Alison A Moore

University of California, San Diego | UCSD · Department of Medicine

The rapidly changing policy climate related to cannabis legalization has led to drastic changes in cannabis use in the United States (US). Medical cannabis use is increasing overall, but at a faster rate among older adults compared to other age groups. The aim was to investigate older adults’ cannabis use behaviors and attitudes around disclosing m...

Background Forced migration results in exposure to trauma, interrupted access to healthcare, and loss of social support and may increase dementia risk. Literature on refugees’ knowledge of dementia and its risk factors is scant. This study investigates refugee perspectives on dementia and their access to cognitive healthcare in the United States (U...

Background: Spousal loss is a stressful life event that is associated with loneliness and social isolation, both of which affect mental and physical health. The primary objective of this paper was to synthesize longitudinal studies that investigated loneliness and social isolation in widowhood. Methods: A systematic search of the literature was co...

Objective This analysis evaluated the validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) tool for older adults. Methods We performed a subgroup analysis of older adults aged ≥65 (n = 184) from the TAPS tool validation study conducted in 5 primary care clinics. We compared the interviewer and self-ad...

Background The number of older adults entering opioid treatment programs (OTPs) to treat opioid use disorder (OUD) is increasing. However, the lived experiences of aging in OTPs have not been examined. Objective To explore the aging experience with OUD and barriers to medical care for older adults who receive care in OTPs. Design From November 20...

Background Navigating the complex decision‐making and coordination challenges of a cancer diagnosis is difficult for any person diagnosed with cancer. This burden can become untenable for Latinos living with Alzheimer’s and Related Dementias (ADRD). The literature has demonstrated the disproportionate burden of late‐life comorbidities on Latino pop...

Introduction: While there is increasing interest in the use of cannabis to manage a range of health-related symptoms, little is known about trends in recent cannabis use with respect to various health conditions. Methods: We examined data from a US representative sample of noninstitutionalized adults age ≥ 18 from the 2015–2019 National Survey on D...

While voice user interfaces offer increased accessibility due to hands-free and eyes-free interactions, older adults often have challenges such as constructing structured requests and perceiving how such devices operate. Voice-first user interfaces have the potential to address these challenges by enabling multimodal interactions. Standalone voice...

The likelihood of benefit from a preventive intervention in an older adult depends on its time-to-benefit and the adult’s life expectancy. For example, the time-to-benefit from cancer screening is >10 years, so adults with <10-year life expectancy are unlikely to benefit. To examine receipt of screening for breast, prostate, or colorectal cancer an...

Introduction: Older adults living with Alzheimer's disease and related dementias (ADRD) who are then diagnosed with cancer are an understudied population. While the role of cognitive impairment during and after cancer treatment have been well-studied, less is understood about patients who are living with ADRD and then develop cancer. The purpose o...

While standalone Voice Assistants (VAs) are promising to support older adults’ daily routine and wellbeing management, onboarding and setting up these devices can be challenging. Although some older adults choose to seek assistance from technicians and adult children, easy set up processes that facilitate independent use are still critical, especia...

Introduction Refugees experience higher rates of mental illness such as depression and post-traumatic stress disorder (PTSD) which are documented risk factors for dementia. Faith and spiritual practices have been shown to play a significant role in patients' understanding and coping with illness, however, this field of study among refugee populatio...

Objectives: Observational studies have suggested that moderate alcohol use is associated with reduced risk of dementia. However, the nature of this association is not understood. We investigated whether light to moderate alcohol use may be associated with slower brain aging, among a cohort of older community-dwelling adults using a biomarker of br...

Background: The use of cannabis among older adults is increasing in the United States. While cannabis use has been suggested to help alleviate chronic symptoms experienced by older adults, its potential adverse effects may lead to unintended consequences, including increased acute healthcare utilization related to its use. The objective of this st...

