Correlates of alcohol-related discussions between older adults and their physicians

J Am Geriatr Soc. 2010 Dec;58(12):2369-74. doi: 10.1111/j.1532-5415.2010.03176.x. Epub 2010 Nov 18.


Objectives: To identify predictors of alcohol-related patient-physician discussions.

Design: Cross-sectional study using baseline data from a randomized controlled trial.

Setting: Community-based group practice.

Participants: Thirty-one physicians in Project Senior Health and Alcohol Risk Education and 3,305 of their patients aged 60 and older who use alcohol and completed a survey that included the Comorbidity Alcohol Risk Evaluation Tool (CARET).

Measurements: At study baseline, older adults were asked whether alcohol-related discussions with a physician had occurred in the prior year. This outcome was modeled using logistic regression models with physician random effects. Predictor variables included patient-level variables such as demographics and seven CARET-defined risk factors, specifically a medical or psychiatric comorbidity that alcohol might worsen, a potentially alcohol-related symptom, use of a medication that may interact negatively with alcohol, excessive quantity or frequency of alcohol use, binge drinking, concern from others about drinking, and drinking and driving. Physician-level predictors (age, sex, years since graduation, specialty) were also included.

Results: The probability of reporting alcohol-related discussions declined with patient age (e.g., odds ratio (OR)=0.40 for patients aged ≥80) and was significantly lower for Latinos (OR=0.38). Drinking and driving (OR=1.69) or concern from others (OR=6.04) were significantly associated with alcohol-related discussions; having comorbidities or using medications that may interact with alcohol were not.

Conclusion: Although patient demographics, including age and ethnicity, are associated with the occurrence of alcohol-related discussions, clinical factors that may negatively interact with alcohol to increase risk are not. This suggests that physicians may not be attuned to the entire spectrum of alcohol-related risks for older adults.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / prevention & control*
  • Alcoholism / prevention & control*
  • Alcoholism / rehabilitation
  • California
  • Cross-Sectional Studies
  • Female
  • Frail Elderly
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Education as Topic*
  • Physician's Role*
  • Physician-Patient Relations*
  • Primary Health Care*
  • Quality of Life
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires