Alcohol use among Older Adults in Inpatient Psychiatry in Ontario: Individual and Community Factors Related to Problematic Use
Notice bibliographique
Résumé
Background: Alcohol use among older adults is usually not identifiable and could be mistaken for other medical or psychiatric conditions. As sometimes an underlying cause, problematic alcohol use (PAU) continues to impact older adults with mental health issues who are admitted to inpatient psychiatry care. About 60% of older adults with undiagnosed alcohol related problems are found to have depression, repeated falls, delirium, heart failure, or chest infections when admitted to acute care (2). The associations between PAU and poor health outcomes is concerning as it could exacerbate the health conditions of older adults. Current predictions indicate an increase in the older adult population in Canada. Therefore, using the Andersen behavioural model of health care use, this study sought to investigate the prevalence of PAU among older adults, the characteristics of older adults who use alcohol, and the types of community support systems available. \nMethods: Two data sources were used for this study. First, data from the Ontario Mental Health Reporting System (OMHRS) with inpatient information on mental and physical health, social support and service use, based on the Resident Assessment Instrument-Mental Health (RAI-MH) was used to conduct a multiple logistic regression analysis. OMHRS sample data included all older adults discharged from an inpatient mental health hospital between January 1, 2011, and December 31, 2016. Second, data from ConnexOntario was used to conduct a geographic analysis of psychiatric admission rates in relation to health service locations and PAU in the Waterloo-Wellington region of Ontario. \nResults: Study results from the OMHRS data indicated that of the total number of older adults admitted to inpatient psychiatric care (n = 21,577), about 10% (n = 2,107) had PAU. Older adult men were twice as likely to have PAU compared to women. Older adults had an increased the odds of having PAU if they were educated (1.4), employed (1.5), or living in their own residence (1.3). However, living with someone (0.8) and being 65 years or older (0.6) decreased the odds of an older adult having PAU. Contextual results for the Waterloo-Wellington region of Ontario showed that the clustering of psychiatry admissions for older adults were higher in areas with a cluster of services such as Guelph and Cambridge. However, in areas such as rural Wellington, there were high psychiatry admission rates for older adults but fewer mental health and addictions services. The study findings indicate that more seniors programs were needed to support older adults with mental health and addiction problems. In addition, older adults with PAU were likely to face the challenge of traveling further to utilize current available mental health and addictions support services in other cities. \nConclusion: This study identified the prevalence and characteristics of PAU among older adults admitted to psychiatric inpatient treatment; and highlighted some of the individual and contextual factors that are associated with the increased odds of PAU among this population. On an individual level, understanding the associated mental health and addictions service needs of older adults could contribute to providing better support before, during, and after psychiatry admissions. Contextually, factors such as the availability and accessibility of these mental health support services for older adults need to be further investigated to identify its role in service utilization.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».