High Percentage Of Older Adults Research Articles

P129: Buiding a telepsychiatry program for older people in rural Portugal

The geriatric psychiatry team at the Local Health Unit of Baixo Alentejo (ULSBA) serves the largest district of Portugal, the district of Beja, covering 10,4% of Portugal area. Baixo Alentejo is predominantly rural and a relatively poor area, with a high percentage of older adults (28% of its population being over 65 years old), a declining population due to unremitting exodus, an underdeveloped public transportation system and insufficient health care assistance. Among the telemedicine programs developed in the last decades, care in nursing homes for the elderly has figured prominently. Many studies report decrease of costs and inconvenience resulting from patients having to travel to hospitals, and so to optimize, simplify and reduce costs of psychogeriatric care.We report the planning and implementation of a telepsychiatry program adopted by a geriatric psychiatry team of a local mental health service, starting in 2023. Videoconference consultations were provided for 58 nursing homes, with an average of 10 patients per day. Most patients were initially evaluated at the hospital by a nurse and a psychiatrist, being all subsequent consultations made every three to six months. Most patients were female. The most frequent diagnosis was dementia due to Azheimer disease. A clinical evaluation standardized sheet was sent prior to the consultation and the interview with the nurse had the purpose of completing those data that the psychiatrist considered necessary after reading the material sent. The presence of staff in the room with the patient not only helped carry out the interview, but it also allowed observation of how the patient interacted in a face-to-face situation.Healthcare institutions all over the world are increasingly adopting telehealth services given their numerous benefits in enhancing access to care. This practice comes with several challenges, being the fact that a nurse or someone from the staff must be present in the teleconsultation one of the most significant ones, as staff is already overburdened.Innovations to overcome sensory deficits and collaboration with community services should be explored to improve its acceptance among the most vulnerable population.It is fundamental to assess cost-effectiveness and patient/caregivers satisfaction with the service.

Assessment and comparison of anticholinergic exposure in older adults at a Basic Health Unit in Porto Alegre

Objectives: To estimate the anticholinergic burden in geriatric patients using two scales and to assess the degree of agreement between them. Methods: Data from an observational study conducted in a primary health care service were used. Anticholinergic burden was assessed using the Belgian Scale Muscarinic Acetylcholinergic Receptor ANTagonist Exposure Scale and the Brazilian Scale of Medicines with Anticholinergic Activity. The cumulative anticholinergic burden score was classified using a categorical approach: Brazilian scale (0: none; 1 – 2: low; ≥ 3: high) and Belgian scale (0: none; 0.5 – 1.5: low; ≥ 2: high). The degree of agreement between the two instruments was obtained through Cohen’s kappa coefficient. Results: A total of 374 older people were included, most of them female and aged between 60 and 69 years. At least one potentially inappropriate drug with anticholinergic activity was used by 60.70% of patients according to the Brazilian scale and 32.89% by the Belgian scale. On average, 20.85% were under high anticholinergic exposure. Overall, on both scales, the most commonly recurrent medications were those indicated for the treatment of psychiatric disorders. Agreement between the scales was moderate (Kappa = 0.43). Conclusions: A high percentage of older adults was exposed to drugs with an anticholinergic burden, posing risks to health and quality of life. Consensus is needed on how anticholinergic burden is calculated by these scores, as well as standardization of the list of included drugs.

WHAT MOTIVATES PHYSICIANS TO ADDRESS CAREGIVER NEEDS? THE ROLE OF EXPERIENTIAL SIMILARITY

Abstract Despite the negative emotional and physical consequences of caregiving, caregivers’ needs and risks are often overlooked in health care settings. This study used survey data from a national random sample of primary care physicians (N=106) to examine the factors associated with physicians’ perceived responsibility to identify caregiver needs and risks, focusing on three theoretically implicated variables: 1) experiential similarity (i.e., physicians having personal experience with caregiving), 2) structural similarity (i.e., physicians being older and female), and 3) secondary exposure to caregivers (i.e., more time seeing older patients and a higher percentage of older adults in their patient panel). Physicians in our sample consisted of 42.5% women; most of whom were white (73.6%). The majority (76.5%) agreed or strongly agreed that they were responsible for identifying caregivers’ needs and risks. Multivariable models controlling for physicians’ age and gender revealed that physicians who had personal experience with caregiving were four times more likely than those without caregiving experience to feel responsible to identify caregivers’ needs and risks (adjusted odds ratio [aOR] 3.90; 95% confidence interval [CI] 1.34-11.41) and to assess caregivers’ mental health concerns (aOR 3.58; 95% CI 1.29-9.94). Structural similarity and secondary exposure did not play significant roles in motivating physicians. Findings highlight the role of experiential similarity in physicians’ motivation to assess caregivers’ needs and risks. Future work may benefit from designing intervention programs for physicians that incorporate experiential learning activities (e.g., conversations in which caregivers share their experiences) and evaluating whether such programs enhance physicians’ sensitivity toward family caregivers.

