Loren Stein
CONSUMER HEALTH INTERACTIVE

Note: This article has been localised for an Irish audience.

If you're over 60, you may use alcohol in much the way you did when you were younger. You may have a glass of wine at a meal, a beer or two in the pub, or a gin and tonic at a party with friends. And if your doctor says it's fine for you to drink, there's nothing wrong with it.

But if you've found yourself feeling tense and irritable when you're not drinking, you may have a problem. A large proportion of the country's alcoholics is over 60. It's a problem that's often hidden. Problem drinking often goes undiagnosed for the simple reason that people tend to live less public lives as they grow older. Furthermore, doctors may not link symptoms that are also common signs of ageing -- falls, loss of appetite, failing memory, sleep problems, or depression -- to alcohol abuse.

Not everyone who drinks has an alcohol problem but you may need help if you notice any of the following:

•Drinking to calm the nerves, forget worries, or reduce depression

•Loss of interest in food

•Gulping drinks down too fast

•Lying or trying to hide drinking habits

•Drinking alone

•Hurting yourself or others while drinking

•Getting drunk regularly.

•Needing more alcohol to get "high"

•Feeling irritable, resentful, or unreasonable when not drinking

•Developing medical, social, or financial problems caused by drinking.

Another set of questions sometimes used to determine whether a person has an alcohol problem is the "CAGE" test-:

•Have you ever felt you should C ut down on your drinking?

•Have people A nnoyed you by criticising your drinking?

•Have you ever felt bad or G uilty about your drinking?

•Have you ever had a drink first thing in the morning (an "E ye opener"), to steady your nerves, or to get rid of a hangover?

Answering "yes" to two or more of these questions may indicate a drinking problem.

It's all subjective. You might begin drinking more after retirement because the sudden overabundance of free time can leave you with the feeling that you've lost purpose in life. The resulting boredom and sense of uncertainty could invite you to drink more than you usually do. Or you might have suffered from loneliness after your children moved away, or after the death of your spouse or friends. It's natural to feel lonely under those circumstances, which push some people to turn to alcohol for comfort. You might also be suffering from stress or depression. The very real difficulties of ageing -- failing health, limited mobility, financial hardships, or caring for an ailing spouse -- can easily pile up and impel older people to drink. Or -- and this is true in two-thirds of the cases of alcohol abuse in later life -- you might have had a drinking problem that has become worse over the years.

Yes. Animal and human studies show that sensitivity to alcohol increases with age. Based on that information, some experts recommend that people over 65 have no more than one drink per day.

The reason? You have a decreased tolerance for alcohol. As we age, our bodies don't metabolise and excrete alcohol as efficiently; this results in higher blood alcohol levels per drink and swifter, longer-lasting intoxication. Even if you were a moderate drinker in your youth, you may find that the same amount of alcohol you used to drink will lead to trouble when you're older.

Alcohol increases the risks for falls and accidents, which can be very serious for people in this age group. It also slows down brain activity, affecting alertness, judgement, coordination, and reaction time.

In addition, drinking worsens many medical conditions common in older people, including high blood pressure and ulcers. What's more, the effects of alcohol can make some medical conditions hard to diagnose. For example, alcohol causes changes in the heart and blood vessels and can dull pain that might be a warning sign of a heart attack. Alcohol abuse can also mimic Alzheimer's disease, with its symptoms of confusion and memory loss. Over time, heavy drinking permanently damages the brain and central nervous system as well as the liver, heart, kidneys, and stomach.

Finally, the elderly are the heaviest users of prescription medicines and over-the-counter drugs, and mixing these substances with alcohol can either exaggerate or reduce the effects of many medications. In turn, drugs can intensify the impact of alcohol. (A good number of medications, in fact, already contain alcohol.)

Be aware that mixing alcohol with drugs such as tranquillisers and sleeping pills, as well as some antidepressants, anti-anxiety drugs, antihistamines, and painkillers, is extremely dangerous and potentially fatal. If you drink, consult with a doctor or pharmacist about potential interaction problems with the drugs you're taking. And always make sure to check prescription drugs for instructions and warnings about alcohol.

Women are more likely to become alcoholics late in life. In addition, women do not metabolise alcohol as efficiently as men do, so they are more likely to become dangerously intoxicated. Late-stage complications of alcoholism in women -- liver damage, hypertension, anaemia, and malnutrition -- develop faster and with lower levels of alcohol intake than in men.

Of elderly problem drinkers, two-thirds are "chronic" abusers, or people who have been heavy drinkers for many years. The rest are termed "situational" drinkers, having turned to alcohol later in life in response to significant and often traumatic life changes, such as bereavement, illness, disability, and retirement. Among situational drinkers, women outnumber men.

Older people who seek help for a drinking problem have a good chance for recovery because they are likely to stick with treatment programmes, especially when the programmes are geared specifically to their needs.

If you are a relative or friend of an older person with a drinking problem, you can also help by realistically assessing the difficulties he or she faces and being alert to changes in behaviour. You can assist by helping him acknowledge and mourn any losses that may have spurred the problem drinking, by helping him find treatment and a support group, and by suggesting alternative activities. If he or she is in danger from alcoholism, you may want to intervene -- that is, confront the person (perhaps with a counsellor present) about the difficulties caused by the alcohol abuse and suggest the person- enter an inpatient or outpatient detoxification and rehabilitation programme.

Contact your general practitioner. Your family doctor is very used to dealing with alcohol-related problems and with the medical implications of alcohol abuse. Futhermore, many GPs have a special interest in alcohol problems. Your doctor can also advise you about the local programmes in your area to tackle alcohol abuse. Alcoholics Anonymous: 01 4538998.

-- Loren Stein is a health and medical writer living in Palo Alto, California. She is also a regular contributor to WebMD.

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published June 12, 2001
Copyright © 2000 Consumer Health Interactive

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