohol-use disorders (AUDs) function more poorly, have more behavioral problems and use more health services than do demographically matched controls without such disorders, and (2) whether AUDs interact with alcohol consumption to predict poorer behavioral and health services outcomes among nursing home residents.
  
  
  METHODS
  We used Department of Veterans Affairs (VA) Patient Treatment File data to identify a nationwide sample of older VA nursing home residents with recent AUD diagnoses (n = 3,336) and a demographically matched sample without such diagnoses (n = 3,336). The groups were compared on the Resident Assessment Instrument Minimum Data Set indices of health-related functioning, substance use, problem behavior and health services use. We conducted two-way analyses of variance to determine interactions between presence of an AUD and alcohol consumption on problem behavior and health services use.
  
  
  RESULTS
  Residents with AUD diagnoses functioned somewhat better than demographically matched controls. However, they were more likely to have falls and fractures, difficulties in social functioning and to use more health services. AUD diagnoses interacted with alcohol consumption to predict an elevated risk of falls and fractures and more mental health services use.
  
  
  CONCLUSIONS
  Older residents with an AUD form a distinct nursing home population that functions somewhat better than residents without such disorders but they may pose more challenges to staff and use more health care services. Residents' drinking histories should be considered in formulating nursing home policies about alcohol consumption.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, Menlo Park Division, Menlo Park, California, USA. penny.brennan@med.va.gov
authors.forename: Penny L
authors.initials: PL
authors.lastname: Brennan
authors.forename: Mark A
authors.initials: MA
authors.lastname: Greenbaum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D012114:Residential Treatment; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs