Alcohol Addiction Among the Elderly
Alcohol addiction among the elderly is the most prevalent of addiction disorders. It has been described as a "hidden national epidemic", "underrecognized", and "misdiagnosed." The abuse of alcohol by those 65 and older is often accompanied by impairments in physical, psychological, social and cognitive health. And with 76 million baby boomers beginning to retire, the problem will only continue to grow.
Defining Alcohol Abuse in the Elderly
There are generally two types of elderly patients with drinking problems: the early-onset group and the late-onset drinkers. Early-onset drinkers usually start drinking in the 20s or 30s; this comprises about two thirds of seniors with problems drinking. This group continues their excessive drinking patterns as they age, which usually brings major physical, psychological and cognitive disorders.
Late-onset drinkers are typically in a higher socioeconomic class, have less history of alcoholism in the family, and have far fewer physical and psychological illnesses.
According to a New York University School of Medicine study, this group tends to "resolve their drinking problems more often without formal treatment" [than early-onset drinkers] though "there there is little evidence to suggest that they are more responsive to alcohol treatment than patients who are early-onset drinkers."
This group's alcohol abuse "is often triggered by changes in life such as: retirement, death or separation from a family member, a friend or a pet, health concerns, reduced income, impairment of sleep and/or familial conflict."
The National Institute on Alcohol Abuse recommends for those 65 years of age and older, no more than one drink a day. A drink is classified as 1.5 oz of hard liquor (40% alcohol), 12 oz of beer (5% alcohol) or 5 oz of wine (12% alcohol).
As we age, our bodies are more sensitive to alcohol and our tolerance is decreased. We also have less lean body mass and less total body water making the concentration of ingested alcohol higher. All of this leads to easier intoxication given the same amount of alcohol and higher levels of toxicity.
The following are risk factors for alcohol addiction among the elderly:
- Gender- Elderly men are at a greater risk than elderly women of developing alcohol-related problems because men drink more and more often.
- Family History- Having a family history of alcohol abuse increases the risks.
- Psychiatric Disorders- Disorders like depression and anxiety are a major risk factor in seniors who have alcohol addiction. About 25% of elderly patients with alcohol addiction have major depression.
- Chronic Medical Illness- A chronic illness such as chronic pain or even insomnia predisposes the elderly to alcohol addiction. This is a way for them to self-medicate, to "drink the problem away."
- Social- Seniors who experience loss of spouse, loss of occupation and income, loss of mobility, physical and psychological decline, isolation, and loneliness attempt to cope with these factors by turning to alcohol. Abuse is most often seen in elderly who have been divorced or separated and in widowed men.
How Big Is the Problem?
About 10% of the U.S.'s population abuses alcohol with 17% of those over 65 years old believed to have an alcohol addiction problem. According to research by the University of Kentucky, "2.5 million older adults and 21% of older hospital patients had alcohol-related problems."
Signs of Alcohol in the Elderly
The Center for Substance Abuse Treatment says these signs may indicate alcohol abuse in the elderly.
- Loss of coordination
- Memory trouble after drinking or taking medication
- Changes in sleeping habits
- Unexplained bruises
- Irritability, sadness, depression
- Changes in eating habits
- Unexplained chronic pain
- Wanting to be alone a lot
- Difficulty concentrating
- Lack of interest in social activities
- Trouble staying in touch with friends and family
Consequences of Elderly Alcohol Addiction
The bottom line: the elderly are at much greater risk of serious medical disorders when they abuse alcohol than the similar-aged population who don't abuse alcohol.
Heavy drinking (two or more drinks per day) increases the risk of coronary heart disease, stroke and dementia. In addition, alcohol combined with prescription medication can decrease the rate of blood flow to the liver and kidney causing a 50% decrease in the rate of metabolism of these medications. This can prolong the effects of both and increase the risk of fall, fractures and confusion. Confusion can lead to overdose and/or death.
According to an article on elderly alcohol abuse in the journal American Family Physician, "Gastrointestinal disease and bleeding are common reasons for emergency department visits by older alcoholics.18 Elevated liver enzymes are found in 18 percent of older alcoholics,19 and may indicate alcoholic hepatitis, fatty liver or cirrhosis. One-half of elderly patients with cirrhosis die within one year of diagnosis.
Heavy alcohol consumption can also lead to nutrient deficiency and a host of health issues such as Wernicke-Korsakoff syndrome. This disorder produces confusion, abnormal eye movements and memory issues. Other effects of nutrient deficiency include brittle bones, anemia, and poorly functioning immune and nervous systems.
Other consequences include more depressive symptoms, more trips to the hospital and less satisfaction with life.