Alcohol has been shown to have both beneficial and adverse associations with cognitive health in aging, dependent upon amount consumed, but associations with structural brain measures are less well understood. Here, we investigated whether predicted brain age, calculated using a voxel‐based algorithm trained on a large dataset, differs by alcohol u...

The COVID‐19 pandemic continues to worsen economic inequality, political unrest and violence resulting in unprecedented numbers of refugees and asylees globally. Various stressors related to forced displacement may impact cognitive function as refugees age in hosting countries. However, little is known about how forced displacement impacts percepti...

Cannabis use is growing among older adults to manage medical concerns including poor sleep. In this study, we characterized how patients seen at a geriatrics clinic use cannabis to address sleep disturbance. Specifically, we conducted an anonymous survey of 568 adults, including 83 who reported cannabis use within the past 3 years, to inquire about...

Background: Extensive research suggests that physical activity (PA) is important for brain and cognitive health and may help delay or prevent Alzheimer's disease and related dementias (ADRD). Most PA interventions designed to improve brain health in older adults have been conducted in laboratory, gym, or group settings that require extensive resou...

Objectives This study investigates whether year of arrival to the U.S. and birthplace relate to post-migration cognitive difficulties among foreign- and U.S.-born Arab Americans in later life. Methods We analyzed 19 years (2000–2019) of data from the American Community Survey (ACS) Public Use Microdata Samples (weighted N = 393,501; ages ≥ 50 year...

Background Despite concerns about increasing trends in depression over the past two decades, little is known about recent trends in depression and mental health (MH) treatment among older adults and whether these trends differ by demographic characteristics. Methods We examined data from a US representative sample of noninstitutionalized adults ag...

Population aging is an increasingly important consideration for health care in the 21th century, and continuing to have access and interact with digital health information is a key challenge for aging populations. Voice-based Intelligent Virtual Assistants (IVAs) are promising to improve the Quality of Life (QoL) of older adults, and coupled with E...

Objectives To examine associations between alcohol use and cognitive performance among older adults in Greece and the United States, and assess potential differences due to differing drinking practices in the two countries. Methods Data came from Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) and National Alzheimer’s Coordinating C...

Voice based Intelligent Virtual Assistants (IVAs) promise to improve healthcare management and Quality of Life (QOL) by introducing the paradigm of hands free and eye free interactions. However, there has been little understanding regarding the challenges for designing such systems for older adults, especially when it comes to healthcare related ta...

Background: Recent literature suggests that the gap in prevalence of binge drinking between men and women is closing, but little is known about sex-specific differences in trends and correlates of binge drinking among older Americans. Methods: A total of 18,794 adults, aged 65 years and older were surveyed in the 2015-2019 National Survey on Dru...

Voice based Intelligent Virtual Assistants (IVAs) promise to improve healthcare management and Quality of Life (QOL) by introducing the paradigm of hands free and eye free interactions. However, there has been little understanding regarding the challenges for designing such systems for older adults, especially when it comes to healthcare related ta...

Ecological momentary assessment (EMA) is used to evaluate subjects' behaviors and moods in their natural environments, yet collecting real-time and self-report data with EMA is challenging due to user burden. Integrating voice into EMA data collection platforms through today's intelligent virtual assistants (IVAs) is promising due to hands-free and...

Background Alcohol use is shown to be a risk and protective factor for cognitive impairment. Alcohol use patterns differ across cultures; it is possible inconsistent findings may be partially explained by different drinking patterns across countries. We analyzed datasets from international studies housed in the Global Alzheimer’s Association Intera...

Background/objectives: Use of cannabis is increasing in a variety of populations in the United States; however, few investigations about how and for what reasons cannabis is used in older populations exist. Design: Anonymous survey. Setting: Geriatrics clinic. Participants: A total of 568 adults 65 years and older. Intervention: Not applic...

Older adults living with HIV may have health conditions that amplify the potentially negative health effects of alcohol use. We adapted the Comorbidity Alcohol Risk Evaluation Tool (CARET) screening tool for at-risk drinking to reflect HIV/AIDS and related conditions, medications, and behaviors. The adapted CARET-HIV along with a brief intervention...

