Alcohol use and seniors: What you should know
Gifting your elderly loved one a bottle of wine may be a thoughtful gesture, but alcohol could adversely affect them and even risk their health and safety.
Dr. Robert Roush, director of the Texas Consortium Geriatrics Education Center at Baylor College of Medicine’s Huffington Center on Aging, discusses risks associated with drinking and the elderly in the following Q&A.
Q: How prevalent is alcoholism in elderly Americans?
A: About 16 million adults over age 18 in the United States have alcohol use disorder (AUD). However, only about 1.5 million are receiving treatment at a specialized facility. Almost 90,000 deaths per year are attributable to alcohol-related causes, making that the fourth-leading cause of preventable deaths.
Among adults over 75, 46 percent of men and 33 percent of women consume alcohol. Only about 2 percent of all older adults, though, have reported heavy drinking – more than five drinks in one day. This rate differs by marital status with cohabitating, divorced or separated elders being heavy drinkers at twice that rate.
A note of caution here is that regular use of alcohol in moderation does not meet the definition of AUD, which has clinical implications for those classified.
Q: How is alcohol processed differently in the elderly?
A: Normal aging changes body composition, including more fat tissue and less lean muscle mass accompanied by lower hydration, can cause alcohol to be metabolized in much different ways than in younger adults. The result is that it takes less alcohol to adversely affect an older adult. If one had previously consumed three alcoholic beverages per day, it would be safer to cut that level to two for men and only one for women. This level is also affected by the time interval between drinks, food consumption as well as overall body mass index. Leaner people are affected more quickly than are those who are overweight.
Q: What are some of the psychological risk factors associated with drinking in elderly individuals?
A: The prevalence of major depression disorders in older adults is 20 percent, making persons with a major depressive disorder more likely to abuse drugs – both prescription and over-the-counter – as well as alcohol. Suicide in older white males is extremely high. Social isolation, recent loss of a spouse or pain from musculoskeletal conditions and cancer can all lead to self-abuse. Elders with these “red flags” are at high risk of morbidity and mortality. Geriatric psychiatrists and psychologists like Dr. Mark Kunik and Robert Reichlin, Ph.D., can be a big help to these persons.
Q: What are the risks of alcohol interacting with medication?
A: Most drugs are either fat or water soluble, so when there is less water and more fat (as in most older persons), drugs can act differently. When alcohol is added to the mix, one should always note the medication label or call a pharmacist and make sure what you’re taking is OK with an alcoholic beverage.
Q: How can caregivers identify a problem and how should it be addressed?
A: CAGE is a commonly used screening tool that has good sensitivity and specificity to detect AUD. The interviewer marks down one point for each “yes” answer. A score of two is a sign that the person probably has AUD. A yes to “E” for eye opener, meaning that a person consumes alcoholic beverages first thing in the morning, is enough to warrant obtaining professional help for the individual, regardless of age.
Education is always the key to making people more aware of their risk of developing serious health problems. Here’s a list of how alcohol can affect our bodies.
Additional Resources
If you believe you or someone else in your life may need help, contact the Baylor Psychiatry Clinic at 713-798-4857.
Read more information on alcohol abuse and the elderly from the National Institute on Alcohol Abuse and Alcoholism.
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