Abstract
Introduction
In people over 65, 1 in 6 drink at increased-risk levels and an estimated 1 million are malnourished. However, little is known about alcohol’s harmful effect on older adults’ nutritional status. Therefore, we measured the nutrient intakes and outcomes of older adults, scoring ≥4 on the AUDIT, at index hospital admission and at 3 to 6 months afterwards.
Methods
This mixed-methods project investigated the nutritional status at baseline and follow-up. Nutrient intakes were measured by 24-hour dietary recalls and compared against the UK Government Reference Nutrient Intakes (RNI). Clinical characteristics were measured by the Alcohol Use Disorder Identification Test (AUDIT), Hospital Anxiety and Depression Scale (HADS-A, HADS-D), Six-Item Cognitive Impairment Test (6-CIT) and a health service use analysis. Exploratory analysis, and descriptive statistics are presented.
Results
At baseline (n=30, 70% male, median age 71yrs (IQR=60-91)), the median nutrient intakes of 19/32 (59.38%) nutrients did not meet the RNI. The median intake (as a percentage of the RNI) for energy (kcal) was 62.77% (IQR=7.14-124.76%), for protein was 134.82% (IQR=10.30-215.33%), for fat was 65.83% (IQR=8.72-130.43%), for carbohydrates was 53.42% (IQR=6.07-201.51%), and for fibres was 32.67% (IQR=0.00-156.03%). At follow-up (n=15), this increased to 22/32 (68.75%) nutrients that did not meet the RNI. At baseline (n=30), 80% (24/30) scored ≥8 on the AUDIT, 43.3% (13/30) experienced anxiety, 50% (15/30) experienced depression and 53.3% (16/30) were cognitively impaired. At follow-up, the proportion with harmful alcohol use and anxiety decreased while depression and cognitive impairment remained constant. Polypharmacy (≥5 medications prescribed) was 93% (27/29), multimorbidity was 100% (30/30) and the mortality rate was 20% (6/30).
Conclusion
Older adults’ profound susceptibility to alcohol-related harms and malnutrition are reflected by the notable morbidity and mortality observed. Overall, this study’s findings highlight the complex clinical and sociodemographic status of older adults drinking at increasing risk or dependent levels.