Objective: To examine the predictive value of demographic characteristics and substance abuse indicators to explain treatment seeking for substance abuse problems among older male medical patients. Design: Longitudinal analysis of screening data and treatment seeking behavior. Setting: Inpatient medical and outpatient substance abuse treatment center. Participants: Participants in the study were 855 medically ill male veterans aged 55 and over, who were screened for alcohol problems during inpatient medical treatment after clinician referral. Measurements: The CAGE alcohol screen, drug use and demographic measures administered at time of screening. Predictors of treatment seeking in the sample were examined using structural equation modeling. Results: Expressed interest in treatment and later attendance at a pre-treatment evaluation were associated with younger age and a higher CAGE alcohol screening score. Being unmarried and using drugs in addition to alcohol were associated with treatment interest but not with evaluation attendance. In the path model tested, the effect of higher CAGE score partially explained the effect of younger age on treatment seeking. Conclusions: The model examined shows utility in predicting alcohol treatment seeking in this sample. Age-related factors may deter treatment seeking among older male medical inpatients.

This study examines how individual patient characteristics predict substance abuse treatment initiation among older adults, in an investigation based on the behavioral health service use model. Analyses tested the impact of demographic factors, substance abuse symptoms, depression and cognitive status on subsequent treatment initiation. The sample included 250 older male veterans screened for substance abuse problems during inpatient medical treatment, who also participated in a clinical evaluation for substance abuse treatment. Measures included demographics and CAGE alcohol screening score. A subset of patients also completed the Michigan Alcohol Screening Test-Geriatric Version (MAST-G), Hamilton Depression Scale (HAM-D), and Folstein Mini Mental State Exam (MMSE). Patients who initiated treatment following evaluation had more years of education, better cognitive status, and more symptoms of substance abuse and depression, compared with patients who did not initiate treatment. In logistic regression analysis, CAGE and MMSE scores independently predicted treatment initiation. Findings contribute to the understanding of how clinical characteristics of older adults affect substance abuse treatment initiation.