Substance Abuse Article:

Older adults can learn to recognize and avoid alcohol abuse

While two-thirds of people over the age of 60 abstain from drinking alcohol, as many as one in five may face serious health risks from alcohol abuse - and they may not even recognize that they may be problem drinkers.

"Everyone realizes they can't drink like they might have when they were in their 20s, but few people over 60 understand that they can't drink like they did when they were in their 40s and 50s," notes Dr. Frederic Blow, one of the nation's foremost experts on substance abuse among seniors. "You may be at risk for severe consequences even from what you've always considered moderate social drinking."

Dr. Blow was the keynote speaker at a recent Seattle-area conference on the topic. The conference was sponsored by the Healthy Aging Partnership, a coalition of 30 not-for-profit and public organizations dedicated to the health and well-being of seniors.

Heavy alcohol use late in life increases the risk of dementia, exacerbates other age-related health problems and reduces longevity. Dr. Blow and other health experts recommend that men over the age of 60 have no more than one standard drink per day - even less for women. That's about half the recommended alcohol-consumption levels for younger people. A standard drink is one 12-ounce can of beer, a 5-ounce glass of wine, a 1.5-ounce shot of liquor like gin or scotch, or one 4-ounce glass of liqueur or aperitif like brandy or sherry.

Normal aging-related changes make older adults much more vulnerable to the adverse effects of alcohol. Older people absorb alcohol more quickly and metabolize it more slowly. Tolerance decreases and sensitivity to alcohol increases. They become more cognitively impaired, have a higher blood alcohol concentration, and risk serious complications from alcohol's effects on chronic illness and interaction with medications.

"For someone who says, 'I've always had two martinis before dinner or two glasses of wine with a meal,' it's difficult to understand that aging means those habits must change," Dr. Blow explains.

Until recently, it was thought that older adults faced little risk of becoming problem drinkers late in life. Today, that thinking has changed. More than 10 percent of people in nursing homes have drinking problems or a recent history of problems. About 20 percent of older abusers begin drinking after age 50.

Alcohol abuse can be triggered after years of multiple losses like age-related physical impairments, the death of spouse, change in housing and diminished social support. Often, older people are less likely to seek help or to recognize that they are abusing alcohol. There is a greater stigma to having a "drinking problem" among older adults who may be culturally conditioned to see it as a moral weakness.

The good news, however, is that even very elderly people with long histories of alcoholism can recover.

Dr. Blow suggests the following quick survey for seniors who believe they may need help dealing with their alcohol consumption.

  1. When talking with others, do you ever underestimate how much you actually drink?
  2. After a few drinks, have you sometimes not eaten or been able to skip a meal because you didn't feel hungry?
  3. Does having a few drinks help decrease your shakiness or tremors?
  4. Does alcohol sometimes make it hard for you to remember parts of the day or night?
  5. Do you usually take a drink to relax or calm your nerves?
  6. Do you drink to take your mind off your problems?
  7. Have you ever increased your drinking after experiencing a loss in your life?
  8. Has a doctor or nurse ever said they were concerned about your drinking?
  9. Have you ever made rules to manage your drinking?
  10. When you feel lonely, does having a drink help?

If you answered "yes" to two or more questions, your drinking may put you at risk.

To find resources for this or any other issue associated with living a healthier life as an older adult, you can get free and confidential information and assistance by calling 1-844-348-KING (1-844-348-5464) or visiting the Healthy Aging Partnership's web site at www.4elders.org. HAP is generously supported by its partner agencies, Puget Sound Energy and the Comprehensive Health Education Foundation.