The alcohol use disorder treatment gap and its correlates among middle-aged and older adults

Alcohol use disorders (AUD) are under-treated, particularly among older adults. Using data from national treatment registers can expand knowledge on the AUD treatment rate among older adults and on potential biases in treatment receipt. The aim of this paper was to determine the AUD treatment prevalence rate and to investigate sociodemographic, health-related and substance use-related correlates of AUD treatment receipt among older adults with different degrees of problematic alcohol use.

The study sample (n = 13,403; inclusion criteria: age 55-80 years, positive CAGE-C) is a subsample from the representative cross-sectional 2017 Danish National Health Survey. It was enriched with data from Danish National Registers, including the National Alcohol Treatment Database. Weighted 12-month AUD treatment prevalence rates were determined. Logistic regression analysis was applied to identify correlates of treatment receipt. All analyses were conducted among: (i) the study sample; (ii) the 28.9% with a positive original CAGE (n = 3725); and (iii) the 6.1% endorsing the CAGE's E-criterion (n = 692).

The 12-month AUD treatment prevalence was 0.5% in the study sample, 1.6% in the CAGE-, and 3.8% in the E-criterion subsample. Not being married or partnered, loneliness and contacts with health care providers were positively associated with AUD treatment receipt in all three samples.

Even in the subsample with putative alcohol withdrawal, the AUD treatment rate did not reach 5%. This finding suggests that putative AUD is significantly undertreated in older adults. Contacts with other health care providers may facilitate AUD treatment entry in this age group.