April is Alcohol Awareness Month, which has been sponsored by the National Council on Alcoholism and Drug Dependence (NCADD) every year since 1987. Efforts to promote awareness of and education about the effects of alcohol use and misuse often focus on adolescents and young adults. However, the use of alcohol can place older adults at a greater risk for physical, mental, and emotional decline as they age.
The NCADD describes the misuse of alcohol among people age 60 and older as “underestimated, underidentified, underdiagnosed, and undertreated” (www.ncadd.org), and they attribute the causes of this lack of attention to the issue to three main factors:
- Health care providers interpret the symptoms caused by alcohol misuse as dementia, depression, or some other health problem common to older adults.
- Older adults often try to hide their alcohol use and are reluctant to seek treatment
- Family members live in denial that a problem exists, or are ashamed and do not seek help to address the issue.
Exactly what patterns of alcohol use place older adults at risk? The American Geriatrics Society and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) define “risky” drinking for those over age 65 as more than seven alcoholic drinks per week or more than three in one day. Long-term alcohol use can cause liver disease, high blood pressure (increasing the risk of heart disease and stroke), and cognitive impairment (due to shrinkage of the frontal lobes of the brain). It can worsen diabetes, congestive heart failure, and mood disorders such as depression and anxiety (www.nihseniorhealth.gov). However, older adults should also be aware of how even moderate alcohol intake can affect them. In general, older adults are more sensitive to alcohol than younger people because their bodies process alcohol more slowly, and contain less water (so alcohol is more concentrated). The physical and mental effects of alcohol can lead to falls, car accidents, and injury-causing incidents in the home. In addition, when alcohol is consumed within several hours of taking certain medications, the medications may be less effective or harmful reactions may occur. Risks are present for both prescription and non-prescription medications.
The government organization SAMHSA (Substance Abuse & Mental Health Services Administration) found in a national survey last year that 2.1% of older adults reported heavy alcohol use within the last month (five or more drinks daily on five or more days per month). Based on current population statistics, this means there are over 900,000 older adults living with the effects of alcohol dependence or abuse. With government statistics predicting our 65+ population to almost double by the year 2050, the issues associated with older adults and alcohol dependence or abuse are expected to have an even greater impact on society.
Older adults experience one of two types of alcoholism. Two-thirds of alcoholics are those who have consumed significant amounts of alcohol for most of their adult lives, and are referred to as early-onset alcoholics. The remaining one-third are those start drinking larger amounts later in life, and are referred to as late-onset alcoholics. Women compose a higher percentage of late onset alcoholics than men, and late onset alcoholism is often triggered by life changes such as the loss of a significant other or retirement. The good news is that late-onset older adult alcoholics have the highest rate of recovery of any age group. In Cumberland County, Kristin Noecker, Program Coordinator for the RASE Project in Carlisle (Recovery, Advocacy, Service, Empowerment), sees a mix of late-onset alcoholics and those affected by a lifetime pattern of excessive alcohol use.
Information provided by Ms. Noecker indicates that research has shown that the involvement of family and friends is a primary factor in the recovery of older adults. However alcoholism is a topic that can make many people uncomfortable. In future columns we will address the warning signs of possible alcoholism in older adults, how to approach a loved one when there is a concern about addiction, and general concepts related to recovery.
Karen Kaslow, RN
The RASE Project assists individuals of all ages. Kristin Noecker welcomes your questions about alcoholism, substance abuse, and recovery. She can be reached at 717-249-6499 or Kristinnoecker@raseproject.org. Her office is located at 8 S. Hanover Street in Carlisle.