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Alcohol use disorders in older people

Published online by Cambridge University Press:  19 October 2009

Simon Coulton*
Affiliation:
Centre for Health Service Studies, University of Kent, UK
*
Address for correspondence: Professor Simon Coulton, Centre for Health Service Studies, George Allen Wing, University of Kent, Kent CT2 7NZ. Email: s.coulton@kent.ac.uk

Summary

The number of people aged 65 years or more is increasing worldwide. Alcohol use disorders (AUD) are a common condition in the older population, and this combined with the changing age demographic in the population means that AUD in this population is a significant public health concern. AUD has a major impact upon the physical, psychological and social health of the older population. There is evidence that older people do benefit from interventions to reduce alcohol consumption as much as, if not more than, younger populations. There is evidence that AUD in the older population often goes undetected and the potential for beneficial behavioural health change is not realized.

Type
Psychological and social gerontology
Copyright
Copyright © Cambridge University Press 2009

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References

1WHO. International statistical classification of diseases and related health problems. Geneva: WHO, 2004.Google Scholar
2Vestal, RE, McGuire, EA, Tobin, JD, Andres, R, Norris, AH, Mezey, E. Aging and ethanol metabolism. Clin Pharmacol Ther 1977; 21: 343–54.CrossRefGoogle ScholarPubMed
3Smith, T, Levitt, MD. Ethanol concentration and gastric alcohol dehydrogenase activity. Gastroenterology 1995; 109: 663–4.CrossRefGoogle ScholarPubMed
4Lang, I, Wallace, RB, Huppert, FA, Melzer, D. Moderate alcohol consumption in older adults is associated with better cognition and well-being than abstinence. Age Ageing 2007; 36: 256–61.CrossRefGoogle ScholarPubMed
5Temple, MT, Leino, EV. Long-term outcomes of drinking: a 20-year longitudinal study of men. Br J Addict 1989; 84: 889–99.CrossRefGoogle ScholarPubMed
6Adams, WL, Cox, NS. Epidemiology of problem drinking among elderly people. Int J Addict 1995; 30: 1693–716.CrossRefGoogle ScholarPubMed
7Atkinson, R. Late onset problem drinking in older adults. Int J Geriatr Psychiatry 1994; 9: 321–6.CrossRefGoogle Scholar
8Schonfeld, L, Dupree, LW. Antecedents of drinking for early- and late-onset elderly alcohol abusers. J Stud Alcohol 1991; 52: 587–92.CrossRefGoogle ScholarPubMed
9Atkinson, RM, Tolson, RL, Turner, JA. Late versus early onset problem drinking in older men. Alcohol Clin Exp Res 1990; 14: 574–9.CrossRefGoogle ScholarPubMed
10Menninger, J. Assessment and treatment of alcoholism and substance related disorders in the elderly. Bulletin of the Menninger Clinic 2002; 66: 166–84.CrossRefGoogle ScholarPubMed
11Reid, M, Van Ness, P, Barry, L, Guo, Z. Pain and alcohol consumption in older persons: Is there a relationship? Gerontologist 2003; 43: 40.Google Scholar
12Brennan, PL, Schutte, KK, Moos, RH. Pain and use of alcohol to manage pain: prevalence and 3-year outcomes among older problem and non-problem drinkers. Addiction 2005; 100: 777–86.CrossRefGoogle ScholarPubMed
13Lang, I, Guralnik, J, Wallace, RB, Melzer, D. What level of alcohol consumption is hazardous for older people? Functioning and mortality in US and English national cohorts. JAGS 2007; 55: 4957.CrossRefGoogle ScholarPubMed
14Drummond, C, Oyefeso, A, Phillips, T et al. National Alcohol Research Project: The 2004 national alcohol needs assessment of England. London, Department of Health, 2005.CrossRefGoogle Scholar
15Coulton, S, Watson, J, Bland, M et al. The effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care (AESOPS) – a randomised control trial protocol. BMC Health Serv Res 2008; 8: 129.CrossRefGoogle ScholarPubMed
16Hajat, S, Haines, A, Bulpitt, C, Fletcher, A. Patterns and determinants of alcohol consumption in people aged 75 years and older: results from the MRC trial of assessment and management of older people in the community. Age Ageing 2004; 33: 170–7.CrossRefGoogle ScholarPubMed
17Goldstein, MZ, Pataki, A, Webb, MT. Alcoholism among elderly persons. Psychiatr Serv 1996; 47: 941–3.Google ScholarPubMed
18Crome, IB. Alcohol problems in the older person. J Royal Soc Med 1997; 90: 1622.CrossRefGoogle ScholarPubMed
19Falaschetti, E, Malbut, K, Primatesta, P. The general health of older people and their use of health resources. Health Survey for England. HMSO, London, 2002.Google Scholar
20Valmadrid, CT, Klein, R, Moss, SE, Klein, BEK, Cruickshanks, KJ. Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus. JAMA 1999; 282: 239–46.CrossRefGoogle ScholarPubMed
21Mukamal, KJ, Chung, HJ, Jenny, NS et al. Alcohol consumption and risk of coronary heart disease in older adults: The cardiovascular health study. JAGS 2006; 54: 30–7.CrossRefGoogle ScholarPubMed
22Mattace-Raso, FUS, Van Der Cammen, TJM, van den Elzen, APM et al. Moderate alcohol consumption is associated with reduced arterial stiffness in older adults: The Rotterdam study. J Gerontology Series A – Biol Sci and Med Sci 2005; 60: 1479–83.CrossRefGoogle ScholarPubMed
23Abramson, JL, Williams, SA, Krumholz, HM, Vaccarino, V. Moderate alcohol consumption and risk of heart failure among older persons. JAMA 2001; 285: 1971–7.CrossRefGoogle ScholarPubMed
24Mukamal, KJ, Kronmal, RA, Mittleman, MA et al. Alcohol consumption and carotid atherosclerosis in older adults – The cardiovascular health study. ATVB 2003; 23: 2252–9.CrossRefGoogle ScholarPubMed
25Mukamal, KJ, Chung, HJ, Jenny, NS et al. Alcohol use and risk of ischemic stroke among older adults the cardiovascular health study. Stroke 2005; 36: 1830–4.CrossRefGoogle ScholarPubMed
26Reid, MC, van Ness, PH, Hawkins, KA, Towle, V, Concato, J, Guo, ZC. Light to moderate alcohol consumption is associated with better cognitive function among older male veterans receiving primary care. J Geriatr Psychiatry Neurol 2006; 19: 98105.CrossRefGoogle ScholarPubMed
27Pahor, M, Guralnik, JM, Havlik, RJ et al. Alcohol consumption and risk of deep venous thrombosis and pulmonary embolism in older persons. JAGS 1996; 44: 1030–7.CrossRefGoogle ScholarPubMed
28Department of Heath. Sensible Drinking. The Report of an Inter-departmental Working Group. London, Department of Health, 1995.Google Scholar
29Decker, J, Goldstein, JC. Risk factors in head and neck cancer. N Engl J Med 1982; 306: 1151–5.CrossRefGoogle ScholarPubMed
30Longnecker, MP. Alcohol consumption and risk of cancer in humans: an overview. Alcohol 1995; 12: 8796.CrossRefGoogle ScholarPubMed
31Wright, F, Whyley, C. Accident prevention and risk taking by elderly people: The need for advice. London, Age Concern, 1994.Google Scholar
32Malmivaara, A, Heliovaara, M, Knekt, P, Reunanen, A, Aromaa, A. Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults. Am J Epidemiol 1993; 138: 384–94.CrossRefGoogle ScholarPubMed
33Royal College of Physicians. Alcohol. Can the NHS afford it? London, Royal College of Physicians, 2002.Google Scholar
