Current US census estimates predict that by the year 2020, 18% of the population will be 65 years or older. As most adults in this age group have health care needs, it is vital that clinicians are competent in identifying and intervening in the most common health issues among older adults.
The article in this issue by Blazer and Wu again reminds us that alcohol use, including binge drinking, is common among older adults and that despite popular culture, alcohol misuse does not disappear as one ages. As noted in the article, the findings are very consistent with other epidemiological literature.
Blazer and Wu found that 13% of men and 8% of women reported at-risk drinking and that 14% of men and 3% of women reported binge drinking.
This is not to suggest that many older drinkers have a diagnosis of alcohol dependence. However, identification and delivery of appropriate interventions focused on those with regular heavy use of alcohol and binge drinking provide an opportunity for clinicians to help improve overall health, promote independence, and reduce health care costs.
One of the strengths of the Blazer and Wu study is its large, diverse sample, which seems well representative of the population seen in outpatient primary care and mental health clinics.
Including subjects ages 50-64 was helpful for comparison, as it showed drinking was greater in the younger group than in the older individuals. The study variables used to assess alcohol use for patients with low-risk, at-risk, and binge drinking were clinically appropriate, as they were set to detect those who might be most at risk for harm related to their drinking.
One of the findings of great importance was that alcohol misuse in this population was a marker for other problems, including;
- illicit drug use,
- tobacco use, and
- misuse of prescription medications.
The data demonstrate differences between at-risk and binge drinkers across various demographic groups. For instance, the variables associated with men and women who reported binge drinking suggest that those at risk from each sex tended to be from different backgrounds.
These associations can help target at-risk populations, but our overall goal is to screen all of our geriatric patients.
Research; Alcohol Misuse Among the Elderly: An Opportunity for Prevention, Sarah Mathews, David W Oslin. The American Journal of Psychiatry. Oct 2009. Vol. 166, Iss. 10; p. 1093 (3 pages)