The Invisible Epidemic: Senior Citizens and Alcoholism

Last Updated: February 4, 2020

Alcohol Abuse Among the Elderly

Alcohol is the most commonly abused substance among adults aged 65 or older, and alcoholism is a serious disease affecting many of our senior citizens.1 The use of alcohol among older men and women has steadily increased over recent years, with one study reporting a significant increase in binge drinking among women age 60 or older.2  According to results from the 2018 National Survey on Drug Use and Health:3
  • More than 1 in 10 seniors report binge drinking (the consumption of 4-5 drinks in about 2 hours) during the past month.
  • 1 in 40 seniors report heavy drinking (binge drinking on 5 or more days in the past month). 
  • 1.6% of seniors have been diagnosed with an alcohol abuse disorder. 
Unfortunately, alcohol abuse among older adults often goes unrecognized, unreported, and untreated; for these reasons alcoholism among the elderly has been described as an “invisible epidemic.”4 

Alcohol-Related Health Issues in Seniors

Increased Sensitivity to Alcohol

Aging lowers the body’s tolerance for alcohol and makes drinking very risky for the elderly. As we get older our body becomes less efficient at breaking down alcohol, causing alcohol to stay in our systems for a longer time and increasing the risk of alcohol poisoning.5  The decline of lean body mass is another characteristic of aging. With less muscle to absorb alcohol, seniors experience the intoxicating effects of alcohol much more quickly, and from lower amounts of consumed alcohol, compared to when they were younger. This puts older adults at an increased risk for falls, fractures, car crashes, and other unintentional injuries. 

Dehydration

Alcohol causes the body to reabsorb less water than it would with no alcohol in our system. Senior citizens are extremely susceptible to the dangers of dehydration caused by alcohol, as many of these individuals already suffer from some form of dehydration in their daily lives.  Studies show that up to 30% of elderly people suffer from dehydration due to inadequate daily fluid intake.6 Another study found that about 4 in 10 older adults admitted into hospitals show signs of dehydration.7 As we age, we naturally lose the capacity to retain water. The total amount of water in the body decreases by approximately 15% (about 6 L) from the age of 20 to 80.8  In addition to this loss of body water, seniors exhibit decreased kidney function, another condition that further contributes to the dehydration resulting from alcohol consumption.  

Increased Health Problems

Certain health problems are common in older adults. Heavy drinking can exacerbate the risk of many health issues that seniors are already at risk of contracting simply due to their age. Some of the health problems associated with alcohol abuse that older adults may encounter include:9-10 
  • Diabetes.
  • High blood pressure.
  • Congestive heart failure.
  • Liver problems.
  • Osteoporosis.
  • Memory problems.
  • Mood disorders.

Bad Interactions with Medications

Many prescription and over-the-counter medications can become dangerous or even deadly when combined with alcohol. Because so many older adults take multiple drugs each day to manage chronic health conditions, one of the biggest health risks among seniors is the mixing of medications and alcohol.   One study found that more than 1 in 3 drinkers aged 60 years or older consume alcohol in quantities that can cause harm when combined with their current medications.11 In addition to adverse interactions, alcohol also modifies serum drug concentrations and increases drug toxicity, further increasing the dangers of drinking for seniors currently on medications.5   According to the National Institute on Alcohol Abuse and Alcoholism, medications that can dangerously interact with alcohol include:10
  • Aspirin.
  • Acetaminophen.
  • Cold and allergy medicine.
  • Cough syrup.
  • Sleeping pills.
  • Pain medication.
  • Anxiety or depression medicine.
  • Herbal remedies (such as kava kava, St. John’s wort, chamomile, valerian, and lavender).

