Academic journal article Alcohol Research

Use and Misuse of Alcohol among Older Women

Academic journal article Alcohol Research

Use and Misuse of Alcohol among Older Women

Article excerpt

Older women may be at particular risk for alcohol-related problems. They are more likely than men to outlive their spouses and to face other losses that typically lead to loneliness and depression--factors that may prompt alcohol use. As Drs. Frederic C. Blow and Kristen Lawton Barry explain, women also are physiologically at greater risk for alcohol-related health problems as they age. Because of these risks, alcohol use recommendations for older women generally are lower than those set for both older men and younger women. Potential alcohol problems can be detected by routine screening in primary health care settings, clinics, nursing homes, and other facilities. The use of screening and brief intervention may help minimize alcohol problems in older women. Although research on the success of brief interventions with this population is limited, the findings are promising. (pp. 308-315)

Older women may be especially at risk for alcohol problems because they are more likely than men to outlive their spouses and face other losses that may lead to loneliness and depression. Physiologically, women are also at greater risk for alcohol-related health problems as they age. Because of these risks, alcohol use recommendations for older women generally are lower than those set for both older men and younger women. Screening and brief intervention may be especially useful in minimizing alcohol problems in older women. Although brief intervention research with this population is limited, the findings are promising. KEY WORDS: alcohol use disorder in the elderly; female; risk factors; protective factors; prevalence; identification and screening for AODD (alcohol and other drug disorders); brief intervention; prevention goals; treatment method; treatment outcome; recommendations or guidelines

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The growth in the number of people age 60 and older will bring a soaring increase in the amount and cost of primary and specialty care for this group. In 1990, those over the age of 65 comprised 13 percent of the U.S. population; by the year 2030, older adults are expected to account for 22 percent of the population (U.S. Bureau of the Census 1996). Community surveys have estimated the prevalence of problem drinking among older adults to range from 1 percent to 15 percent (Adams et al. 1996; Fleming et al. 1999; Moore et al. 1999). Among older women, the prevalence of alcohol misuse ranged from less than 1 percent to 8 percent in these studies. As the population age 60 and older increases, so too could the rate of alcohol problems in this age group. However, early detection efforts by health care providers can help limit the prevalence of alcohol problems and improve overall health in older adults.

Many of the acute and chronic medical and psychiatric conditions that lead to high rates of health care use by older people are influenced by the consumption of alcohol. These conditions include harmful medication interactions, injury, depression, memory problems, liver disease, cardiovascular disease, cognitive changes, and sleep problems (Gambert and Katsoyannis 1995). For example, Thomas and Rockwood (2001) found that the occurrence of all types of dementia (with the exception of Alzheimer's disease) was higher in a sample of 2,873 people age 65 and older with definite or questionable alcohol abuse (1) compared with those who did not abuse alcohol. At 18 months after baseline, mortality from all causes in this sample was higher among those with definite abuse (14.8 percent) or questionable abuse (20 percent) than among those with no alcohol abuse history (11.5 percent). The risk for negative alcohol-related health effects is greater for older women than for older men at the same amounts of alcohol use.

Researchers have recently recommended that screening and interventions focused on lifestyle factors, including the use of alcohol, may be the most appropriate way to maximize health outcomes and minimize health care costs among older adults (Blow 1998; Barry et al. …

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