Development of Older Adult Food Insecurity Index to Assess Food Insecurity of Older Adults

ObjectivesQuantifying the number of older adults that are food insecure in a specific geographic area is critical in developing and scaling public health prevention and response programs at the local level. However, current estimates of older adult food insecurity only consider financial constraints, following the same methodology as the general population, even though the drivers for older adults are different and multidimensional. This study aims to build a general approach to quantify the food-insecurity among older adults at the local level, using publicly available data that can be easily obtained across the country.Methods13 risk factors for food insecurity among older adults were identified leveraging existing studies, following the Social Ecological Model (SEM), and the weighted impact of each factor was determined. Publicly available data sources were identified for each factor, ZIP code level data was compared to national averages, and the weighted data for each factor were aggregated to determine the overall food insecurity at the local level.ResultsBased on the averaged odds ratios across all the studies, of the 13 risk factors, beyond financial constraints, having a disability was the most impactful factor and distance to the nearest grocery store was the least impactful. A ZIP code level model of Honolulu County was developed as an example to demonstrate the approach, showing that food insecurity among older adults in the county was 2.5 times that which was reported from the Current Population Survey (16.5% versus 6.5%).ConclusionThis evidence-based model considered factors that impact food insecurity among older adults across all the spheres of the SEM. The drivers of food insecurity among older adults are different than the drivers for the general population, resulting in a higher percentage of older adults being food insecure than currently reported.

Sexual activity and satisfaction in older adults from a Brazilian cohort study

Objectives: Although the majority of older adults experience sexual satisfaction regardless of their sexual activity, there are few studies that address sexuality in aging, especially in Latin America. The objective of this study was to assess the prevalence of sexual activity and satisfaction among older adults in two time-points, as well as their sociodemographic and health predictors. Method: We analyze data from 1,464 older adults aged 60 years or over from the Health, Well-Being, and Aging (SABE) cohort study conducted in Brazil. Multivariable regression models were used to determinate the factors associated with sexual activity and sexual satisfaction, stratified by gender. Results: Among older adults, the prevalence of sexual activity was 48%, while the vast majority reported feeling sexually satisfied (80%). Men had more sexual activity than women, while women presented greater sexual satisfaction than men. After the follow-up, older adults that were married were more likely to have sexual activity. In women, being older than 71 years was associated with lower sexual activity. In men, those with mobility problems and depression were less likely to have sexual activity. Regarding sexual satisfaction, having depression remained a leading factor for lower sexual satisfaction in men. Conclusion: Despite beliefs, a high percentage of older adults reported being sexually active and feeling sexually satisfied. Our results highlight the gender difference in the predictors of sexual activity and sexual satisfaction. Since sexuality is important for well-being throughout life, preventing factors that decrease sexual activity and sexual satisfaction in aging could help improve the quality of life of older adults.

Impact of COVID-19 on Older Employees of a Large State University: Findings From a Mixed-Methods Study

Burgeoning research on the effects of COVID-19 and university experiences in the U.S. tends to focus on transmission of COVID-19 virus or student-related consequences of COVID-19. However, none to our knowledge examine the effects on older university employees. Universities employ a higher percentage of older adults with diverse job responsibilities and socioeconomic status, presenting a unique closed community for understanding the pandemic’s consequences for older adults. Our aims are to: 1) understand older university employees’ concerns related to COVID-19, 2) develop intervention strategies to mitigate the adverse impact of the COVID-19 pandemic on the health and wellbeing of older employees, and 3) test the interventions within the target population to help reduce stress and promote wellbeing. Using a community participatory approach, we sought input from employees aged 50 and older at the University of Arizona. Mixed methods were used to collect qualitative (six focus groups; N= 24) and quantitative (online survey; N=1030) data. We conducted and evaluated a set of interventions (i.e., virtual Tai Chi and Qigong, walking exercises, and meditation) using focus group feedback, process evaluation, and outcome assessment with validated questionnaires on sleep quality, mindfulness and psychological wellbeing. Findings show that a significant percentage of older employees worried about getting COVID-19 and had experienced undesirable changes in sleep quality, weight, and physical activity, and concerns about caregiving; however, we also observed psychological resilience in this population. The study highlights the importance of developing immediate and effective programs for promoting health and wellbeing for older employees during the pandemic.

