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David W Oslin

Publications and source records attributed to David W Oslin.

41 records · Page 3Linked to original sources
PubMedDate not supplied

Late-life alcoholism: issues relevant to the geriatric psychiatrist.

Alcohol use and abuse are often overlooked as an important clinical issue in older adults. However, with a rapidly growing population of older adults who grew up during an era of increased illicit drug and alcohol use, there are reasons to believe that there will be a greater impact of alcohol abuse or dependence on the next generation of older adults. Because older adults seek the majority of behavioral health care either in primary care settings or from mental health providers, it is necessary for primary care providers and geriatric mental health providers to become proficient at assessing and providing interventions. This article discusses the state of research in this area and reviews clinically-relevant concepts related to identifying, assessing, and treating older adults with alcohol-related disability.

Aged↗
PubMedDate not supplied

Alcoholism treatment adherence: older age predicts better adherence and drinking outcomes.

OBJECTIVE: Adherence to treatment has been demonstrated to be an important factor for remission from alcohol dependence. The authors compared therapy and medication adherence for treatment of alcohol dependence in older adults with adherence in younger adults. METHODS: All subjects were participants in a randomized, double-blind, placebo-controlled efficacy trial of naltrexone for the treatment of alcohol dependence. All subjects received a medically-based psychosocial intervention focused on motivating patients to change and on adherence to treatment. The therapy is nonconfrontational and is delivered by a nurse-practitioner. RESULTS: Compared with younger adults, older adults had greater attendance at therapy sessions and greater adherence to the medication. Age-group was the only pretreatment factor associated with adherence. The greater adherence in older adults translated to less relapse than in younger adults. CONCLUSION: Treatment for alcohol dependence can be effective for older adults. Older adults appear to respond well to a medically-oriented program that is supportive and individualized. In fact, findings from this study suggest that older adults can be treated in mixed-age treatment settings when psychotherapeutic strategies are used that are age-appropriate and delivered on an individual basis.

Adult↗
PubMedDate not supplied

Alcohol-related dementia: validation of diagnostic criteria.

OBJECTIVE: The authors sought to validate the diagnostic criteria for alcohol-related dementia. METHODS: The sample consisted of veterans consecutively admitted to a 240-bed VA Nursing Home Care Unit. Baseline and follow-up assessments included measures of cognition and functioning. The diagnosis and type of dementia was determined within 2 months of admission by a geropsychiatrist using patient interviews, chart review, and information from a structured collateral interview. Residents were followed for up to 2 years. RESULTS: Data were collected on 192 of the residents, of whom, 158 (82%) were diagnosed with some form of dementia. Alcohol-related dementia (ARD) was diagnosed in 16 residents (10.1%), probable Alzheimer dementia (AD), in 26 (16.5%); vascular dementia (VD), in 46 (29.1); and mixed or dementia of undetermined origin, in 70 (44.3%). Those with ARD were less cognitively impaired and were more often unmarried. Residents with ARD demonstrated a stabilization of both cognition and functional status, whereas those with AD and VD showed a general decline in both cognition and functional status. CONCLUSION: These results serve to validate the diagnostic criteria for ARD and suggest that abstinence may be of clinical value in treating patients with dementia and alcohol dependence. Further research needs to be conducted to confirm the value of abstinence.

Aged↗
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Managing suicide risk in late life: access to firearms as a public health risk.

OBJECTIVE: The authors assessed the prevalence of gun availability for elderly patients to determine whether gun availability is related to the presence of suicidal or depressive symptoms. METHODS: This is a cross-sectional epidemiologic survey of firearm availability and safety practices. A random sample of older adults with a scheduled primary-care clinic appointment was selected and screened with the General Health Questionnaire and questions about suicidality and alcohol use. Participants were also asked about the availability of firearms in their home and about safe gun practices. RESULTS: Of 1,023 patients screened, 285 (27.9%) reported having some type of firearm in the home, and 202 (19.7%) reported having a handgun in the home. Patients with suicidal ideation or high levels of depression or psychological distress were not significantly more or less likely to have a gun in the home than those without these emotional stressors. The strongest predictors of firearm availability were being male and being married. CONCLUSIONS: These preliminary data suggest that a significant proportion of elderly people have firearms available to them in their homes. Those patients with emotional distress did not differ from those without distress with respect to having firearms available to them. These data strongly suggest the need for screening for firearm availability and education about the safe storage of firearms as a potential means of prevention of suicide among elderly patients suffering from emotional distress or suicidal ideation.

Aged↗