34Thomas, V, Rockwood, K. Alcohol abuse, cognitive impairment and mortality among older people. JAGS 2001; 49: 415–20.CrossRefGoogle ScholarPubMed
35Feuerlein, W, Kufner, H. Alcohol and alcohol problems research. 11. Federal Republic of Germany. Br J Addict 1986; 81: 613–9.CrossRefGoogle ScholarPubMed
36Crome, P. What about the elderly? In Glass, I (ed), The International Handbook of Addiction Behaviour. London, Routledge, 1991.Google Scholar
37Dunne, FJ. Misuse of alcohol or drugs by elderly people. BMJ 1994; 308: 608–9.CrossRefGoogle ScholarPubMed
38Pringle, KE, Ahern, FM, Heller, DA, Gold, CH, Brown, TV. Potential for alcohol and prescription drug interactions in older people. JAGS 2005; 53: 1930–6.CrossRefGoogle ScholarPubMed
39Woodhouse, P, Keating, W, Coleshaw, S. Factors associated with hypothermia in patients admitted to a group of inner city hospitals. Lancet 1987; 2: 1201–5.Google Scholar
40Callahan, C, Tierney, W. Health service use and mortality among older primary care patients with alcoholism. JAGS 1995; 43: 1378–83.CrossRefGoogle ScholarPubMed
41Mulinga, JD. Elderly people with alcohol-related problems: Where do they go? Int J Geriatr Psychiatry 1999; 14: 564–6.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
42Horton, AM Jr.Alcohol and the elderly. Md Med J 1986; 35: 916–8.Google ScholarPubMed
43Reid, MC, Tinetti, ME, Brown, CJ, Concato, J. Physician awareness of alcohol use disorders among older patients. J General Int Med 1998; 13: 729–34.CrossRefGoogle ScholarPubMed
44Ewing, JA. Detecting alcoholism. The CAGE questionnaire. JAMA 1984; 252: 1905–7.CrossRefGoogle ScholarPubMed
45Selzer, ML. The Michigan Alcoholism Screening Test (MAST): The quest for a new diagnostic instrument. Am J Psychiatry 1971; 127: 1653–8.CrossRefGoogle Scholar
46Blow, F. Michigan Alcohol Screening Test – Geriatric Version. Ann Arbor, University of Michigan, 1991.Google Scholar
47Saunders, J, Aasland, O, Babor, T, de la Fuente, J, Grant, M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption – II. Addiction 1993; 88: 791804.CrossRefGoogle ScholarPubMed
48Fiellin, DA, Reid, MC, O'Connor, PG. Screening for alcohol problems in primary care: a systematic review. Arch Intern Med 2000; 160: 1977–89.CrossRefGoogle ScholarPubMed
49Adams, WL, Barry, KL, Fleming, MF. Screening for problem drinking in older primary care patients. JAMA 1996; 276: 1964–7.CrossRefGoogle ScholarPubMed
50Morton, JL, Jones, TV, Manganaro, MA. Performance of alcoholism screening questionnaires in elderly veterans. Am J Med 1996; 101: 153–9.CrossRefGoogle ScholarPubMed
51Coulton, S, Drummond, C, James, D et al. Opportunistic screening for alcohol use disorders in primary care: comparative study. BMJ 2006; 332: 511–7.CrossRefGoogle ScholarPubMed
52Reid, M, Anderson, P. Geriatric substance use disorders. Med Clin North Am 1997; 81: 999.CrossRefGoogle ScholarPubMed
53Moyer, A, Finney, JW, Swearingen, CE, Vergun, P. Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 2002; 97: 279–92.CrossRefGoogle ScholarPubMed
54Miller, WRR. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York, Guildford Press, 1991.Google Scholar
55Wallace, P, Cutler, S, Haines, A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. BMJ 1988; 297: 663–8.CrossRefGoogle ScholarPubMed
56Bertholet, N, Daeppen, JB, Wietlisbach, V, Fleming, M, Burnand, B. Reduction of alcohol consumption by brief alcohol intervention in primary care. Arch Intern Med 2005; 165: 986–95.CrossRefGoogle ScholarPubMed