Objectives: Binge drinking is a risk factor for a range of harms. This study estimates the national prevalence of binge drinking and adds to our understanding of correlates of binge drinking among older adults in the United States. Design: Cross-sectional analysis. Setting/participants: A total of 10 927 adults, aged 65 years or older, from th...

Older persons living with HIV (PLWH), often defined as age 50 years and older, are a rapidly growing population, with high rates of chronic pain, substance use, and decreased physical functioning. No interventions currently exist that address all three of these health outcomes simultaneously. An 8-week behavioral intervention combining cognitive-be...

Background: Adults 50 and older make up approximately 50% of persons living with HIV. Multiple co-morbidities are common among this group, including chronic pain and substance abuse, yet little is known about the daily factors that either enhance or inhibit these experiences or behaviors. This study explored daily drivers of substance use, pain, a...

Adults with medical multimorbidity (≥2 chronic conditions) present challenges for health care systems to provide coordinated care. Substance use can complicate the management of chronic medical conditions, but little research has focused on the intersection of medical multimorbidity and substance use. This study uses cross-sectional analysis of 115...

Background While the number of older adults who engage in unhealthy drinking is increasing, few studies have examined the role of online alcohol screening and intervention tools for this population. The objective of this study was to describe characteristics of drinking behaviors among older adults who visited an alcohol screening and intervention...

Background: Binge drinking among older adults has increased in the past decade. Binge drinking is associated with unintentional injuries, medical conditions, and lower health-related quality of life. No studies have characterized multimorbidity among older binge drinkers. Methods: We examined past 30-day binge alcohol use and lifetime medical co...

We explored the effect of older partner’s age and age difference between partners on condomless sex among men who have sex with men (MSM). We analyzed dyads (n = 1720) from participants (n = 969) in the Sexual Acquisition Transmission of HIV Cooperative Agreement Program. We used modified Poisson regression to model the probability of a sexual enco...

The number of older adults who engage in unhealthy substance use is expected to increase substantially to levels never seen before. Older adults, owing to physiologic changes in aging, are at high risk for the adverse effects of alcohol and illegal drug use. Screening and prevention can help older patients to be better informed of the risks of subs...

While numbers and proportions of older adults with behavioral health issues are expected to substantially increase, there is also a widening gap in available services for older adults. Mobile health interventions (mhealth) are a way to address existing barriers to treatment, provide frontline assessment and increase access to services for older adu...

Chronic pain and substance use disorders occur commonly among HIV-infected persons. Recent CDC guidelines recommend non-pharmacologic approaches over opioid medications for the management of chronic pain. This is particularly relevant for persons with substance use disorders. Structured physical activity may be an effective strategy for pain reduct...

Method: Using Amazon's Mechanical Turk, 138 male and female drinkers aged 50 to 75+ were recruited to complete an online survey that asked about their: perceptions of their drinking, quantity and frequency of drinking, and any comorbid health and/or mental health disorders/medications. They were then provided either NF or PF. NF provided informati...

While numbers and proportions of older adults with behavioral health issues are expected to substantially increase, there is also a widening gap in available services for older adults. Mobile health interventions (mhealth) are a way to address existing barriers to treatment, provide frontline assessment and increase access to services for older adu...

Objectives: This study compared the association between social networks and alcohol consumption among middle-aged (MA) and older adults (OA) to better understand the nature of the relationship between those two factors among OA and MA. Method: We examined Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Current drinker...

Background: Alcohol use is common among older adults, and this population has unique risks with alcohol consumption in even lower amounts than younger persons. No recent studies have estimated trends in alcohol use including binge alcohol use and alcohol use disorders (AUD) among older adults. Methods: We examined alcohol use among adults age ≥5...

