Alcohol and the Elderly

There have been periodic reports that claim moderate drinking in old age might be beneficial health-wise. Moderate drinking, though, is like one drink a day. For the most part, alcohol misuse among the elderly is complicated and most often devastating if the problem is advanced.

Often, alcohol problems among the elderly go undetected. What’s wrong with an older person enjoying alcohol in retirement? There’s nothing wrong with drinking, per se, but there are special considerations when dealing with alcohol and the elderly. What type of medication is the elderly person taking, and how does this medication interact with alcohol? Is the elderly person’s liver functioning normally? I’ve talked to elderly alcoholics who claim they are drinking less than they once did, so they can’t have a problem — what happened is that their liver was damaged and the alcohol basically went straight into the blood stream, thus taking less alcohol to create the same effect as before. Just because the elderly alcoholic is drinking less doesn’t mean they’ve learned to control their drinking — it usually means the liver is not functioning properly and it takes less alcohol to achieve the desired effects. This is from The International Center for Alcohol Policies.

Older adults are more sensitive to the negative health effects of alcohol than their younger counterparts. This is due to their generally poorer health status and increased likelihood that they use medications that may interact with alcohol (Fink et al., 2002). In addition, the normal ageing process is accompanied by certain physiological changes that can exacerbate the potential for harm. For example, a decrease in total body water and an increase in body fat in the elderly affect the body’s ability to absorb and metabolize alcohol, resulting in higher blood alcohol concentrations than in younger people for the same amount of alcohol consumed (Adams & Cox, 1995; Meier & Seitz, 2008; Onder et al., 2002; Seitz & Simanowski, 1994; Weathermon & Crabb, 1999; see also ANNEX 1: The Basics about Alcohol). For older people, therefore, alcohol consumption, in some circumstances, may be associated with greater risk for injury (Resnick & Junlapeeya, 2004; Yuan et al., 2001), and sustained heavy drinking is associated with a number of negative health outcomes (e.g., elevated risk for gastric cancer in elderly women: Song et al., 2008; liver disease: Meier & Seitz, 2008; diabetes: Riserus & Ingelsson, 2007; depressive/anxiety symptoms: Kirchner et al., 2007). Drinking may be a particular issue for older women. Hormonal changes accompanying menopause may contribute to elevated risk of breast cancer with increased alcohol consumption levels (Onland-Moret, Peeters, van der Schouw, Grobbee, & van Gils, 2005).

It’s complicated treating an elderly person for an alcohol problem, but professionals trained to deal wit the special needs can help add quality years to the end of life. It’s a shame to die a painful death from alcoholism in retirement when a person should be enjoying the freedom of not working and doing what they really like to do. While an alcoholic might give the impression they enjoy drinking, when it becomes a problem it’s a painful, frightening and confusing existence.