Cambridge Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK.
Age Ageing. 2018 Mar 1;47(2):175-184. doi: 10.1093/ageing/afx132.
harmful alcohol consumption is reported to be increasing in older people. To intervene and reduce associated risks, evidence currently available needs to be identified.
two systematic reviews in older populations (55+ years): (1) Interventions to prevent or reduce excessive alcohol consumption; (2) Interventions as (1) also reporting cognitive and dementia outcomes. Comprehensive database searches from 2000 to November 2016 for studies in English, from OECD countries. Alcohol dependence treatment excluded. Data were synthesised narratively and using meta-analysis. Risk of bias was assessed using NICE methodology. Reviews are reported according to PRISMA.
thirteen studies were identified, but none with cognition or dementia outcomes. Three related to primary prevention; 10 targeted harmful or hazardous older drinkers. A complex range of interventions, intensity and delivery was found. There was an overall intervention effect for 3- and 6-month outcomes combined (8 studies; 3,591 participants; pooled standard mean difference (SMD) -0.18 (95% CI -0.28, -0.07) and 12 months (6 studies; 2,788 participants SMD -0.16 (95% CI -0.32, -0.01) but risk of bias for most studies was unclear with significant heterogeneity. Limited evidence (three studies) suggested more intensive interventions with personalised feedback, physician advice, educational materials, follow-up could be most effective. However, simple interventions including brief interventions, leaflets, alcohol assessments with advice to reduce drinking could also have a positive effect.
alcohol interventions in older people may be effective but studies were at unclear or high risk of bias. Evidence gaps include primary prevention, cost-effectiveness, impact on cognitive and dementia outcomes.
据报道，老年人的有害饮酒量正在增加。为了进行干预并降低相关风险，需要确定现有的证据。
对两个老年人群体（55 岁以上）进行了两项系统评价：（1）预防或减少过度饮酒的干预措施；（2）作为（1）报告认知和痴呆结局的干预措施。从 2000 年到 2016 年 11 月，在英语的经合组织国家中进行了全面的数据库搜索。排除了酒精依赖治疗。数据以叙述性和荟萃分析的方式进行综合。使用 NICE 方法评估偏倚风险。根据 PRISMA 报告审查。
确定了 13 项研究，但没有一项研究涉及认知或痴呆结局。其中三项与初级预防有关；10 项针对有害或危险的老年饮酒者。发现了一系列复杂的干预措施、强度和交付方式。3 个月和 6 个月的综合结果（8 项研究；3591 名参与者；合并标准均数差（SMD）-0.18（95%置信区间-0.28，-0.07）和 12 个月（6 项研究；2788 名参与者 SMD -0.16（95%置信区间-0.32，-0.01）有总体干预效果，但大多数研究的偏倚风险不明确，存在显著异质性。有限的证据（三项研究）表明，更密集的干预措施，包括个性化反馈、医生建议、教育材料、随访，可能最有效。然而，简单的干预措施，包括简短干预、传单、评估饮酒情况并提供减少饮酒的建议，也可能产生积极影响。
老年人的饮酒干预措施可能有效，但研究存在不明确或高偏倚风险。证据缺口包括初级预防、成本效益、对认知和痴呆结局的影响。