Social Games: The Intersection of Established Reward Structures and Exercise for Older Rural Adults

A high percentage of older adults engages with games; however research about impacts of gaming on older adults is focused almost exclusively on games intended to strengthen cognitive health or slow age-related cognitive decline, very little relates gaming to exercise. Rural –dwelling older adults are underrepresented in this as in other health-related research. Nonetheless, recent developments that explore effectiveness of embedding positive health behaviors (including exercise) in established games such as Bingo hold great promise for addressing the endemic social isolation and chronically debilitating conditions often associated with rural aging. Using recent research with a challenging population group (rural Appalachian older adults) as an anchor for discussion, this paper describes the state of the art of such interventions and, through a multinational lens, finds that these suggest a new direction for gaming design that could enhance effectiveness of the use of gaming to improve health and happiness of rural adults. Part of a symposium sponsored by the Rural Aging Interest Group.

Expanding Beyond Maximum Grade: Chemotherapy Toxicity over Time by Age and Performance Status in Advanced Non-Small Cell Lung Cancer in CALGB 9730 (Alliance A151729).

Prior comparisons of chemotherapy adverse events (AEs) by age and performance status (PS) are limited by the traditional maximum grade approach, which ignores low-grade AEs and longitudinal changes. To compare fatigue and neuropathy longitudinally by age (<65, ≥65 years) and PS (0-1, 2), we analyzed data from a large phase III trial of carboplatin and paclitaxel versus paclitaxel for advanced non-small cell lung cancer (CALGB 9730, n = 529). We performed multivariable (a) linear mixed models to estimate mean AE grade over time, (b) linear regression to estimate area under the curve (AUC), and (c) proportional hazards models to estimate the hazard ratio of developing grade ≥2 AE, as well as traditional maximum grade analyses. Older patients had on average a 0.17-point (95% confidence interval [CI], 0.00-0.34; p = .049) higher mean fatigue grade longitudinally compared with younger patients. PS 2 was associated with earlier development of grade ≥2 fatigue (hazard ratio [HR], 1.56; 95% CI, 1.07-2.27; p = .02). For neuropathy, older age was associated with earlier development of grade ≥2 neuropathy (HR, 1.41; 95% CI, 1.00-1.97; p = .049). Patients with PS 2 had a 1.30 point lower neuropathy AUC (95% CI, -2.36 to -0.25; p = .02) compared with PS 0-1. In contrast, maximum grade analyses only detected a higher percentage of older adults with grade ≥3 fatigue and neuropathy at some point during treatment. Our comparison of complementary but distinct aspects of chemotherapy toxicity identified important longitudinal differences in fatigue and neuropathy by age and PS that are missed by the traditional maximum grade approach. Clinical trial identification number: NCT00003117 (CALGB 9730) IMPLICATIONS FOR PRACTICE: The traditional maximum grade approach ignores persistent low-grade adverse events (AEs) and changes over time. This toxicity over time analysis of fatigue and neuropathy during chemotherapy for advanced non-small cell lung cancer demonstrates how to use longitudinal methods to comprehensively characterize AEs over time by age and performance status (PS). We identified important longitudinal differences in fatigue and neuropathy that are missed by the maximum grade approach. This new information about how older adults and patients with PS 2 experience these toxicities longitudinally may be used clinically to improve discussions about treatment options and what to expect to inform shared decision making and symptom management.

Is social connectedness a risk factor for the spreading of COVID-19 among older adults? The Italian paradox.

Italy was one of the first European countries affected by the new coronavirus (COVID-19) pandemic, with over 105,000 infected people and close to 13,000 deaths, until March 31st. The pandemic has hit especially hard because of the country's demographic structure, with a high percentage of older adults. The authors explore the possibility, recently aired in some studies, of extensive intergenerational contact as a possible determinant of the severity of the pandemic among the older Italian adults. We analyzed several variables to test this hypothesis, such as the percentage of infected patients aged >80 years, available nursing home beds, COVID-19 incidence rate, and the number of days from when the number of positive tests exceeded 50 (epidemic maturity). We also included in the analysis mean household size and percentage of households comprising one person, in the region. Paradoxically, the results are opposite of what was previously reported. The pandemic was more severe in regions with higher family fragmentation and increased availability of residential health facilities.

