Older adults are usually diagnosed with fewer alcohol use disorders compared to younger and middle age adults. The number of Alcohol Use Disorders in older adults is only second to prescription medication disorders or polypharmacy.
Aging increases vulnerability to the effects of alcohol used alone or in combination with illicit drugs and medications. Alcohol use also contributes to diabetes, cancer and cardiovascular diseases and increases the risk of other comorbid conditions.
The standard/appropriate level of alcohol consumption for adults age 65 and older is advised to be limited to one standard drink per day: 12 oz of beer, 4 to 5 oz of wine, one and a half ounces of distilled spirits, or it could be 7 standard drinks per week and no more than 3 drinks per occasion.
The US Preventive Task Force recommends that all adults be screened for alcohol use and that risky drinkers be provided with counseling. The first step is to ask “do you drink alcohol?” and if so “how much alcohol do you drink?”
A short form alcohol screening instrument tailored to the needs of older adults can be used, and if two or more “yes” responses are present, it suggests an alcohol problem. Behavioral counseling has been demonstrated to reduce alcohol misuse of older adults for whom the severity of alcohol disorders is generally lower than younger adults.
The goal of screening is to identify “at risk” drinkers, persons drinking at levels linked with negative outcomes for physical and mental health like falls, stroke, depression, hypertension and gastrointestinal problems.
Brief interventions by healthcare providers following positive screening of older adults have been shown to be useful in reducing alcohol consumption. Older adults with alcohol use disorders responded to treatment with rates comparable to younger adults.
Anyone who would like to ask me a medical question relating to the health of older adults can email me at questions@apexmedicalgroup.org. I hope to provide a helpful answer in a future issue of this newspaper.
Disclaimer: The information shared in this column is based on current practice guidelines but is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your healthcare provider with any questions regarding a medical condition.
Dr. Arvind Mohanaselvan, M.D., is a physician board certified in internal medicine, with a subspecialty in geriatrics. He currently works at Apex Medical Group as a primary care and geriatric medicine provider. Email questions for Paging the Doctor on Call to questions@apexmedicalgroup.org
