Prevalence and correlates of at-risk drinking among older adults: the project SHARE study.
BACKGROUND
At-risk drinking, excessive or potentially harmful alcohol use in combination with select comorbidities or medication use, affects about 10% of elderly adults and is associated with higher mortality. Yet, our knowledge is incomplete regarding the prevalence of different categories of at-risk drinking and their associations with patient demographics.


OBJECTIVE
To examine the prevalence and correlates of different categories of at-risk drinking among older adults.


METHODS
Cross-sectional analysis of survey data.


METHODS
Current drinkers ages 60 and older accessing primary care clinics around Santa Barbara, California (n = 3,308).


METHODS
At-risk drinkers were identified using the Comorbidity Alcohol Risk Evaluation Tool (CARET). At-risk alcohol use was categorized as alcohol use in the setting of 1) high-risk comorbidities or 2) high-risk medication use, and 3) excessive alcohol use alone. Adjusted associations of participant characteristics with at-risk drinking in each of the three at-risk categories and with at-risk drinking of any kind were estimated using logistic regression.


RESULTS
Over one-third of our sample (34.7%) was at risk. Among at-risk individuals, 61.9% had alcohol use in the context of high-risk comorbidities, 61.0% had high-risk medication use, and 64.3% had high-risk alcohol behaviors. The adjusted odds of at-risk drinking of any kind were decreased and significant for women (odds ratio, OR = 0.41; 95% confidence interval: 0.35-0.48; p-value < 0.001), adults over age 80 (OR = 0.55; CI: 0.43-0.72; p < 0.001 vs. ages 60-64), Asians (OR = 0.40; CI: 0.20-0.80; p = 0.01 vs. Caucasians) and individuals with higher education levels. Similar associations were observed in all three categories of at-risk drinking.


CONCLUSIONS
High-risk alcohol use was common among older adults in this large sample of primary care patients, and male Caucasians, those ages 60-64, and those with lower levels of education were most likely to have high-risk alcohol use of any type. Our findings could help physicians identify older patients at increased risk for problems from alcohol consumption.
Barnes
Andrew J
AJ
Department of Health Services, School of Public Health, University of California Los Angeles, P.O. Box 951772, Los Angeles, CA 90095-1772, USA. abarnes2@gmail.com
Moore
Alison A
AA
Xu
Haiyong
H
Ang
Alfonso
A
Tallen
Louise
L
Mirkin
Michelle
M
Ettner
Susan L
SL
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology*; D000437:Alcoholism / Q000191:economics / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D016730:Program Development; D015397:Program Evaluation; D012307:Risk Factors; D012309:Risk-Taking
JAMA. 2003 Jan 1;289(1):70-5
12503979
Arch Intern Med. 1996 Jun 10;156(11):1150-6
8639009
Br J Nurs. 2007 Nov 8-21;16(20):1254-8
18073655
Br J Psychiatry. 1991 Jan;158:72-5
2015453
Pharmacol Res. 2007 Mar;55(3):237-47
17363263
J Stud Alcohol. 2004 Sep;65(5):621-30
15536772
Am J Epidemiol. 1990 Nov;132(5):902-9
2239905
Am J Psychiatry. 2009 Oct;166(10):1162-9
19687131
Health Care Financ Rev. 2006 Spring;27(3):49-61
17290648
Addict Behav. 2007 May;32(5):967-76
16938410
Addiction. 2003 Dec;98 Suppl 2:1-12
14984237
J Am Geriatr Soc. 2006 May;54(5):757-62
16696740
JAMA. 1993 Sep 8;270(10):1222-5
8355385
Am J Public Health. 1991 Apr;81(4):452-7
2003623
South Med J. 2004 Jul;97(7):664-72
15301124
Patient Educ Couns. 2001 Nov;45(2):133-41
11687327
Am J Public Health. 2004 Nov;94(11):1985-91
15514241
Lancet. 2009 Jun 27;373(9682):2223-33
19560604
Int J Technol Assess Health Care. 2001 Winter;17(1):125-36
11329839
Arch Gerontol Geriatr. 2002 Feb;34(1):55-78
14764311
J Geriatr Psychiatry Neurol. 2000 Fall;13(3):115-23
11001133
Med Care. 2005 Mar;43(3):229-36
15725979
J Stud Alcohol. 2002 May;63(3):316-24
12086132
J Stud Alcohol. 2003 Nov;64(6):884-92
14743953
Addiction. 2006 Jan;101(1):91-9
16393195
J Am Geriatr Soc. 2002 Oct;50(10):1717-22
12366628
J Am Coll Cardiol. 2007 Sep 11;50(11):1009-14
17825708
J Am Geriatr Soc. 2003 Jan;51(1):44-9
12534844
J Stud Alcohol. 2003 Mar;64(2):219-26
12713195
Am J Geriatr Pharmacother. 2007 Mar;5(1):64-74
17608249
Med Care. 1999 Feb;37(2):165-79
10024121
J Gen Intern Med. 2007 Jan;22(1):92-7
17351846
Fam Pract. 2003 Jun;20(3):270-5
12738695
Aging (Milano). 2000 Jun;12(3):221-7
10965380
Biometrics. 1999 Jun;55(2):652-9
11318229
Alcohol Clin Exp Res. 2008 Apr;32(4):639-44
18341648