Predictors of Long-Term Alcohol Use Disorder Treatment Receipt Among Middle-Aged and Older Adults With Problematic Alcohol Use.

Introduction: Cross-sectional evidence shows that alcohol use disorders (AUD) are under-treated. Knowledge is needed on longitudinal predictors of long-term receipt of AUD treatment among older adults.

Aims: To identify the: (i) long-term occurrence of AUD treatment receipt during follow-up; (ii) time to treatment; and (iii) predictors of long-term treatment receipt.

Methods: Longitudinal cohort study. To create a baseline, a subsample from the Danish National Health Survey 2017 with a positive CAGE-C (n = 13,489, aged 55-80 years) was enriched with Danish national register data. AUD treatment data covered a follow-up period of up to 2.9 years following this baseline and came from the National Alcohol Treatment Register. Longitudinal predictors of treatment receipt were investigated with Cox regression analysis; time-to-treatment with Kaplan Meier curves. All analyses were conducted in the whole sample, in a subsample scoring ≥ 2 on the original CAGE (n = 3748, 28.9%), and in a subsample endorsing the CAGE-'Eye-opener'-criterion (n = 707, 6.2%).

Results: In the whole sample, only 1.3% received AUD treatment in the follow-up period (3.9% in the CAGE- and 7.3% in the 'Eye-Opener'-criterion subsample). Across all samples, only about 40% of treatments were initiated by 12 months after baseline. Baseline contacts with health care providers and impaired well-being predicted a greater rate of treatment entry during follow-up (p < 0.05).

Discussion and conclusions: Among older adults, AUD treatment uptake in the 2.9 years after reporting recent problematic alcohol use is rare. Treatment occurs with delay, regardless of problem severity. Contacts with health care providers are opportunities to support subsequent treatment receipt.