Tolerance Equals More Consumption for Older Problem Drinkers

Adults over age 60 who have alcohol problems tend to drink more than their younger counterparts, probably because they have developed greater tolerance for alcohol, according to researchers at Ohio State University.

Science Daily reported that a study found that alcohol-dependent individuals over age 60 consumed an average of more than 40 drinks per week, compared to 25-35 among younger people with similar levels of dependence.

Researchers said that older drinkers developed tolerance for alcohol, meaning they had to drink more to get the same effects.

The older drinkers also reported more monthly binge-drinking episodes.

“A combination of high levels of drinking and the physiological effects of aging are particularly problematic for older adults,” noted researcher Linda Ginzer.

Younger Americans were still more likely to have drinking problems than older Americans, however.

Researchers found that binge drinking was more common among Americans classified as alcohol abusers than among those who were heavy drinkers but not seen as problem drinkers.

“That suggests binge drinking may be a better measure of problem drinking than just the total amount of drinks someone has per week,” Ginzer said.

The findings, drawn on findings from the National Epidemiologic Survey on Alcohol and Related Conditions, were unveiled at a recent meeting of the Gerontological Society of America. From; Join Together Online.

• See also;
• Brief-TSF is designed to address these issues.
• Alcohol & Medication Interactions
• Physical effects of alcohol on women

Elder Alcohol Intervention

Abstract:

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)

Older Adults Often Exceed Alcohol Consumption Limits

Guidelines for “safe” alcohol use among older adults recommend daily limits no more than 2 drinks for men and 1 drink for women, weekly limits no more than 14 drinks for men and 7 drinks for women or a combination no more than 1 drink per day, 7 drinks per week, or 3 drinks per drinking session, regardless of sex.

The proportion of older adults who actually exceed each of these limits (i.e., engage in risky drinking) and experience associated alcohol-related problems is unknown.

To explore these issues, researchers surveyed 1291 non-abstinent, community-dwelling older adults at baseline and 10 years later.

The prevalence of risky drinking differed across guidelines, ranging from 23 percent to 50 percent among women and from 29 percent to 45 percent among men.

Both men and women who exceeded consumption limits were more likely to have alcohol-related problems (e.g., difficulties with relationships and functioning) both at study entry and follow-up. These problems were more prevalent in men.

In this community-based sample, risky drinking (defined by specific consumption levels) was prevalent among older adults, and guideline cut-offs were associated with alcohol-related problems.

Research Reference: Moos RH, Brennan PL, Schutte KK, et al. High-risk alcohol consumption and late-life alcohol use problems. Am J Public Health. 2004; 94(11):1985-1991. From Join Together

• See also;
• Elderly substance abuse