Background: Oral anticoagulation treatment (OAT) such as warfarin therapy is recommended for older adults with atrial fibrillation, heart failure, or who are at risk for venous thromboembolism. Despite its proven benefits, older adults report both dissatisfaction with OAT and reduced quality of life that can potentially lead to low adherence to OAT...

Ten percent of older adults experience elder mistreatment, and it is much more common in older adults with dementia. It is associated with higher rates of psychological distress, hospitalization, and death and, in the United States, costs billions of dollars each year. Although elder mistreatment is relatively common and costly, it is estimated tha...

Purpose: Most malignancies are diagnosed in older adults who are potentially susceptible to aging-related health conditions; however, the manifestation of geriatric syndromes during surgical cancer treatment is not well quantified. Accordingly, we sought to assess the prevalence and ramifications of geriatric events during major surgery for cancer...

The primary objective of this study was to explore how middle-aged gay men in recovery cope with stigma and family relationships. For gay men, perceptions of acceptance of their sexual orientation and degree of social connectedness can play a role in their recovery from alcohol and substance use disorders. Yet gay men may have a more difficult time...

Alcohol is the most commonly used substance among older adults, and older adults face unique risks associated with alcohol use due to the aging process and increases in comorbidity with increasing age. However, older adults are infrequently screened for unhealthy alcohol use, even in primary care. In this chapter, we discuss health risks that are a...

This final chapter provides recommendations from the Editors with regard to future research, policy, and practice initiatives in the field of alcohol and aging in light of the current body of research in this area. Overall, this text has highlighted the need for cross-disciplinary research that accounts for the ever changing, diverse, and growing p...

Background and objectives: Successful diabetes self-management requires behavioral and lifestyle changes. However, low-income patients may face challenges related to poverty that make it difficult to engage in lifestyle changes. We piloted an intervention designed to help older, low-income, Hispanic, patients with diabetes access free or low-cost...

This book provides a current perspective on alcohol and aging to better understand the trends, costs, benefits, and clinical and community evidenced-based strategies. This book embraces not only the physical, cognitive, psychological, and social health benefits of moderate drinking in the elderly, it also delves into the risks of excessive drinking...

Objective: This study was conducted to evaluate the feasibility, usability, and acceptability of using remote monitoring systems (RMS) in monitoring health status (e.g., vital signs, symptom distress) in older adults (≥55) with chronic heart failure (HF). Method: Twenty-one patients (52.4% women, mean age 73.1 ± 9.3) were trained to measure and tra...

Background: At-risk drinking, defined as alcohol use that is excessive or potentially harmful in combination with select comorbidities or medications, affects about 10% of older adults in the United States and is associated with higher mortality. The Project SHARE intervention, which uses patient and provider educational materials, physician couns...

Adult Protective Services (APS) workers in California investigate complaints of elder abuse and must determine the validity of a complaint with minimal guidelines. It is unclear whether APS workers reach similar conclusions given cases with similar circumstances. To assess variation in case findings and reasons for them, we used data from monthly r...

Background Health promotion interventions often include multiple components and several patient contacts. The objective of this study was to examine how participation within a multicomponent intervention (Project SHARE) is associated with changes in at-risk drinking among older adults.Methods We analyzed observational data from a cluster-randomized...

This aim of this study was to characterize trends in alcohol-related hospital admissions among middle-aged and older adults from 1993 to 2010 in relation to age, gender, race, and cohort membership. This study utilized repeated cross-sectional data from the Nationwide Inpatient Sample. Using alcohol-related classified admissions, yearly rates and l...

Breast cancer incidence increases with age, but many older women do not receive appropriate mammography screening. A tool to support provider decision making holds potential to help providers and patients reach the best-informed decisions possible. We developed and tested a decision aid (DA) for healthcare providers to use in mammography screening...

