Alcohol Screening, Brief Intervention, and Referral to Treatment: Evidence for Use in Older Adults

Saturday, 29 July 2017: 1:50 PM

Bryan R. Hansen, PhD
Johns Hopkins School of Nursing, Baltimore, MD, USA


Alcohol use among older adults has been identified as a significant and potentially growing public health problem with the growing entry of the baby boomer cohort in older adulthood (Le Roux, Tang, & Drexler, 2016). As adults age, they become more sensitive to the effects of alcohol, are more likely to have one or more health conditions requiring medication, and more likely to encounter interactions between alcohol and health conditions or medications. There is also an increased risk of malnutrition with alcohol use (Barry & Blow, 2016). Heavy alcohol use and alcohol withdrawal have been implicated as risk factors for cognitive impairment and the development of delirium (Bommersbach, Lapid, Rummans, & Morse, 2015). Therefore, the purpose of this presentation is to examine the evidence for alcohol screening, brief intervention, and referral to treatment for older adults.


The application of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to the care of older adults is well supported by the literature. Screening is recommended for all older adults and several alcohol screening instruments have been developed and validated for use with older adults, including the Short Michigan Alcoholism Screening Test – Geriatric Version (SMAST-G) and the Alcohol Use Disorders Identification Test short form (AUDIT) (Bommersbach et al., 2015). Brief intervention has been well-established in the literature as a highly effective tool for adults under age 60 and the few studies validating its use among older adults have found similar results (Barry & Blow, 2016). Referral to treatment is especially important among older adults who are at-risk or currently engaging in heavy alcohol use. Older adults’ reduction in alcohol use must be carefully monitored and managed to avoid complications such as delirium, seizures, and other adverse health outcomes for which they are at substantial risk (Bommersbach et al., 2015).


This content is included in a teaching and learning module, which is integrated in the nursing curriculum for pre-licensure nursing program.


SBIRT is a recommended for use with older adults, but special care must be used for those at highest risk or those currently with heavy alcohol use to minimize the risk of harm. Incorporation of this content into nursing curricula is suggested to enhance the nursing care of older adults and promote positive health outcomes.