Preventing disability in older adults with mild cognitive impairment: A Strategy Training intervention study.

Non-pharmacological interventions designed to change cognitive function in older adults with Mild Cognitive Impairment have shown mixed results. Few studied interventions directly address preclinical disability. Slowing changes in disability are critical preserve independence and health related quality of life in older adults with Mild Cognitive Impairment. In this study, we discuss the design of the trial, challenges encountered, and solutions generated to guide future trials designed to prevent the onset of disability among at-risk older adults. We compared Strategy Training to enhanced-usual care in 30 older adults with Mild Cognitive Impairment. We recruited 79.7% (n = 188) of the potential participants through direct-to-consumer recruitment. We refined a three-step screening process, including a phone screen, initial in-person screening, and full in-person screening. This screening processes resulted in a high percentage of older adults completing the neuropsychological battery and adjudication of Mild Cognitive Impairment. Conducting a disability prevention among individuals without overt disability is a novel approach. Nevertheless, one of the greatest limitations to our project is the fact that follow-up is restricted to 1 year. Findings from this study can inform the design and conduct of future clinical trials that seek to slow progression of disability in older adults with Mild Cognitive Impairment.

Causes of drop out from a physical exercise supervised program specific to older adults

Abstract Introduction: Physical exercise when performed regularly brings several health benefits, especially for older adults. However, there are barriers that induce these individuals to withdraw from exercise. Objective: This study investigated the causes of drop out from a supervised physical exercise program specific to older adults. Methods: A semi-structured questionnaire was applied by telephone contact, containing questions about their reasons for leaving the program. Demographic data were analyzed by relative and absolute frequencies, and the Chi-square test was used to verify the associations between the variables collected. A significance level of 5% was considered. Results: Fifty-nine older adults were interviewed and the main reasons for drop out were lack of time (33.9%), emergence or worsening of disease (28.8%), and the need to care for family members with health problems (18.7%). A high percentage of older adults (62.7%) showed a worsening in health status after leaving the program, with changes in muscle strength (80.0%), balance (76.7%), and motor coordination (40.0%). Conclusion: A professional intervention is suggested to enable organizational control of factors related to lack of time, as well as a logistical monitoring service for older adults and/or family members who fall ill, promoting the return to practice as soon as possible.

Where You Age Matters: Individual- and County-Level Predictors of Formal and Informal Care in Rural Appalachia.

Despite overall improvements in the U.S. health care, older adults living in rural counties, such as Appalachian Virginia, continue to be underserved. Multinomial regression models, including both individual and county data from 503 older adults aged 65+, were used to examine factors associated with informal and formal care use. Older adults with stronger filial beliefs and less positive attitudes toward community services preferred informal help. If the county had more formal care services, however, older adults were more likely to use them, regardless of their filial beliefs. Disparities based on gender were observed, in that women who lived in counties with a higher percentage of older adults below the poverty line were more likely to receive no help than men. Developing effective service promotion tactics, destigmatizing community services, and targeting services and support, especially to women, could decrease health disparities in rural Appalachia and similar geographic areas.

USO DE BASTÓN Y CAÍDAS EN ADULTOS MAYORES CHILENOS DE LA COMUNIDAD

Aim: To describe the characteristics of cane use and prevalence of falls in community-dwelling older adults who have received technical assistance in a Family Health Center. Method: Quantitative, descriptive and crosssectional study. Sample consisted of 64 older adults between 60 and 94 years of age. A questionnaire addressing socio-demographics, health, cane use and fall-related information was used to collect the data. Statistical analysis was performed with SPSS. An informed consent form was delivered and designed in compliance with Chile’s guidelines on research and confidentiality of information. Results: 95.3% of participants reported knowing the motives for cane use; 7.8% use a cane while walking within home; 45.3% use a cane while walking outdoors; 46.9% use a cane to walk anywhere; and 48.4% said that they do not like to use the cane. The prevalence of falls in the last six months was 73%; 61% of those who have fallen were not using a cane when they fell, and 94% expressed fear of falling. Conclusion: The findings show that a high percentage of older adults is not using a cane, and therefore the ultimate goal of delivering mobility devices is not being achieved. Cane use evaluation and education should be considered as an older adults’ health control measure.