Increased Risk for Acquiring STDs

A rising problem among the elderly is the spread of sexually transmitted diseases (STDs), especially among those living in senior living communities. According to an analysis of patient data from more than 110,000 healthcare providers, the diagnosis rates for herpes simplex, gonorrhea, syphilis, hepatitis B, trichomoniasis, and chlamydia have risen 23% in older adults (over age 60) from 2014 to 2017.12  The prevalent abuse of alcohol among seniors can further increase the spread of STDs, as studies have shown that being drunk during sex is associated with less condom use.13 This can be very problematic, especially since studies have already shown that men and women over the age of 60 have the lowest condom usage of any population.14

Treatment Options

According to guidelines from the National Institute on Alcohol Abuse and Alcoholism, healthy adults over the age of 65 (who do not take medications) should limit their weekly alcohol consumption to 7 drinks while not drinking more than 3 drinks on a given day.10 Seniors with health problems or who take certain medications may need to drink less or abstain from alcohol altogether.  If you are a senior citizen and find it hard to stop drinking, please know that help is available. There are many alcohol-related programs that have been specifically designed for seniors.  Research has shown that older adults with multiple chronic health conditions and depression are nearly 5 times as likely to be problem drinkers as older adults with the same conditions and no depression.15 If you drink and also suffer from depression, you may want to consider looking for a dual diagnosis treatment program that can effectively treat your mental illness and addiction side-by-side.

Sources

  1. Substance Abuse and Mental Health Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
  2. Breslow, R.A., Castle, I.P., Chen, C.M., & Graubard, B.I. (2017). Trends in Alcohol Consumption Among Older Americans: National Health Interview Surveys, 1997 to 2014. Alcoholism, Clinical and Experimental Research, 41(5), 976-986.
  3. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables.
  4. MDedge Psychiatry. (2016). Study shines light on ‘invisible epidemic’.
  5. Meier, P., & Seitz, H.K. (2008). Age, alcohol metabolism and liver disease. Current Opinion in Clinical Nutrition and Metabolic Care, 11(1), 21-26.
  6. Konings, F.J., Mathijssen, J.J., Schellingerhout, J.M., Kroesbergen, I.H., Goede de, J., & Goor de, I.A. (2015). Prevention of dehydration in independently living elderly people at risk: A study protocol of a randomized controlled trial. International Journal of Preventive Medicine, 6, 103.
  7. El-Sharkawy, A.M., Watson, P., Neal, K.R., Ljungqvist, O., Maughan, R.J., Sahota, O., & Lobo, D.N. (2015). Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study). Age and Ageing, 44(6), 943-947.
  8. Gille, D. (2010). Overview of the physiological changes and optimal diet in the golden age generation over 50. European Review of Aging and Physical Activity, 7(1), 27-36.
  9. National Council for Aging Care. (2018). Alcohol Abuse Amongst the Elderly: A Complete Guide.
  10. National Institute on Alcohol Abuse and Alcoholism. (2019). Older Adults.
  11. Barnes, A.J., Moore, A.A., Xu, H., Ang, A., Tallen, L., Mirkin, M., & Ettner, S.L. (2010). Prevalence and Correlates of At-Risk Drinking Among Older Adults: The Project SHARE Study. Journal of General Internal Medicine, 25(8), 840-846.
  12. Becker’s Hospital Reviews. (2018). STDs on the rise among seniors.
  13. Kerr, D.C., Washburn, I.J., Morris, M.K., Lewis, K.A., & Tiberio, S.S. (2015). Event-Level Associations of Marijuana and Heavy Alcohol Use With Intercourse and Condom Use. Journal of Studies on Alcohol and Drugs, 76(5), 733-737.
  14. Schick, V., Herbenick, D., Reece, M., Sanders, S.A., Dodge, B., Middlestadt, S.E., & Fortenberry, J.D. (2010). Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. The Journal of Sexual Medicine, 7(Suppl 5), 315–329.
  15. Mowbray, O., Washington, T., Purser, G., & O‘Shields, J. (2017). Problem Drinking and Depression in Older Adults with Multiple Chronic Health Conditions. Journal of the American Geriatrics Society, 65(1), 146-152.
Last Updated on February 4, 2020
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