Health Effects of Alcohol and Comorbidity in Older Adults

描述(由申请者提供)：这项以患者为中心的职业中期研究人员奖(K24)将允许应聘者通过发展对老年拉丁裔饮酒的新关注来继续她的职业发展，增强她指导初学临床医生的研究人员的能力，并进一步研究她在理解、识别和干预方面的研究，以降低老年人饮酒相关的风险。她的研究重点是这样一种观点，即老年人因饮酒、医疗和精神状况、症状和药物使用(即有风险的饮酒)的特定组合而患与酒精有关的并发症的风险增加。这项研究的目标是更好地了解在具有不同合并症的老年人中饮酒的风险和好处，并防止这一人群中与酒精相关的不良后果。该研究计划包括两项正在进行的试验，以测试筛查和简短建议干预措施在初级保健环境中减少老年人高危饮酒的有效性，即健康生活随年龄增长研究(HLAYA)和项目共享。它还包括两个拟议的试点项目。第一项是一项研究，通过认知和结构化采访，探索HLAYA筛查和干预方法在洛杉矶老年拉美裔人中减少高危饮酒的效用。第二项是一项研究，将药房数据与邮寄的调查数据结合起来，以确定服用足够数量酒精时可能有风险的药物的老年人，然后随机分配这些有风险的饮酒者，让他们收到关于风险的邮寄个性化反馈，以确定此类反馈是否降低了他们的风险。候选人将通过开展拟议的和正在进行的研究，完成课程作业，并与由3名拉丁裔健康专家、1名酒精和老龄化专家以及另一名老年人安全用药专家组成的咨询委员会互动，了解包括拉美裔在内的老年人对饮酒和健康的担忧。在已规划的研究和培训的基础上，还提出了未来研究的计划。由于候选人是一位对拉丁裔有新兴趣的老年病学酒精研究人员，她的指导计划将集中在a)老龄研究人员进入酒精领域；b)酒精研究人员进入老龄化；以及c)拉丁裔研究人员同时研究衰老和酒精。她将使用结构化的方法为特定项目的受训者提供指导，并为他们的研究提供职业建议以及技术和资金支持。在接下来的五年里，这位候选人的目标是保持在研究方面的全力，获得老年拉丁裔饮酒与健康以及识别和减少高风险饮酒方法的专业知识，加强她的指导技能和经验，通过演讲和出版物传播她的研究成果，并帮助培训下一代以患者为导向的调查人员，以推进老年人，包括老年人拉丁裔饮酒及其风险的研究。

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.