Age differences in physical activity intentions and implementation intention preferences.

This study aimed to examine older adults' physical activity intentions and preferred implementation intentions, and how intentions and preferred implementation intentions differ between older, middle aged and younger adults. A cross-sectional Australian wide telephone survey of 1217 respondents was conducted in 2016. Multiple and ordinal regression analyses were conducted to compare intentions and preferred implementation intentions between older (65+), middle aged (45-64) and younger adults (<45). A higher percentage of older adults had no intentions to engage in regular physical activity within the next 6months (60%) compared to younger adults (25%). Older adults' most popular preferences included being active at least once a day and for 30min or less and were more likely to prefer more frequent and shorter sessions compared to younger adults. Both older and middle aged adults were more likely to prefer slower paced physical activity compared to younger adults who preferred fast paced physical activity. Physical activity interventions for older adults should address the high percentage of older adults with no intentions and public health campaigns for older adults should promote 30min daily sessions of slow paced activity.

Factores asociados a la desnutrición o al riesgo de desnutrición en adultos mayores de San Juan de Pasto, Colombia: Un estudio transversal

Introducción. La desnutrición es un problema común en los adultos mayores relacionada tanto con los cambios propios del envejecimiento como con otros factores de salud, sociales y económicos. El objetivo de este estudio fue determinar la frecuencia de desnutrición o riesgo de desnutrición y los factores asociados, en adultos mayores de San Juan de Pasto, Nariño, Colombia.Material y métodos. Estudio transversal en una muestra de 261 adultos mayores. Para valorar el estado nutricional se utilizó el Mini Nutritional Assessment (MNA) y para la evaluación cognitiva se aplicó el Mini-Mental State Examination (MMSE). Los síntomas depresivos se determinaron a través de la escala Yesavage y el grado de independencia funcional con la escala de Lawton y Brody. Para establecer la asociación entre los factores sociodemográficos y clínicos con el MNA, se realizó un modelo de regresión logística y se calculó la Odds Ratio (OR) crudo y ajustado con su respectivo intervalo de confianza del 95% (IC95%).Resultados. El 60,1% de los adultos mayores presentó riesgo de desnutrición y el 6,5% desnutrición. Quienes pertenecían a niveles socioeconómicos bajos (OR=2,07; IC95%: 1,18-3,64), con nivel de dependencia funcional (OR=2,74; IC95%: 1,07-5,53) y sintomatología depresiva (OR=7,02; IC95%: 2,08-23,74), presentaron mayor desnutrición o riesgo de desnutrición.Conclusiones. Estos hallazgos muestran un alto porcentaje de adultos mayores con desnutrición o riesgo de desnutrición asociados a un nivel socioeconómico bajo, implicación o dependencia funcional y sintomatología depresiva. Se requiere un manejo integral orientado hacia la valoración e intervención planificada, teniendo en cuenta los factores asociados a esta condición nutricional.

The dynamics of poverty transitions in Mexico

Purpose More than half of the Mexican population lives in poverty. While there are many studies about poverty in Mexico, there are very few about the dynamics of poverty. The purpose of this paper is to measure chronic and transient poverty in Mexico and to analyze its determinants. Design/methodology/approach Based on the spells approach, a transition matrix was estimated and a multinomial logistic regression analysis was conducted to investigate the effects of various socioeconomic and demographic variables upon the dynamics of poverty. Findings It was found that 36 percent of households are chronically poor and 64 percent are transiently poor. The results show that variables directly related to chronic poverty are belonging to an ethnic minority group, living in a rural area, a large family size, having a high percentage of older adults and children in the household and having a female household head. Having more education, having more assets, the age of the household head and having access to potable water and electricity in the household are variables positively related with the probability of escaping poverty. Originality/value To the authors knowledge, this is the first study on the dynamics of poverty using the spells approach for Mexico as a whole, not just for urban areas. The value of this work is that it estimates chronic and transitory poverty in Mexico as well as their possible determinants. The study findings can be used by the government to design and implement public policies to alleviate both chronic and transient poverty in Mexico.

