A Scoping Review and Meta-Analysis of Brief Interventions for Older Adults with Alcohol Problems

Background: The population of older adults in America is projected to double between the years of 2010 and 2050, due in large part to the generation known as the baby boomers. Along with this increase in overall population comes an increase in overall substance use rates, including alcohol use. Due to numerous biological and social changes, older adults are at a higher vulnerability to alcohol use than younger age groups. Older adults are also the least likely age group to perceive a need for treatment or be screened for alcohol use by medical professionals. Brief interventions have been established as a means of reducing drinking levels and risks, however little attention has been given to the efficacy of brief interventions in older adult populations. The purpose of this study is to provide a scoping review and meta-analysis of studies which have examined the effectiveness of brief interventions in reducing older adult drinking levels and drinking risks. 

Methods: Multiple databases were searched to identify relevant journal articles, including PsycInfo, PubMed, Social Work Abstracts, SocIndex, Ageline, Cochrane Library, Social Gerontology, Social Services Abstracts, and Google Scholar. Search terms used in these queries included “brief intervention”, “brief alcohol intervention”, “brief advice”, “physician advice”, “motivational interviewing”, and “motivational enhancement”, as well as the inclusion of either “older adult” or “elderly” and “alcohol” to every search. Studies had to include a quantitative design (ideally randomized control trials) with an alcohol measure as a main outcome variable. Studies were then critically appraised and relevant data was extracted. A meta-analysis of results was then conducted using the Cochrane Library’s RevManager 5.

Results: A total of thirteen (N=13) brief intervention studies met the full requirements to be included in the final review. None of the studies included a follow-up beyond 12 months. The most common alcohol outcomes measured were: (1) frequency of drinking, (2) quantity of drinking, (3) binge drinking days, (4) changes in drinking risk levels, and (5) healthcare utilization. Overall, a majority of studies showed significant differences in alcohol measures between intervention and control groups, indicating positive effects of brief interventions. The meta-analysis of 3-month outcomes (N=4) showed a significant effect on mean drinks per week (Z= 2.74, p < .01), with a combined effect size of -0.34 (-0.59, -0.10). At 12 months, interventions had no significant effect on drinks per week (Z=1.56, ns).

Conclusions and Implications: Although with only a few supporting studies, results from this review suggest that brief interventions are effective at reducing drinking levels and alcohol-related risks among older adult problem drinkers in the short-term. To understand the long-term effects of brief interventions, more studies will be needed with attention given to consistent feedback and follow-up throughout the time period of the study. Social work practitioners and researchers can benefit from this work through development and evaluation of additional interventions to improve the long-term substance use outcomes of older adults.