Alcohol and Older People

Generally alcohol consumption declines with age, however there is evidence that today's population of elderly people may be relatively heavier drinkers than in previous generations. This could be the result of a number of factors including this generation having lived in a time where alcohol is highly socially available and acceptable as well as having a higher disposable income in retirement.

Why are older people at risk?

Decline in general health
As we age our bodies change which can mean we become more sensitive to the effects of alcohol. Some of these physical changes include:

• A fall in ratio of body water to fat – older people have less water for the alcohol to be diluted in.
• Decreased hepatic blood flow – the liver will receive more damage.
• Inefficiency of liver enzymes – alcohol will not be broken down as effectively
• Altered responsiveness of the brain – alcohol will have a faster effect.

Hidden Harm
Older people are more likely to drink at home which means that where problems develop they are less likely to be detected and there may be more dangers of accidents such as fires and falls.

Lifestyle Disruption
The loss of routine and structure brought by retirement, bereavement and widowhood, declining health, and social isolation which can lead to boredom, depression and a lack of coping mechanisms. A third of older people who misuse alcohol developed the habit after the age of sixty.

Medication
Over a third of those over 75 take four or more medicines. Many prescriptions and over the counter medicines can interact with alcohol and can result in physical and psychological illness, injury and death.

Lack of alcohol education
Older people are much less aware of the concept of units with the main focus of alcohol education being young people. The notion that alcohol is 'one of the few pleasures they have left' furthers the barrier between the elderly and appropriate education.

Misdiagnosis
Some consequences of alcohol misuse, such as incontinence, falls, cognitive impairment, self neglect and dementia are often regarded as merely signs of ageing. Often the health problems brought on by alcohol misuse are treated, but the primary cause of such ailments is overlooked.

Cognitive Impairment
The loss of cognitive function is a serious health problem, and the likelihood of developing impaired brain function increases with age and with alcohol consumption. Alcohol related brain damage (ARBD) appears to occur in 50% of people with severe chronic alcohol problems, and long term alcohol misuse is associated with alcohol dementia, Wernike-Korsakoff Syndrome.

Why are older women particularly at risk?

At all ages in life women are more susceptible to the effects and the risks from alcohol than men, but this is particularly true as we age. Until now most of the awareness raising work around units and other associated risks has been targeted at younger women. Many older women are still unaware of the damage alcohol is doing to their health.

• Cancers - Increased risk of a number of cancers inclusing a significant increase in risk of breast cancer, and endometrial cancer.
• Osteoporosis - increased chance of developing osteoporosis and a delay in the healing of fractures
• Medication - Women are more sensitive to over the counter and prescription medicationthan men. Combining alcohol with some of these medications can be extremely risky.
• Isolation, depression and loneliness - Women are on average likely to outlive than men by 6 years. Very often older women find themselves living alone due to bereavement and can find this situation very isolating and experience feelings loneliness, depression.

Hidden Harm for Older Women
The hidden harm of alcohol is a significant issue for all older people however due to the fact that women outlive men and often find themselves living alone, it is of particular concern when looking at older women. If a women is drinking at home to help her cope with feelings of loneliness and isolation, drinking patterns can go unnoticed for a considerable time, usually until a real health problem arises. Research shows that women are half as likely as men to self refer themselves for help with an alcohol problem.

Society's View of Older Women
Older women are not seen as a group who would traditionally have an issue with alcohol misuse. This view can lead to women with alcohol problems being overlooked and their issues being misdiagnosed as described earlier. Additionally this societal view can create difficulties for women when trying to access services for an alcohol problem – often older women feel a real stigma about admitting they may have a problem and as targeted services for older women do not exist older women can often find they don't know where to turn for help.

Download the GINA Older Women and Alcohol factsheet.

Download the 'Alcohol and Ageing: The Views of Older Women and Carers' report.