Determinants of Support Exchange Between Grandparents and Grandchildren in Rural China: The Roles of Grandparent Caregiving, Patrilineal Heritage, and Emotional Bonds

Mutuality of support provision is a necessary precondition of family solidarity. However, the exchange of care between grandparents and grandchildren has largely been neglected. Using data from the fourth wave of the Anhui Study in China, this study investigated determinants of support exchange between grandparents and grandchildren. Results showed that more grandparents received support from than provided support to their grandchildren. A higher percentage of older adults exchanged support with the grandchildren of their eldest child if that child was male rather than female. Older adults who had strong emotional bonds with the middle generation, especially with sons, or had experience caring for grandchildren were much more likely to receive support from and provide support to their grandchildren. This study confirms the intergenerational solidarity theory and norms of kinship obligation in rural China, where social services are limited.

Social Media as a Sentinel for Disease Surveillance: What Does Sociodemographic Status Have to Do with It?

Introduction: Data from social media have been shown to have utility in augmenting traditional approaches to public health surveillance. Quantifying the representativeness of these data is needed for making accurate public health inferences.Methods: We applied machine-learning methods to explore spatial and temporal dengue event reporting trends on Twitter relative to confirmed cases, and quantified associations with sociodemographic factors across three Brazilian states (São Paulo, Rio de Janeiro, and Minas Gerais) at the municipality level.Results: Education and income were positive predictors of dengue reporting on Twitter. In contrast, municipalities with a higher percentage of older adults, and males were less likely to report suspected dengue disease on Twitter. Overall, municipalities with dengue disease tweets had higher mean per capita income and lower proportion of individuals with no primary school education.Conclusions: These observations highlight the need to understand population representation across locations, age, and racial/ethnic backgrounds in studies using social media data for public health research. Additional data is needed to assess and compare data representativeness across regions in Brazil.

Indicadores antropométricos em idosos de Florianópolis: estudo populacional em 2002 e em 2010

The objective of this study was to describe and compare specific anthropometric indicators in older adults from Florianópolis who participated in two population-based studies conducted in 2002 and 2010. A total of 865 older adults in 2002, and 1,657 older adults in 2010 were assessed for weight, height, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Significant increases in body weight of 3.0 kg for men and 4.9 kg for women were identified from 2002 to 2010 (P&lt;0.05). The BMI also increased in both genders (+0.9 kg/m2 for men and +1.6 kg/m2 for women), while height increased only in women (+1.5 cm) (P&lt;0.05). No significant differences were observed for WC or WHtR. BMI classification revealed an increase in the prevalence of overweight/obesity in both genders (P&lt;0.05). However, when the subjects were classified based on WC and WHtR, no significant difference was observed between the two time points in either gender, highlighting the high percentage of older adults (&gt; 70%) with inadequate WC and WHtR in 2002 as well as in 2010. The results suggest an increase in weight and BMI from 2002 to 2010 in older adults from Florianópolis. Furthermore, the prevalence of overweight/obesity characterized by BMI increased in women and men, whereas WC and WHtR remained unchanged between 2002 and 2010.

Alcohol consumption among the elderly primary health care patients: The impact of alcohol on overall health

Introduction: Alcoholism is the third most common psychiatric disorder among the elderly, yet it often goes undiagnosed in primary care setting. Objective: To estimate the prevalence of alcohol use disorders among elderly primary care patients in Bosnia and Herzegovina and to determine the presence of different health problems related to alcohol consumption. Method: The study was conducted in 10 family medicine practices. Family physicians randomly selected a group of 40 patients over 60 years of age registered with their practice. As a part of Comprehensive Geriatric Assessment, patients were asked to complete Alcohol Consumption Screening Questionnaire, Functional Status Questionnaire, Geriatric Depression Scale (GDS), Mini mental screening examination (MMSE), and Hamilton Anxiety Scale. Screening results were followed by additional clinical evaluation. To estimate the feasibility of Alcohol Consumption Screening Questionnaire, one family member or a caregiver of each patient was questioned about patient's habits and health problems. Results: Eighty-nine (22%) patients were current drinkers. Of those, 59% were harmful drinkers, 26% hazardous and 15% nonhazardous drinkers. Women accounted for 27% of current drinkers. MMSE revealed dementia symptoms in 37%, and symptoms of mild cognitive impairment (MCI) in 25% of current drinkers. Depression symptoms were found in 38% and anxiety symptoms in 6% of current drinkers. Functional status was decreased in hazardous and harmful drinkers. Conclusion: High percentage of older adults in Bosnia and Herzegovina is regular users of alcohol. Hazardous and harmful drinking is associated with significant morbidity. These findings demonstrate the usefulness and importance of the excess alcohol use screening in all primary care settings serving adults over age 60.