Exploring the psychosocial needs and nutritional status of older adults with alcohol use disorder: a mixed-methods study (The OLA Study)

Vollständiger Abstract

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Abstract Background Alcohol-related hospital admissions are rising in England, particularly among individuals aged 65 and over. While alcohol intake and nutritional status are important factors in health outcomes, they are often overlooked. Loneliness, also common in this age group, is associated with poorer health and increased mortality. Objectives (1) To explore the clinical and sociodemographic characteristics, and nutritional status of older adults with alcohol use disorder (AUD) admitted to hospital. (2) Explore participants’ experiences of alcohol use in later life, perceptions of health and wellbeing, social relationships, and views on support following hospital admission. Methods Participants were recruited from a UK tertiary teaching hospital and identified as drinking at increased risk using routine AUDIT-C alcohol screening. Measures including 6CIT (Six-item Cognitive Impairment Test), Depression and anxiety (HADS), 24-hour Dietary Recall, Social network composition, De Jong Loneliness Scale, and Meaning in life questionnaire were measured at baseline and 6 months. Qualitative telephone interviews were conducted at 6 months ( n = 7). Qualitative data were analysed using reflexive thematic analysis. Results Thirty older adults (mean age 71) were recruited. Over half (53%) showed cognitive impairment and 50% met the threshold for clinical depression. Median intakes for 4 out of 5 (80%) macronutrients were below Recommended Nutrient Intake (RNI). Recruitment and retention were challenging; 46.7% of participants were lost to follow-up including 20% who died. Qualitative interviews revealed that alcohol use was closely intertwined with later-life social circumstances, particularly social isolation, loneliness, and reduced daily structure, with alcohol sometimes functioning as a source of companionship or routine. Participants frequently framed drinking as a normal and socially sanctioned behaviour shaped by lifelong experiences and social norms. Despite varied patterns of consumption, participants consistently viewed their drinking as non-problematic, defining alcohol-related problems through perceived control rather than quantity consumed. Conclusion Addressing alcohol use in older adults requires a holistic approach that incorporates both health and social factors. Future research should focus on improving study retention, and further exploring the intersections between alcohol use, nutrition, and social connection.