Elders With Alcohol Dependence Receive Less Aftercare

Previous literature suggests that older patients with alcohol dependence respond as well as or better than younger patients to formal treatment. To contrast treatment outcomes between these groups, researchers studied a cohort of 1358 older and middle-aged patients who entered inpatient rehabilitation for alcohol dependence.

• At baseline, elderly patients had significantly worse physical health, better mental health, and less severe alcohol use than did middle-aged patients.
• Similar proportions of elderly and middle-aged patients completed at least 25 days of inpatient rehabilitation (78% and 83%, respectively) and were abstinent in the month after treatment (~85%).
• However, elderly patients were significantly less likely in the month after treatment to engage in aftercare (odds ratio [OR] 0.6), contact a sponsor (OR 0.5), or report a much- or somewhat-improved quality of life (OR 0.4).

Comments:

Although older patients with alcohol dependence respond well to intensive inpatient treatment, this study found they are almost half as likely as middle-aged patients to receive formal or informal aftercare. The chronic relapsing nature of alcohol dependence suggests the need for ongoing care, and the authors propose that patient management via technology (e.g., telephone, Internet) might fill this gap. Since older patients have significant physical health problems for which they commonly seek medical attention, generalist clinicians have a potential role in the long-term monitoring and management of alcohol dependence among the elderly.

Peter D. Friedmann, MD, MPH

Reference:

Oslin DW, Slaymaker VJ, Blow FC, et al. Treatment outcomes for alcohol dependence among middle-aged and older adults. Addict Behav. 2005;30(7):1431–1436.