Alcohol risks for older adults
Many of us may have an older relative or friend that is prone to having one too many. Quite often these events end up being amusing anecdotes to retell at family occasions – ‘remember when Granny had too much sherry and fell into the Christmas tree?’. Other times we may just not notice the fact that ever since his wife died Grandad needs a couple of drinks each night to help him sleep. The fact is that anyone at any age can have a drinking problem.
A national survey in 2008 found that approximately 40% of adults aged 65 and older drink alcohol. In addition, a recent report which surveyed 24,000 Australians on their alcohol use, attitudes and opinions found adults over the age of 70 were the most likely to drink daily, continuing a trend that has lasted over a decade.
Some of these older adults may have had a problem with alcohol throughout their life, whereas for others occasional or moderate drinking may have escalated with age. Age-associated events such as identity loss following retirement, inability to engage in activities due to health issues, isolation and loneliness, or grief following the loss of a loved one, can all contribute to older adults developing a problem with alcohol.
Australian alcohol guidelines offer specific recommendations to minimize the potential for alcohol-related harm in the general population however they only suggest that older adults ‘drink less’. Other sources recommend no more than 3 drinks on a given day with a maximum of 7 drinks per week, although also state that older people with health issues or that take certain medications should drink less or even not at all.
Older adults have an increased risk of experiencing alcohol-related harm for three main reasons.
Older adults who continue to drink alcohol with the same habits as they did whilst they were younger will find that their tolerance for it has decreased, and that they experience the effects of alcohol more quickly. This is because as we age our body becomes less effective at metabolising alcohol. Older adults also have a decreased amount of water in their bodies, meaning that the alcohol is less diluted and resulting in a higher blood-alcohol concentration. Combined, these factors increase the risk of unintentional injuries and falls due to drinking.
As we age we are more likely to be taking a range of medications due to health problems. A recent Irish study found that 60% of drinkers over the age of 60 were taking at least one medication that could adversely react with alcohol. Certain medications such as aspirin, sleeping pills, pain medication or anxiety/depression medicine, can interact badly with alcohol and result in dangerous or even deadly events.
As well as certain medications increasing the vulnerabilities to alcohol older adult drinkers face, the underlying health issues themselves can be exacerbated by drinking. Conditions such as diabetes, high blood pressure, congestive heart failure and liver problems, as well as memory issues and mood disorders can all be worsened through drinking alcohol. Older adults who have had a long-term problematic relationship with alcohol are also more likely to experience alcohol-related brain injury (ARBI). Symptoms of ARBI include social isolation, distractibility and confusion, impulsive or reckless behaviour, impaired judgement and depression.
Another issue contributing to the vulnerability to the effects of alcohol abuse that adult adults face is that they are less likely to engage with treatment services. This may be because they don’t know where to seek help, they’re isolated, or that they lack the mobility to access the services. Friends, family and healthcare professionals may overlook their concerns about older people drinking, being reluctant to bring it up out of embarrassment or with the view of ‘they’re allowed to let loose now, there’s no harm in it’. They may even mistake alcohol-related problems as symptoms attributed with other conditions such as dementia or issues with balance.