Health Effects of Alcohol and Comorbidity in Older Adults

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DESCRIPTION (provided by applicant): This Mid-Career Investigator Award in Patient-Oriented Research (K24) will allow the candidate to continue her career development by developing a new focus on older Latino drinking, enhancing her ability to mentor beginning clinician investigators, and furthering her research in understanding, identifying and intervening to reduce risks associated with alcohol use in older adults. Her research is focused on the idea that older adults are at increased risk for alcohol-related complications based upon their particular combination of alcohol use, medical and psychiatric conditions, symptoms and medication use (i.e., at-risk drinking). The goal of this research is to better understand the risks and benefits of alcohol use among older adults having differing comorbidites and to prevent adverse alcohol-related outcomes in this population. The research plan includes two ongoing trials to test the effectiveness of a screening and brief advice intervention to reduce at-risk drinking in older adults in primary care settings, the Healthy Living as You Age Study (HLAYA) and Project SHARE. It also includes two proposed pilot projects. The first is a study exploring the utility of the HLAYA screening and intervention method to reduce at-risk drinking in older Latinos in Los Angeles via cognitive and structured interviews. The second is a study in which pharmacy data will be coupled with mailed survey data to identify older adults who take medications that might be risky when consumed with sufficient amounts of alcohol, and then to randomly assign these risky drinkers to receive mailed personalized feedback on their risks to determine if such feedback reduces their risks. The candidate will learn about drinking and health concerns among older persons, including Latinos, by conducting the proposed and ongoing studies, completing coursework, and interacting with an advisory board of 3 experts in Latino health, and 1 expert in alcohol and aging and another expert on safe medication use in older adults. Plans for future research based on the planned research and training are also proposed. Because the candidate is a geriatrician alcohol researcher with a new interest in Latinos, her mentoring plan will focus on bringing a) aging researchers into alcohol; b) alcohol researchers into aging; and c) Latino researchers into both aging and alcohol. She will use a structured approach to mentoring trainees for specific projects, and provide career advice and technical and financial support for their research. Over the next five years, the candidate aims to maintain full effort in research, gain expertise in older Latino drinking and health and methods of identifying and reducing at-risk drinking, build upon her mentoring skills and experience, disseminate her research findings through presentations and publications, and help to train the next generation of patient-oriented investigators to advance research in alcohol use and its risks in older persons, including older Latinos.