Drinking Behavior Among Low-Income Older Adults: A Multimethod Approach to Estimating Alcohol Use

Understanding the preference for receiving mental health and substance use support in African Americans 50 and older

OBJECTIVE

This study aims to determine whether current tobacco and/or alcohol use is associated with setting preferences for seeking support for substance use (SU) and mental health (MH) services to African Americans ages 50 and older.

METHODS

Data from 368 African American individuals (aged 50+) who participated in a community-based needs assessment survey were used. Preferences included community-based (e.g., health centers) and traditional settings (e.g., doctor's office). SU was measured as a categorical variable detailing past-month use of conventional cigarettes and alcohol graded by risk levels. Logistic regression models tested the associations between SU and setting preference before and after adjusting for the influence of self-reported MH diagnoses.

RESULTS

Prior to adjustment for the influence of MH outcomes, high-risk use of tobacco and alcohol in the past month was associated with a lower odds of preferring MH/SU support in traditional settings (OR = 0.23, 95% CI = 0.06-0.85) compared to participants engaged in no-/low- risk substance use. This association was no longer significant after accounting for the influence of mental health symptoms and covariates.

DISCUSSION

These results provide preliminary evidence that mental health outcomes mediate the association between substance use and setting preference for seeking MH/SU support in traditional settings.

TRANSLATIONAL SIGNIFICANCE

This exploratory study encourages additional investigation of the association between substance use, setting preferences, and the likelihood of seeking treatment in community health centers using larger sample sizes. Additional opportunities to offer mental health/substance use support to African American older adults within clinical settings should be explored.

Association between dental caries and Helicobacter pylori infection in Japanese adults: A cross-sectional study

Helicobacter pylori (H. pylori) is widely known as a cause of gastric disorders. Presence of H. pylori in dental pulp has been reported. Dental caries may influence the presence or absence of systemic H. pylori infection by serving as a source of H. pylori. In this cross-sectional study, we examined whether H. pylori infection in blood were associated with dental caries in Japanese adults. The participants were 752 individuals (513 males and 239 females, mean age 53.8 years) who underwent both H. pylori testing (H. pylori antibody test and pepsinogen test) and dental checkups at the Asahi University Hospital Human Health Center between April 2018 and March 2019. Those diagnosed as positive for H. pylori antibody test or positive for serum pepsinogen test as H. pylori test in the human health checkup were judged as those with H. pylori infection in the blood. In our study, 83 participants (11%) were determined to be infected with H. pylori in the blood. The proportion of those with decayed teeth was higher in participants with H. pylori infection in blood than in those without H. pylori infection in blood (p< 0.001). The logistic analysis showed that presence of H. pylori infection in blood was positively associated with those with decayed teeth (OR, 5.656; 95% CI, 3.374 to 9.479) after adjusting for age, gender, gastric disease, regular dental checkups, antibiotic medication history, and decayed teeth. Furthermore, the proportion of H. pylori infection in blood increased according to number of decayed teeth (p< 0.001). The results indicate that H. pylori infection in blood were associated with decayed teeth. Untreated dental caries may have an impact on systemic H. pylori infection.

Immediate effects of a brief intervention to prevent alcohol and medication interactions among older adults

Risk of experiencing alcohol and medication interactions (AMI) is significant among older adults due to the substantial prevalence of alcohol and medication use in this segment of the population. Given the lack of community-level AMI prevention interventions for older adults, this study aimed to examine the immediate effects of a brief, pharmacy-based intervention to prevent AMI among older adults, as well as assess differential effects by past-month drinking status. A convenience sample of 134 adults aged 59 and older was recruited from four pharmacies in rural Virginia. Participants were assessed on their AMI awareness, intentions and importance prior to and immediately after exposure to intervention materials. Findings support immediate, positive intervention effects on AMI awareness, intentions and perceived importance of AMI messaging. Changes from pre to post-test did not differ by drinking status, but participants who consumed alcohol were less likely than non-drinkers to recognize the potential consequential severity of alcohol and medication interactions at both time points. Recommendations and future research to prevent AMI are discussed.