Short summary

Background: Rates of problematic alcohol use among adults aged 55+ have been increasing, but only a minority of older adults with problematic alcohol use seek help. Aims: To identify the size of the alcohol treatment gap and the correlates of current and predictors of future help seeking within the group of adults aged 55+ with problematic alcohol use in Denmark. Methods: Registry-and survey based epidemiological study.

Rationale

Background: Alcohol is a significant yet avoidable contributor to morbidity and mortality across age groups. For adults aged 55+, risks are especially high: due to age-related physical changes, these adults have less body water and slower liver function. When they consume alcohol, they experience higher and longer-lasting blood alcohol concentrations than younger individuals. Alcohol use among adults aged 55+ contributes to serious illnesses as cardio-vascular illness, cancer, and stroke. It causes illness exacerbation and unwanted interaction with medication. In spite of these risks, up to 16% of adults aged 55 - 74 and 11% of adults aged 75+ in Southern Denmark, have alcohol misuse. This situation is part of the ongoing ageing of the baby boomer generation which has already led to increased alcohol use rates, alcohol-related mortality, and demand for alcohol treatment among older adults. Older adults with alcohol misuse face a double risk of falling into a treatment gap: alcohol misuse is severely undertreated and older adults have the lowest rate of seeking addiction treatment of any age group. They also face diagnostic under-detection and suboptimal treatment referrals. Despite the significance of the problem, core information is lacking to date in Southern Denmark and in international research on the topic. We do not know the full size of the alcohol treatment gap among older adults in Southern Denmark. We do not know how those who enter treatment differ from those who do not. Importantly, we do not know how to identify those who need extra help to initiate treatment in the future. These are major roadblocks to the planning of alcohol treatment provision in agreement with patient needs in Southern Denmark and across the country.

Project aims Among older adults with alcohol misuse in Southern Denmark, we will investigate: a) the size of the alcohol treatment gap: i. Overall in Southern Denmark ii. Among inpatients treated in somatic hospitals and psychiatry iii. Among outpatients seeing their physician and psychiatric outpatients b) the prevalence of physical illness, psychiatric conditions, loneliness, contacts with hospitals and physicians, gender, and social inequality as predictors of current and future alcohol treatment entry c) trends in all aspects described under a) and b) from 2013 to 2021 d) differences between Southern Denmark and the other regions in factors described in a) and b).

Description of the cohort

Three cohorts are built on participants of the 2013, 2017, and 2021 Danish National Health Survey, respectively. The samples are restricted to those with a positive CAGE-C and age 55 - 80 years.

Data and biological material

Survey data and national registry data (e.g., National Patient Registry, Health Care Registry, Alcohol Treatment Registry)

Collaborating researchers and departments

Research Unit of General Practice, Department of Public Health, University of Southern Denmark

• Prof. Jens Søndergaard, PhD

Unit of Clinical Alcohol Research

• Prof. Anette Søgaard Nielsen, PhD

Team Geriatric Psychiatry, Community Psychiatry, Odense

• Prof. Kjeld Andersen, PhD