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No studies have evaluated the relationship between cognitive impairment and alcohol treatment outcomes amongst older drinkers. This study aims to explore the extent of cognitive impairment amongst older adults seeking alcohol treatment and examine the relationship between cognitive impairment, treatment retention and alcohol use following treatment.

The study used data from the Drink Wise Age Well programme; an alcohol intervention service for older adults (aged 50+). The Montreal Cognitive Assessment was used to screen for cognitive impairment; alcohol use was assessed using the alcohol use disorders identification test.

In total, 531 participants completed the assessment at treatment entry. Over half the sample were male (57%), with a mean age of 60 years (Standard deviation: 7.09). Almost half (48.4%) had cognitive impairment at the entry to treatment: 51.6% had a normal cognitive function, 41.4% had mild cognitive impairment, 5.8% had moderate cognitive impairment and 1.1% had severe cognitive impairment. Cognitive impairment was not associated with increased treatment drop-out and was not predictive of alcohol use following treatment. Alcohol treatment was associated with a significant improvement in cognitive functioning.

This study suggests there may be a significant amount of unidentified cognitive impairment amongst older adults attending alcohol treatment. Assessment and routine screening for cognitive impairment in drug and alcohol services may help in care planning and setting treatment goals; in the absence of routine screening opportunities for treatment planning and intervention may be missed.

The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics.

A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England.

Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers.

Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings.

Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits.

This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

Public relations (PR) research has given little space to the opinions, innovations and experiences of those working in marginalised or ‘dirty’ roles or occupations. To ensure that the worlds of these ‘others’ are represented this chapter explores the lives and work of women working in PR and communication roles in the ‘adult’ industry (worth an estimated $15 billion worldwide). Tibbals notes that ‘the voices and experiences of women working in the adult film industry are often overlooked’ (2013, p. 21) and dismissing a highly profitable but ‘dirty’ sector is to overlook and denigrate the people who work in it and the experiences and knowledge created therein. To explore my research questions I gathered informal interview data from women working in PR and combined this with published literature which recorded the lives of women who carried out PR and communications roles in the adult industry. My research demonstrates that high quality PR work is carried out within the adult industry and that the industry attracts women from diverse backgrounds, many of whom progress quickly within a meritorious environment. Nonetheless, these women often feel difficulty in explaining or justifying their work to family and friends and have strategies to avoid discussing their work to those outside the industry. They also have to work within a media environment where adult industry issues are not well or correctly reported.