Canadian Guidelines on Alcohol Use Disorder Among Older Adults

  • Peter R. Butt University of Saskatchewan, Saskatchewan Health Authority
  • Marilyn White-Campbell Baycrest Health Sciences
  • Sarah Canham University of Utah
  • Ann Dowsett Johnston University of Waterloo
  • Eunice O. Indome University of Waterloo
  • Bonnie Purcell London Health Sciences Centre, Western University
  • Jennifer Tung Grand River Hospital
  • Lisa Van Bussel Western University, Parkwood Institute

Abstract

Background

Alcohol use disorder (AUD) is an increasingly common, under-recognized, and under-treated health concern in older adults. Its prevalence is expected to reach unprecedented levels as the Canadian population ages. In response, Health Canada commissioned the Canadian Coalition of Seniors’ Mental Health to create guidelines for the prevention, screening, assessment, and treatment of AUD in older adults.

Methods

A systematic review of English language literature from 2008–2018 regarding AUD in adults was conducted. Previously published guidelines were evaluated using AGREE II, and key guidelines updated using ADAPTE method by drawingon current literature. Recommendations were created and assessed using the GRADE method.

Results

Twenty-two recommendations were created. Prevention recommendations: Best advice for older adults who choose to drink is to limit intake to well below the national Low-Risk Alcohol Drinking Guidelines. Screening recommendations: Alcohol consumption should be reviewed and discussed on an annual basis by primary care providers. This type of discussion needs to be normalized and approached in a simple, neutral, straight-forward manner. Assessment recommendations: Positive screens for AUD should be followed by a comprehensive assessment. Once more details are obtained an individualized treatment plan can be recommended, negotiated,

and implemented. Treatment recommendations: AUD falls on a spectrum of mild, moderate, and severe. It

can also be complicated by concurrent mental health, physical, or social issues, especially in older adults. Naltrexone and Acamprosate pharmacotherapies can be used for the treatment of AUD in older adults, as individually indicated. Psychosocial treatment and support should be offered as part of a comprehensive treatment plan.

Author Biographies

Peter R. Butt, University of Saskatchewan, Saskatchewan Health Authority
Department of Family Medicine
Sarah Canham, University of Utah
College of Social Work
Ann Dowsett Johnston, University of Waterloo
School of Public Health and Health Systems
Eunice O. Indome, University of Waterloo
School of Public Health and Health Systems
Bonnie Purcell, London Health Sciences Centre, Western University
Department of Psychology
Lisa Van Bussel, Western University, Parkwood Institute
Department of Psychology
Published
2020-03-13
How to Cite
Butt, P. R., White-Campbell, M., Canham, S., Dowsett Johnston, A., Indome, E. O., Purcell, B., Tung, J., & Van Bussel, L. (2020). Canadian Guidelines on Alcohol Use Disorder Among Older Adults. Canadian Geriatrics Journal, 23(1), 143-148. https://doi.org/10.5770/cgj.23.425
Section
Clinical Practice Guidelines/Consensus Statements