up to HomeAlcohol and Older People
How many older people have alcohol problems?
No matter what the statistics tell us, many readers will know personally that alcohol can and does cause problems for a significant number of older people.
Official statistics show that people over 65 drink approximately half the quantities consumed by the population as a whole. There is clearly a tendency for alcohol consumption to decline as people get older.
It is very easy to conclude from the research available that there is much confusion about the extent of this problem. One study managed to find estimates of the extent of the problem ranging from 2% of the population through to 50%. The determining factor was almost always the nature of the part of the over 55 population that was studied.
The physical effects of alcohol on older people
While noting the signs and symptoms of alcohol problems it is worth noting the specific physical impact of alcohol on older people. On average, older people are likely to have a poorer physical condition than younger people. Three issues in particular are worth highlighting:
- Accidents – Alcohol impairs co-ordination so creating the increased risk of accidents. In an older person whose co-ordination may already be poor the likelihood of accidents is that much greater. In particular, alcohol can exacerbate tremulousness of the hands. Poor concentration due to alcohol can also lead to accidents.
The risk of falls is also greatly increased and the consequences of these falls can be catastrophic for an older person, including broken bones and a fear of further falls which can affect daily living tasks, socialisation and independence. - Depression – Alcohol is not a stimulant, it depresses the central nervous system and as a result drinking can cause or exacerbate an existing state of depression, perhaps due to a loss or bereavement.
- Incontinence – Alcohol can increase the likelihood of loss of control of bowel and bladder movements.
It is also worth mentioning Korsakfoff’s Syndrome. This is brain damage caused by excessive use of alcohol. It is almost identical in its effects to senile dementia and medical practitioners may find it hard to tell the two apart in some cases. Those who are concerned about the psychological capacity of an older person need to bear in mind the possibility that an apparent dementia may be alcohol induced.
Misdiagnosis
It is important to point out the danger of misdiagnosis – too readily assuming that alcohol is the problem. For example, some people found staggering and collapsing in apparent drunkenness on the streets may well have been suffering the consequences of hardening of the arteries. If this misdiagnosis is continued it could lead to the patient receiving inappropriate medication, which will only serve to make matters worse.
There are also a number of medical conditions which may ‘mimic’ alcohol problems. The most obvious is the hand tremors caused by Parkinson’s disease.
How much should older people drink
People do not lose their ability to process alcohol as they age. People’s ability to cope with a particular level of alcohol consumption is related to their physical condition, not their age.
The key influences on an individual’s safe limit are:
- Their physical health
- Their weight
- Their medication
- The state of their liver
An underweight person, who is using medication because of poor physical health, should observe a lower safe limit than a healthier contemporary no matter what their age. Conversely, a healthy and hearty 69 year old may be able to drink just as much as a younger person. However, it is true that on average as people grow older their liver will become less able to break down alcohol. Therefore some doctors have suggested that, as a general rule, older people should set themselves lower limits, perhaps between a third or a half lower than the general limits.
(Ward Michael John – Working with Difficult to Engage Older Problem Drinkers Course Handouts 2006)
