Preface

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Alcohol and older people from a public health perspective

OBJECTIVES AND METHODS: As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. RESULTS: 369 references were identified, from which 78 papers were selected. CONCLUSIONS: The review confirms the paucity of data on this topic and the need for more specific research. Although there is scarce evidence, the elderly seems to respond equally well to alcohol policy, screening instruments and brief interventions as do younger adults. According to a lifecycle approach, a future focus on the middle aged is also recommended

Alcohol and older people: the European project VINTAGE: good health into older age; design, methods and major results

Consum d'alcohol; Persones grans; Disseny de recercaConsumo de alcohol; Personas mayores; Diseño de investigaciónAlcohol drinking; Aged; Research designObjectives: The European project VINTAGE – Good Health Into Older Age aims at filling the knowledge gap and building capacity on alcohol and the elderly, encouraging evidence- and experience-based interventions. Methods: Systematic review of scientific literature on the impact of alcohol on older people; ad hoc survey and review of grey literature to collect EU examples of good practices for prevention; dissemination of findings to stakeholders involved in the field of alcohol, aging or public health in general. Results: Design and procedures of the VINTAGE project are described, providing also an outline of major results, with particular attention to those related to the dissemination activity. Conclusions: Much more information and research is needed. This issue should be part of both alcohol and healthy ageing policies.The VINTAGE project “Good Health into Older Age” is a project funded by the Executive Agency for Health and Consumers, under the European Commission Second Programme of Community Action in the Field of Health 2008-2013 (Grant Agreement no. 20081203)

Longevity and health expectancy in an ageing society: implications for public health in Italy

Summary. Introduction. While the prolongation of life expectancy is due to medical, economic, social and public health advancements, longevity may not necessarily be an indicator of real development. Epidemiologic data indicate, in fact, that advanced age carries the risk of multiple diseases, disability and loss of autonomy. Materials and methods. How the years gained are lived need to be assessed evaluating quality of life, health status, and disability. Results and conclusions. Good health care planning should aim to ensure that the years of life gained are lived in good health conditions in the light of the World Health Organization's declaration that "increased longevity without quality of life is an empty prize. Health expectancy is more important than life expectancy"

Randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website: cost-effectiveness analysis

To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a standard face-to-face brief intervention (BI)

Alcohol and older people. The European project VINTAGE: good Health Into Older Age. Design, methods and major results

OBJECTIVES: The European project VINTAGE - Good Health Into Older Age aims at filling the knowledge gap and building capacity on alcohol and the elderly, encouraging evidence- and experience-based interventions. METHODS: Systematic review of scientific literature on the impact of alcohol on older people; ad hoc survey and review of grey literature to collect EU examples of good practices for prevention; dissemination of findings to stakeholders involved in the field of alcohol, aging or public health in general. RESULTS: Design and procedures of the VINTAGE project are described, providing also an outline of major results, with particular attention to those related to the dissemination activity. CONCLUSIONS: Much more information and research is needed. This issue should be part of both alcohol and healthy ageing policies

Randomised controlled non-inferiority trial of primary care based facilitated access to an alcohol reduction website (EFAR-FVG)

Introduction There is a strong body of evidence demonstrating effectiveness of brief interventions by primary care professionals for risky drinkers but implementation levels remain low. Facilitated access to an alcohol reduction website constitutes an innovative approach to brief intervention, offering a time-saving alternative to face to face intervention, but it is not known whether it is as effective. Objective To determine whether facilitated access to an alcohol reduction website is equivalent to face to face intervention. Methods Randomised controlled non-inferiority trial for risky drinkers comparing facilitated access to a dedicated website with face to face brief intervention conducted in primary care settings in the Region of Friuli Venezia-Giulia, Italy. Adult patients are given a leaflet inviting them to log on to a website to complete the AUDIT-C alcohol screening questionnaire. Screen positives are requested to complete an online trial module including consent, baseline assessment and randomisation to either standard intervention by the practitioner or facilitated access to an alcohol reduction website. Follow up assessment of risky drinking is undertaken online at 1 month, 3 months and 1 year using the full AUDIT questionnaire. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. The trial is being undertaken as an initial pilot and a subsequent main trial. Results 12 practices have participated in the pilot, and more than 1300 leaflets have been distributed. 89 patients have been recruited to the trial with a one month follow-up rate of 79%. Discussion The findings of the pilot study suggest that the trial design is feasible, though modifications will be made to optimize performance in the main trial which will commence in January 2014. Plans are concurrently underway to replicate the trial in Australia, and potentially in the UK and Spain