57Ballesteros, J, Duffy, JC, Querejeta, I, Arino, J, Gonzalez-Pinto, A. Efficacy of brief interventions for hazardous drinkers in primary care: systematic review and meta-analyses. Alcohol Clin Exp Res 2004; 28: 608–18.CrossRefGoogle ScholarPubMed
58Whitlock, EP, Polen, MR, Green, CA, Orleans, T, Klein, J. Behavioral counselling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the US Preventive Services Task Force. Ann Int Med 2004; 140: 557–68.CrossRefGoogle Scholar
59Poikolainen, K. Effectiveness of brief interventions to reduce alcohol intake in primary health care populations: a meta-analysis. Prev Med 1999; 28: 503–9.CrossRefGoogle ScholarPubMed
60Kahan, M, Wilson, L, Becker, L. Effectiveness of physician-based interventions with problem drinkers: a review. Can Med Assoc J 1995; 152: 851–9.Google ScholarPubMed
61Fleming, MF, Manwell, LB, Barry, KL, Adams, W, Stauffacher, EA. Brief physician advice for alcohol problems in older adults – A randomized community-based trial. J Family Pract 1999; 48: 378–84.Google ScholarPubMed
62Blow, F, Barry, K. Older patients with at risk and problem drinking patterns: New developments in brief interventions. J Geriatr Psychiatry Neurol 2000; 13: 115–23.CrossRefGoogle ScholarPubMed
63Curtis, J, Geller, G, Stokes, E. Characteristics, diagnosis and treatment of alcoholism in elderly patients. JAGS 1989; 37: 310–6.CrossRefGoogle ScholarPubMed
64Gordon, AJ, Conigliaro, J, Maisto, SA, McNeil, M, Kraemer, KL, Kelley, ME. Comparison of consumption effects of brief interventions for hazardous drinking elderly. Subst Use Misuse 2003; 38: 1017–35.CrossRefGoogle ScholarPubMed
65Oslin, D, Pettinati, H, Volpicelli, J. Alcoholism treatment adherence. Am J Geriatr Psychiatry 2002; 10: 740–7.CrossRefGoogle ScholarPubMed
66Blow, FC, Walton, MA, Chermack, ST, Mudd, SA, Brower, KJ. Older adult treatment outcome following elder-specific inpatient alcoholism treatment. J Subst Abuse Treat 2000; 19: 6775.CrossRefGoogle ScholarPubMed
67Schonfeld, L, Dupree, LW, Dickson-Euhrmann, E et al. Cognitive-behavioral treatment of older veterans with substance abuse problems. J Geriatr Psychiatry Neurol 2000; 13: 124–9.CrossRefGoogle ScholarPubMed
68Project MATCH Research Group. Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH post-treatment drinking outcomes. Effectiveness of treatment for alcohol problems. J Stud Alcohol 1997; 58: 729.CrossRefGoogle Scholar
69UKATT Research Team. Effectiveness of treatment for alcohol problems: Finding of the randomised UK Alcohol Treatment trial. BMJ 2005; 311: 541–4.Google Scholar
70Kraemer, KL, Conigliaro, J, Saitz, R. Managing alcohol withdrawal in the elderly. Drugs Aging 1999; 14: 409–25.CrossRefGoogle ScholarPubMed
71O'Connell, H, Chin, AV, Cunningham, C, Lawlor, B. Alcohol use disorders in elderly people – redefining an age old problem in old age. BMJ 2003; 327: 664–7.CrossRefGoogle ScholarPubMed
72Dufour, M, Fuller, RK. Alcohol in the elderly. Ann Rev Med 1995; 46: 123–32.CrossRefGoogle ScholarPubMed
73Mann, K, Lehert, P, Morgan, MY. The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis. Alcohol Clin Exp Res 2004; 28: 5163.CrossRefGoogle ScholarPubMed
74Oslin, D, Liberto, JG, O'Brien, J, Krois, S. Tolerability of naltrexone in treating older, alcohol-dependent patients. Am J Addict 1997; 6: 266–70.Google ScholarPubMed
75Oslin, D, Liberto, JG, O'Brien, J, Krois, S, Norbeck, J. Naltrexone as an adjunctive treatment for older patients with alcohol dependence. Am J Geriatr Psychiatry 1997; 5: 324–32.CrossRefGoogle ScholarPubMed