Exploring the role of gender on treatment outcomes in older adults with alcohol use disorder

Background:Alcohol use disorder (AUD) treatment is at least as effective for older adults as for other age groups. However, the role of gender as a potential influencing factor in various treatment outcomes remains understudied within the older adult population. This study aims to investigate the role of gender in drinking behavior and quality of life as AUD treatment outcomes among older adults (60+ years).
Methods:We will utilize data from the Elderly Study; a single-blind multi-national (USA, Germany, and Denmark) randomized controlled trial, conducted from 2014 to 2016. At baseline, patients were n = 693 individuals aged 60 and above, who fulfilled DSM-5 criteria for AUD. All patients received brief, outpatient treatment based on motivational enhancement therapy (MET; 4 sessions). The intervention group received additional community reinforcement approach treatment, age-adapted to seniors (CRA-S; up to 8 sessions). Information on demographics, alcohol consumption patterns, and quality of life measures were collected at baseline, and at 4, 12, 26, and 52-week follow-ups. For the present study, primary outcome measures will be drinks per day, drinks per drinking day, percentage of days abstinent, percentage of heavy drinking days, and blood alcohol content (BAC). Secondary outcome measures will be change in the World Health Organization (WHO) risk drinking levels (very high, high, moderate, low) and quality of life domain scores. Statistical analyses, by means of generalized estimating equations (GEE), with a specific focus on gender as a covariate, will explore differential impacts on treatment outcomes after one year. Missing data will be handled using multiple imputation (response rate relative to baseline was 73.3% at week 52, n = 508). Analyses, including subgroup analyses, will be performed without adjustment, and with adjustment for age and other covariates.
Preliminary results:At baseline, most patients were men (59.7%). Female patients, (mean age 66.0, SD: 4.6), were slightly older than males (mean age 65.3, SD: 4.6). At baseline, males reported higher means of drinks per day (6.3, SD: 5.5) and drinks per drinking day (9.4, SD: 7.0) than females (4.3, SD: 3.9; and 6.7, SD: 4.8), respectively; both p < 0.01). Other baseline differences and findings from the GEE based on the one-year follow-up will be presented at the conference.
Conclusions:By focusing on the putative role of gender, this study will add to a nuanced understanding of the complexities surrounding treatment responses in older adults with AUD. The findings will have the potential to inform the development of gender-specific and personalized interventions for this underrepresented age-group.