VINTAGE Good Health into Older Age

1. VINTAGE Good Health into Older Age VINTAGE Overview Aneurin Owen info@ias.org.uk

2. VINTAGEGood Health into Older Age • Rationale of project: • Ageing population of EU – growth in absolute numbers • Alcohol use disorders common in older people • 27% of 55+ consume 50g of alcohol at one sitting at least once per week

4. At present, there is no indication that light to moderate alcohol drinking would be harmful to cognition and dementia, and it is not possible to define a specific beneficial level of alcohol intake.

5. Road accident in the elderly: the next priority?

6. Several Member States attribute recent increases in alcohol consumption, hospita- lisation and mortality to reductions in the price of alcohol and increased availability; • Five Member States (Finland, Sweden, the UK, Latvia and Poland) report significant increases in alcohol related hospitalisations over the past 5–10 years, but two (Slovenia and Germany) report small reductions • Only one country (Italy) has an alcohol consumption guideline for elderly adults (no more than one standard drink, or about 12 grams of pure alcohol, per day). The remaining Member States surveyed use the recommendation for all adults, which is typically no more than two standard drinks per day (or about 24 g of pure alcohol); • Training programs to assist healthcare staff with the detection and management of alcohol problems among the elderly do not currently exist in most Member States, although three (Sweden, Finland and the UK) conduct programmes which touch on these issues;

7. The numbers of older people are increasing. • Many use alcohol, tobacco and prescribed medications. Some use illicit drugs, some gamble. • Most of these behaviours are moderate and enjoyable. They should not be discouraged per se. • Many use alcohol, tobacco and prescribed medications. Very few use illicit drugs, but many gamble (often by playing bingo). • The extent of alcohol and other “addiction” problems amongst older people in the UK is unclear. Regular screening and more research are needed. • Staff training is required to improve both detection and management of problems related to alcohol and other behaviours. • Health professionals must ensure older people are aware of the possible interactions with alcohol and medication. • More services for older people with alcohol and other problems are going to be needed in future.

8. ‘Alcohol and Ageing’ – “Is alcohol a major threat to healthy ageing for the baby boomers?” – A Report by the Alcohol and Ageing Working Group, NHS Scotland • Recommendations • Key recommendation – Age-based sensible drinking limits should be developed • More research on the use of alcohol by the baby boomers should be conducted. • Education regarding alcohol targeted at the baby boomers should be provided • Training of heath and social care professionals in opportunistic screening and brief • Interventions should be introduced • ‘Unit of alcohol’ labelling of beverages • Increase in price of beverages containing alcohol via taxation in order to reduce • consumption

9. VINTAGE Good Health into Older Age • EU Public Health Programme 2008 – 2011 • - Promote healthy ageing • Prevent harmful alcohol use among • older people including the transition • period from work to retirement • - Establish good practice and formulate • prevention guidelines and policies

10. VINTAGE Evaluation report - referee’s conclusion This project is of high relevance to the implementation EU strategy to support Member States in reducing alcohol related harm, to the Work plan and to Community health programme. Scientific reviews on health and alcohol consumption in elderly and on effective practices will contribute to the knowledge and good practice exchange at EU and country level. The project could also have potential impact on the health of citizens, health services utilization, sustainability of health systems and consequently on reduction of health inequalities.

11. Health Scotland (2006) Alcohol and Ageing, A Report by the Alcohol & Ageing Working Group, Edinburgh: NHS Health Scotland.

12. Hospital Episode Statistics –changes in selected hospital admissions age 65+ (2002 – 2007)

13. VINTAGE Objectives and Methods • The main aim of VINTAGE is to improve knowledge and to build capacity, at European, national and local level, in order to prevent the harmful use of alcohol among elderly subjects: • - provide evidence-based information on the impact of alcohol on health and well-being  systematic reviews • collect examples of best practices, effective policies and programmes regarding the reduction of harmful alcohol use  structured template • active dissemination of reports, best practices, relevant laws and infrastructures  specific website

14. Collected examples include a wide range of activities, for example laws and policies to reduce BAC level in older people, restrictions to alcohol access, information messages and campaigns, or alcohol prevention and treatment services, sensitive to the elder's need, including the transition from work to retirement Project any action (research, prevention, etc.) endorsed with a clear start and end point Programme a group of integrative, continuously implemented actions bPractices intervention approaches that, through experience or research, have been proven to reliably lead to a desired result (in a specific target group of people) Definition adopted in the collection of PPbP

