Alcohol Misuse among the Elderly
Psychology of Adulthood and Aging
University of Southern Maine
Ruth Mugisha Brasier
Alcohol misuse in elderly people is a common but under recognized issue associated with major physical and psychological health problems. The misuse of alcohol among the elderly develops later in life often due to issues such as bereavement, feeling of loneliness, or depression. The effects of alcohol may be increased in elderly patients because of pharmacologic changes associated with aging. Interactions between alcohol and drugs, prescription and over-the-counter, may also be more serious in elderly persons. Additionally, physiologic changes related to aging can alter the presentation of medical complications of alcoholism. Because alcohol misuse in the elderly has unique causes and characteristics, treatments designed specifically for the elderly might help combat this problem. Better integrated and outreach services are needed. Training of healthcare professionals in this area and pragmatic research should be prioritized to improve detection, treatment and service provision for this vulnerable and neglected population.
Alcohol Misuse among the Elderly
Older adults aged 65 and older constitute the fastest growing segment of the American population. In 1990, those over the age of 65 comprised 13 percent of the U.S. population; by the year 2030, older adults are expected to account for 22 percent of the population (U.S. Bureau of the Census 1996). As the elderly population increases, so too could the rate of alcohol problems in this age group. A substantial number of older adults are drinking at higher than recommended levels and it is a growing problem that is often ignored or missed by many healthcare providers. In a study of community-dwelling persons 60 to 94 years of age, 62 percent of the subjects were found to drink alcohol, and heavy drinking was reported in 13 percent of men and 2 percent of women. Overall, about 6 percent of older adults are considered heavy users of alcohol. In this study, heavy drinking is defined as having more than two drinks per day (Miranda et al, 1996). Older adults are more sensitive to alcohol and less able to metabolize it, both of which contribute to adverse effects at any level of drinking. Alcohol can aggravate some medical problems, reduce a person’s ability to function, increase the risk of falls, and negatively interact with medication. Although the extent of alcoholism among the elderly is debated, the diagnosis and treatment of alcohol problems are likely to become increasingly important. However, early detection efforts by health care providers can help limit the prevalence of alcohol problems and improve overall health in older adults. Alcohol Misuse
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Center for Substance Abuse Treatment (CSAT) recommend that people age 65 and older consume no more than one standard drink per day or seven standard drinks per week (O’Connor et. Al., 1998). The equivalent of 0.5 oz of alcohol is considered one drink: approximately 12 oz of beer or 5 oz of wine. There are three main types of alcohol misuse: hazardous drinking, harmful drinking, and dependent drinking. Hazardous drinking is defined as the regular consumption of more than the recommended upper limit of alcohol. Hazardous drinking also carries additional risks such as being involved in an accident, taking part in risky or illegal behavior when drunk such as driving under the influence. Harmful drinking is “a pattern of drinking that causes damage to physical health (e.g. the liver) or mental health (e.g. episodes of depression secondary to heavy consumption of alcohol)” (Sign, 2003). In some cases, these problems may be obvious, such as depression, alcohol related accident, and acute pancreatitis (inflammation of the pancreas). Finally, dependent drinking means that...