Center for Addiction Medicine

04/04/2008 - Drinking Problems in Seniors Often Go Unnoticed

Anyone at any age can have a drinking problem. Drinking problems in older people often go unnoticed by the public, family members and even doctors.

Although statistics vary on alcoholism among seniors, between 1.1 and 2.3 million senior citizens use alcohol to deal with grief and loneliness, and as much as 10% to 15% of health problems in this population may be linked to alcoholism.

Despite the fact that alcohol and substance abuse among the elderly remain for the most part unreported, undiagnosed, or ignored, one fact is clear: alcohol-related problems among the elderly are much greater than perceived.

A recent study published in the Journal of the American Geriatrics Society addressed the notion that unhealthy use of alcohol by older adults is both underidentified and undertreated.

The study used data from the 2003 Access to Care file of the Medicare Current Beneficiary Survey (MCBS) to examine self-reported drinking patterns among seniors. Focus was on three survey items regarding alcohol consumption, specifically, the quantity and frequency of drinking; heavy episodic drinking and types of alcoholic beverages consumed.

This study found that prevalence of problem drinking was sharply higher for men and for those aged 65 to 70. In addition, higher income was associated with unhealthy drinking, as was better functional and self-perceived health status.

Although self-reported alcohol consumption is in general considered to be as accurate as other measures of drinking, elderly people may be more likely to underreport alcohol use because of stigma. In addition, because of certain disease states and interactions between medication and alcohol not captured in the study, a portion of the group that drinks within guidelines is likely to be using alcohol in circumstances that place them at risk.

The findings of the study emphasize the value of continuing to develop and use broad and targeted approaches to reducing alcohol misuse.

Treating alcohol abuse and addiction among seniors is of significant concern. The costs in dollars and health effects arising from older adults' unhealthy alcohol use are substantial, and the magnitude is likely to grow as the large baby boom generation ages. Data shows elderly people are hospitalized for conditions associated with alcohol at approximately the same rate as for myocardial infarction.

A big part of the problem is getting doctors to accept that elderly alcoholics exist, according to the American Medical Association. Clinicians may be less likely to suspect unhealthy alcohol use in older adults, and physicians are less likely to identify alcohol disorders in patients with higher income or education and in women.

The community and care givers will often turn a blind eye to the problem and accept it as a condition of aging, a reaction to loss or grief, or it's "just the way he is." Many times physicians merely presume their older patients are non-drinkers.

The AMA and other groups are encouraging doctors to take a closer look at their older patients to identify substance abuse problems, because treatment for these patients can be highly successful.

If the problem is properly diagnosed, help is available. It has been discovered that alcohol problems can be successfully treated, even in the later years. Elderly alcoholics tend to respond well to treatment, and stay in programs.

Identification of older adults who are drinking risky amounts is essential for appropriate and timely clinical intervention. For clinicians in healthcare settings in which elderly people are treated, understanding alcohol consumption patterns and patient characteristics associated with unhealthy alcohol use is important. Given the widespread lack of recognition of unhealthy alcohol use, being especially alert to risk factors may assist in detection, diagnosis and treatment for seniors.

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