Objectives To determine the initial efficacy of a mailed screening and brief intervention to reduce at-risk drinking in persons aged 50 and older.DesignPilot randomized controlled trial.SettingUniversity of California at Los Angeles Department of Medicine Community Offices and Primary Care Network.ParticipantsIndividuals aged 50 and older who were...

Background: This study explores how middle-aged gay men (African-American, Latino, & White) in recovery experienced minority stress. We understand that gay men experience family rejection, stigma and discrimination, and are more likely than heterosexual men to abuse alcohol into older age. Alcohol is often used to cope with these social disadvantag...

Although the myth that older adults do not use mood-altering substances persists, evidence suggests that substance use among older adults has been underidentified for decades. The baby boom generation is unique in its exposure to, attitudes toward, and prevalence of substance use-causing projected rates of substance use to increase over the next tw...

Objectives: The purpose of this pilot study was to describe patterns of alcohol consumption among continuing care retirement community(CCRC) residents and to explore the role of drinking motives and affective states on drinking context and consumption. Method: We utilized a phone-based daily diary approach to survey older adults about their dail...

Little is known about alcohol misuse and depression among Latino day laborers despite the fact that they encounter multiple stressors (e.g., job instability, unsafe work environments). A structural equation model tested the relationships among laborer stress, social support, health status, current alcohol misuse, and depression. A sample of 89 male...

Objective: To describe and compare characteristics of older adults who drive after drinking and those who do not, whether an intervention addressing at-risk drinking reduces risk among those reporting driving after drinking, and reasons reported for driving after drinking. Methods: Secondary data analysis of a randomized trial testing the effica...

Objective: The purpose of this study was to examine the effectiveness of a patient-provider educational intervention in reducing at-risk drinking among older adults. Method: This was a cluster-randomized controlled trial of 31 primary care providers and their patients ages 60 years and older at a community-based practice with seven clinics. Recr...

This study explores how sober gay Latino men obtain support from their families. Familial ties can be a protective health factor, yet many gay Latinos experience rejection from family members because of their sexuality. There are very few studies that examine the extent and quality of emotional support from kin for this population. Understanding fa...

To compare 12-month outpatient healthcare expenditures of at-risk and not-at-risk drinkers aged 60 and older. Secondary analysis of data from Project Senior Health and Alcohol Risk Education, a cluster, randomized trial to test the efficacy of an intervention to reduce at-risk drinking. Seven primary care clinics in or near Santa Barbara, Californi...

The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited. The aim of...

Objective: To evaluate and compare the attitudes and preferences of younger and older adults regarding health information exchange with providers, and identify barriers and limitations to meaningful use. Study design: Cross-sectional study. Methods: Qualitative and quantitative data gathered from online surveys of younger and older adult patie...

To examine associations of alcohol and tobacco use disorders and psychiatric conditions among older U.S. adults. Sample was individuals aged at least 65 years (N = 8,205) who participated in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. Measurements included lifetime and past 12-month Diagnostic and Statistical Manu...

To understand characteristics of older at-risk drinkers and reasons why they decide to change or maintain their alcohol consumption. Secondary analysis of data from a randomized controlled trial to reduce drinking in at-risk drinkers. Three primary care sites in southern California. Six hundred thirty-one adults aged 55 and older who were at-risk d...

To examine the association between alcohol consumption and mortality among older Mexican American men, with and without pre-existing cardiovascular conditions. We conducted survival analysis among 908 men aged 65-80 years from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE), a longitudinal population-based...

In one Los Angeles study, 20 % of day laborers reported excessive drinking. Older adults are more sensitive to alcohol's effects, yet heavy drinking persists among Latinos until they are in their 60s. No interventions to reduce heavy drinking exist for aging day laborers. We recruited 14 day laborers aged 50 and older in Los Angeles. We identified...

The use of opioid medications as treatment for chronic non-cancer pain remains controversial. Little information is currently available regarding healthcare providers' attitudes and beliefs about this practice among older adults. This study aimed to describe primary care providers' experiences and attitudes towards, as well as perceived barriers an...