The VINTAGE project

Older people drink for many reasons, including to be sociable, to relax, and to block out loneliness (Graham et al. 1996), and often continue the same drinking patterns they had before retirement (Bacharach et al. 2004). On the other hand, older people who develop adverse medical conditions or physical symptoms are more likely to reduce their frequency of drinking or to abstain from alcohol (Moos et al. 2005).   Harmful alcohol use is common among older people. The 2007 Eurobarometer survey estimates that 27% of European people aged 55+ years had episodes of binge drinking (5+ drinks of 50g alcohol on a single occasion) at least once a week during the previous 12 months (Eurobarometer, 2007). Alcohol use disorders are frequent in older people, and with an ageing European population will increase in absolute numbers (O’Connell et al 2003). The major alcohol-related conditions among older people include neuropsychiatric conditions, cancers (mouth, digestive system, liver, female breast), cerebrovascular diseases, in addition to accidents and injuries. Although alcohol can reduce the risk of coronary heart diseases, scientific evidence shows that the degree of protection is lower in older people than in middle-aged people (Abbott et al 2002). Harmful alcohol use of older people leads to a reduction in healthy life years, and to a preventable increase of health and welfare costs. Despite the extent of harmful alcohol use among older people, there are surprisingly few recent systematic reviews that document the full extent of such harm, or that provide the evidence base for cost effective policies and programmes to reduce it, investing in the health and well-being of older persons. VINTAGE aims at reducing this knowledge gap, by providing evidence base of harmful alcohol use among older people and collecting concrete and practical examples of best practice across all European countries, at country, regional and municipal levels.  Inevitably, since the risk of life-time death increases both with the volume of lifetime alcohol use and the frequency of heavy drinking occasions (Rehm et al 2008), policies and programmes that intervene in later middle age, at the work place and at the time of retirement are featured in VINTAGE literature reviews and in the collection of best practices. The general objective of VINTAGE is to build capacity at the European, country and local levels by providing the evidence base and collecting best practices to prevent the harmful use of alcohol amongst older people, including the transition from work to retirement. The specific objectives of VINTAGE are: To systematically identify, document and summarize the existing scientific and grey literature on: the impact of alcohol on the health and well-being of older people the prevention of harmful alcohol use in older people To collect best practices, laws and infrastructures to prevent harmful alcohol use by older people across all European countries at different levels To ensure that information about and the main findings of the project (all relevant reports, examples of best practices, and relevant laws and infrastructures) are actively disseminated, along with relevant key findings and implications for policy and programme development, to those responsible for alcohol policy and programme development, including those working in the fields of health and welfare of older people at the European, country, regional and municipal levels, in order to help build the capacity and knowledge of such personnel in making informed and evidence-based decisions.

the impact of alcohol on the health and well-being of older people the prevention of harmful alcohol use in older people

The project is coordinated by the Istituto Superiore di Sanità (ISS), Population Health and Health Determinant Unit of the National Centre for Epidemiology, Surveillance and Health Promotion, which provide overall coordination and management of the project. A Management Team, composed of the Project Coordinator, other relevant staff of ISS and the Work Packages Leaders, is responsible for ensuring the timely completion of planned actions and deliverables (see Timing of Work Packages and Deliverables ) and the respect for budgetary provisions.   Systematic reviews of the international literature are carried out with the aim of documenting the extent and characteristics of harmful alcohol use among older people, including alcohol-related disorders and conditions, and identifying evidence-based interventions and policies to reduce such harm. The search strategies for the reviews adopt standard systematic search criteria, based on a variety of electronic bibliographic databases (e.g., Cochrane Library), as well as on published reports of related EC-co financed projects (e.g., Alcohol in Europe report, Pathways for Health report, etc.). Search engines used include PubMed, MEDLINE, PsychINFO, PsychLit, AgeLine and Google scholar. Abstracts retrieved are assessed to identify studies documenting alcohol-related harm, and providing evidence of effective interventions and experiences. Examples of best practices and related laws and infrastructures to reduce the harm done by alcohol to the health and well-being of older people are gathered from partner agencies in European and international networks (including the Alcohol Policy Network of the Building Capacity project), through a specifically created questionnaire , designed also to assess the quality of collected examples. All findings of the project will be collated into specific reports providing knowledge about the impact of alcohol on the health and well-being of older people, and on experiences, laws, infrastructures, policies and programmes aimed at reducing alcohol-related harm amongst older people at European, country, regional and municipal levels. Reports and all relevant key findings for policy and programme development will be actively disseminated through the following dissemination strategy: creation of the present website, hosted by ISS, containing information on the project, links to websites involved in the topic, and downloadable versions of all VINTAGE outputs; dissemination of electronic copies of VINTAGE reports to a specifically developed list of stakeholders and organizations working in the field of ageing or alcohol, at governmental, non-governmental and private level. joint collaboration with all associated and collaborating partners in order to store VINTAGE data on existing databases, and link VINTAGE website to, and from, European websites concerning alcohol policy and programme development, particularly in the fields of alcohol and welfare of older people, such as: Building Capacity HP-Source database , which collects data on relevant infrastructures and laws and regulations across all alcohol policy and prevention areas. A module on older people will be added to the database DHS Pathways for Health project (PhP) , which collects examples of good practice and systematic reviews of the literature on drink driving, binge drinking, and consumer information and labelling of alcoholic beverages Focus on Alcohol Safe Environments project (FASE) , which collects best practices and systematic reviews of literature on drinking environments, workplaces and regulation of advertising Building Capacity project Eurocare Institutional websites of VINTAGE associated and collaborating partners   An external evaluator will undertake the project evaluation, following a case study evaluation methodology including: Process evaluation (analysis of written documentation, survey of project staff and members, assessment of the quality of information, etc.) Output evaluation (review of project deliverables and outputs in terms of scientific accuracy, readability, usability and ease of access, by a panel of selected scientists) Outcome evaluation (evaluation of increased health and well being of older people through 3 intermediate measures: extent of the dissemination, hits to websites and number of downloaded documents, survey of a sample of stakeholders in order to measure their intention to modify existing policies and infrastructures)

ISS - Istituto Superiore di Sanità , IT Population Health and Health Determinants Unit-CNESPS Associated Partners UNIMAAS - Maastricht University, School for Public Health and Primary Care: Caphri GENCAT – Government of Catalonia, Department of Health, Program on Substance Abuse Barcelona, Spain IAS - Institute of Alcohol Studies, Huntingdon United Kingdom IVZ - Institute of Public Health, Research Centre, Ljubljana, Slovenia THL – National Institute for Health and Welfare, Helsinki, Finland SZU – National Institute of Public Health, Coordination, Monitoring and Research Unit, Praha, Czech Republic Collaborating Partners University of Bergen - Bergen, Norway DHS - Deutsche Haupstelle für Suchtfragen - Hamm, Germany STAP - National Foundation for Alcohol Prevention - Utrecht, Netherlands HCPB - Hospital Clinic I Provincial de Barcelona - Barcelona, Spain Center on Aging, National Research Council, University of Padua - Padua, Italy Department of Neurological and Psychiatric Sciences, University of Florence - Florence, Italy Memory Unit, Center for Aging Brain, Department of Geriatrics, University of Bari - Bari, Italy SIA - Società Italiana di Alcologia - Bologna, Italy EUROCARE ITALIA - Padua, Italy Centro Alcologico Regione Toscana - Florence, Italy AICAT - Associazione Italiana Club Alcolisti in trattamento - Salerno, Italy Università Cattolica Sacro Cuore, Istituto Medicina Interna e Geriatria - Rome, Italy