15. An external evaluation has been undertaken, following a case study evaluation methodology: • Process evaluation • analysis of written documentation (meeting notes and minutes, reports, etc.) • network survey to project staff and members, assessment of quality of information • Output evaluation • review of project outputs, in terms of scientific accuracy, readability, usability and ease of access, by a panel of selected scientists • Outcome evaluation • assessment of long-term increased health and well-beeing of elderly subjects through 3 intermediate measures (extent of dissemination, hits to websites and numbers of documents downloaded, stakeholders intention of modifying existing policies and practices) Evaluation Plan

16. VINTAGE Main Partners

17. VINTAGE Timing of Work Packages (WP and Deliverables (D) Duration of the project 18 months: 01.03.09 – 31.08.10 All deliverables will be submitted to the Executive Agency for Health and Consumers (EAHC) D1 Protocol D7 Final technical and financial report MC Management committee meeting D2 Dissemination plan D8 Evaluation report W Launch of website D3 Website dissemination D Launch of database D4 Interim technical and financial report D5 Report on alcohol and older people D6 Report on best practices

18. VINTAGE WP3 – Evaluation of the project • An external evaluation will be undertaken, following a case study standard methodology • Process evaluation • ✓Analysis of written documentation (meeting notes and minutes, reports etc.) • ✓Network survey to project staff and members • Output evaluation • ✓Review of project deliverables in terms of scientific accuracy, readability, usability • and ease of access • Outcome evaluation • ✓Assessment of long-term increased health and well-being of elderly subjects • ✓3 intermediate measures (dissemination, hits to websites and numbers of • documents downloaded, stakeholders’ intention of modifying existing policies • and practices)

19. VINTAGE Responses from the UK • Older adults’ Support Service in Southwark • Dr Tony Rao • Best practice • Dual diagnosis assessment and home-based service including brief interventions • and harm minimization in the context of a support and recovery model • Additional training for staff • Patient Information Leaflet for R C Psych • Clinical advisory Group (Institute of Psychiatry) hopefully will take on research and development in this area

20. VINTAGE Responses from the UK • Alcohol and Older People • Richard Cyster • Project, Welling, Kent • Working in conjunction with Mental Health and other Social and Primary Care Teams • Developing older people’s networks – community and care agencies to extend the support available • Additional training to promote awareness, knowledge and skills • Caseload and weekly treatment group

21. VINTAGE Responses from the UK • Alcohol Services Lifestyles Team • Dr Lynn Owens, Liverpool PCT • Best practice • Early identification of the role of alcohol in hospital attendance • Provide timely effective interventions • Increase confidence of contemporaneous care givers • Reduce perception of stigma • Part of a service model recognising the risk for older people

22. VINTAGE Responses from the UK • CASA Older People’s service • Michael Fox, London • Project • Counselling, group work and other forms of support to people aged 55+ (no upper age limit) • Training of other professionals • Specialist service now replaced by generic provision

23. VINTAGE -DISSEMINATION- To ensure that information about and the main findings of the project (all relevant reports, examples of best practices, and relevant laws and infrastructures) are actively disseminated along with relevant key findings and implications for policy and programme development, to those responsible for alcohol policy and programme development, including those working in the fields of health and welfare of older people at the European, country, regional and municipal levels, in order to help build the capacity and knowledge of such personnel in making informed and evidence-based decisions.

24. VINTAGE WP2 – Dissemination of results • Electronic dissemination of the project main findings (reports, examples of best practices, laws and infrastructures) through a specific website: • Hosted by ISS, in partnership with DHS (Pathways for Health Project website) and UiB (HP-Source website of infrastructures for alcohol policy) • Links with all websites of associated and collaborating partners • Elaboration of a dissemination strategy to a list serve of relevant stakeholders (governmental, non-governmental and private organisations working in the field of older people)

26. "THE COUNCIL OF THE EUROPEAN UNION: • NOTES: • that older adults (aged 60 and above) are more • sensitive to the effects of harmful use of alcohol • than other adults, and that alcohol-related deaths • among older adults have increased markedly • over the last ten years, and that in some cases • the death rate has more than doubled; INVITES MEMBER STATES TO • INVITES THE COMMISSION AND MEMBER STATES TO • include in existing information systems scientific data on alcohol consumption and harm • caused by harmful use of alcohol in the age group of 60 and above; • - develop and implement early identification and brief intervention procedures in primary and elderly health care and in school health settings