Social factors and readmission after inpatient detoxification in older alcohol-dependent patients.

BACKGROUND AND OBJECTIVES: Alcohol dependence is often a chronic relapsing disorder with frequent admissions to inpatient facilities. This study in older alcohol-dependent inpatients investigates the role of social factors in readmissions after inpatient detoxification. METHODS: In a prospective study, 132 older alcohol-dependent patients admitted to inpatient detoxification (mean age 63.4, SD = 6.6, 39.4% women) were interviewed with the European version of the Addiction Severity Index (Europ-ASI). Readmission to inpatient treatment was monitored up to 1 year after discharge. The effect of social factors on readmission, the number of readmissions and the time to first readmission was established using group comparisons, Poisson regression analysis, and Cox' proportional hazards regression analysis, respectively. RESULTS: Sixty-seven (50.8%) of the 132 patients were readmitted within 1 year. In this group, the median number of readmissions was 2 (IQR = 2, range 1-6) and the median time to first readmission was 88 days (IQR = 116, range 3-356). In a multivariate analysis, spending most leisure time alone predicted fewer readmissions. None of the other social factors predicted readmission, number of readmissions or time to first readmission. DISCUSSION AND CONCLUSIONS: Rehospitalization of older alcohol-dependent patients after detoxification is very common, and generally not predicted by social factors. Only spending most leisure time alone may play a role. SCIENTIFIC SIGNIFICANCE: This study shows that most social factors are-unexpectedly-not associated with rehospitalization of older alcohol-dependent patients after detoxification. "Spending leisure time alone" warrants further study as a potentially modifiable predictor.

Physical and mental health and social functioning in older alcohol-dependent inpatients: the role of age of onset.

AIMS: Age of onset is an important criterion to distinguish subgroups of alcohol-dependent patients. This study investigated physical and mental health and social functioning of older inpatients with early (age <25), late (25-44), and very late (≥45) onset of alcohol dependence. METHODS: In a specialized detoxification ward for older patients in The Hague, the Netherlands, 157 older alcohol-dependent inpatients (38% women, mean age 62.7 ± 6.5) were interviewed with the European version of the Addiction Severity Index. RESULTS: As a group, older alcohol-dependent patients had substantial physical, mental and social problems, which were largely independent of the age of onset of alcohol dependence. Patients with early-onset alcohol dependence had more chronic medical problems and more suicidal thoughts than patients with late-onset alcohol dependence. The very-late-onset group did not significantly differ from the other two groups in any of the variables under study. CONCLUSIONS: Despite previous studies showing more favourable outcomes for the (very) late-onset compared to the early-onset alcohol-dependent group, their comorbid (mental) health and social problems are in many respects similar, and require careful assessment and treatment. This may be crucial for successful treatment and improving quality of life in these patients.