Alcohol Abuse Among Older Adults Poses Unique Dangers

By Hugh C. McBride

For many people, the term “alcohol abuse” is likely to prompt thoughts of binge drinking college students or young adults who end every workday with an extended stop at a local bar. And though these and other similar scenarios do, indeed, account for a significant portion of the alcohol abuse that occurs in the United States every day, the problem of excessive drinking is not limited to those who haven’t yet qualified to receive Social Security benefits.

A 2008 study that was conducted at Brandeis University revealed that almost one in 10 adults who receive Medicare benefits reported drinking unsafe amounts of alcohol. (The U.S. Department of Health and Human Services reports that about 40 million Americans, the vast majority of whom are age 65 or above, are eligible for Medicare.)

“Even though alcohol problems are more prevalent in younger people, a substantial proportion of older adults are consuming alcohol in amounts that exceed recommended guidelines,” Elizabeth Merrick, a co-author of the Brandeis study, said in a March 5, 2008 press release.

Unhealthy at Any Age

The Brandeis researchers, who published their results in the February 2008 edition of the Journal of the American Geriatrics Society, analyzed data that had been collected on more than 12,000 Medicare recipients aged 65 or above. The Brandeis press release and an abstract on the JAGS website provided the following information about the study:

• Nine percent of elderly Medicare beneficiaries reported unhealthy drinking, with higher prevalence in men (16 percent) than women (4 percent).
• “Unhealthy drinking” included consuming more than 30 drinks per month, or drinking four or more drinks on any day in a typical month.
• Among drinkers, self-reported symptoms of depression were associated with unhealthy drinking.
• Several distinct unhealthy drinking patterns were identified and associated with sociodemographic and health characteristics, suggesting the value of additional targeted approaches within the context of universal screening to reduce alcohol misuse by older adults.

Though alcohol abuse is obviously a concern at any age, the behavior poses particular risks within the elderly population, as alcohol may impact older adults more severely than it does younger drinkers. Also, the increased likelihood that older adults are taking various types of medications may raise the risk of adverse effects related to alcohol abuse.

Alcohol’s Impact on the Elderly

A March 10, 2009 article on the USA Today website offered insights into the ways in which alcohol affects older adults (in this case, individuals aged 50 and above) more profoundly than it does younger drinkers.

The article discussed a University of Florida-Gainesville study on the effects of alcohol on drinkers above and below age 50:

• Researchers studied 42 older adults and 26 younger adults, randomly assigning them to drink either alcohol or a nonalcoholic placebo beverage.
• Each person who drank alcohol was given an amount that would raise their blood alcohol level by the same degree.
• The study participants were tested twice at different intervals after drinking to gauge visual-motor coordination and thought processes.
• The older adults performed more poorly than the younger group, but the older drinkers thought they were less impaired.
In the conclusion of the study report (which was published in the March 2009 edition of the Journal of Studies on Alcohol and Drugs), the authors noted that their results “reinforce the common knowledge that self-reported measures may not provide an accurate reflection of performance outcomes and, importantly, that older adults may be impaired even under a moderate dose of alcohol, although they may not be aware … of this impairment.”

Alcohol Abuse & Depression

As the Brandeis study indicated, older adults who abuse alcohol are also more likely than their non-drinking counterparts to report symptoms associated with depression.

The link between depression and substance abuse in older adults continues to be a widely misunderstood relationship, as many signs that would indicate a problem in younger patients (such as confusion, sleep problems, and personality changes) are often overlooked, or considered to be normal parts of the aging process.

The National Institute of Mental Health (NIMH) has reported that as many as one in four adults over the age of 65 may be experiencing symptoms related to depression – a problem that can only be exacerbated by alcohol abuse among older adults. Regardless of whether these depression-related symptoms are the result of mental illness, physical health problems, the interactions between multiple medications, or the abuse of alcohol or other drugs, the fact remains that depression is not a “normal” part of the aging process.

Getting Help

As experts gain a greater understanding of the prevalence and effects of alcohol abuse and other types of substance misuse among older adults, many rehabilitation and recovery programs have developed specific plans to deal with the unique needs of elderly clients. These types of programs are thought to be especially timely, as many members of the Baby Boom generation (those born between 1946 and 1964) continue to struggle with substance addiction as they age.

As is the case with younger clients, addiction treatment for older adults can take many forms, ranging from outpatient therapy to more intensive treatment in a residential program. The key to achieving and maintaining lasting recovery at any age is finding a treatment program that is equipped to meet the specific needs of the person who is struggling to overcome alcohol abuse or another type of drug dependence or addiction.