Recognizing Alcoholism in the Elderly

Alcoholism in the elderly is a problem that is not getting nearly enough attention. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), an estimated 80,000 alcoholics in the United States are seniors. It is estimated that about 50 percent of nursing home residents struggle with alcohol related issues.

Alcohol abuse in the older population tends to go undiagnosed and even unnoticed because people tend to live their lives less publicly as they get older. Because of this, even doctors might not notice, confusing symptoms of alcohol abuse with common signs of aging.

Alcoholism in the Elderly

As you age, your sensitivity to alcohol increases. The reason for this is because your body doesn’t metabolize or excrete the alcohol efficiently. This results in higher blood alcohol levels and faster, long-lasting levels of intoxication. Even people who used to be moderate drinkers will find that the same amount of alcohol they used to drink will cause problems as they age.

There are two types of alcoholism in the elder population: those that are chronic abusers, and those that are situational drinkers. Chronic abusers have been drinking for most of their adult lives and make up two-thirds of the elderly problem drinkers. The remaining one-third situational drinkers turned to alcohol later in life, usually in response to a significant life-changing event such as retirement or a spouse dying.

Women especially should be cautious when drinking later in life. Though men are 5 times more likely to be affected by alcoholism, women are more likely to become alcoholics late in life. Because they cannot metabolize alcohol as efficiently as men do, the complications of long-term alcohol abuse develop more rapidly in women.

What Signs Should I Look For?

There are many different signs of alcoholism in older persons. You may not notice them because some of them are symptoms that are common for aging persons. However, if you notice a senior you love is exhibiting more than a couple of these signs, you may want to talk to them about their drinking habits.

• Drinks alone, or in a hidden way
• Often has the smell of alcohol on their breath; may use mouthwash to try and cover scent
• Drinks in spite of warning labels on prescription medications
• Is often slightly tipsy and has slurred speech
• Drinks to calm nerves, forget worries, or reduce depression
• Downing drinks too fast
• Loss of interest in food
• Loss of interest in activities that used to bring pleasure
• Hurting yourself or others when drinking
• Irritable, resentful or unreasonable when drinking
• Medical, social, or financial problems caused by drinking

The CAGE Screening

If your senior loved one lives alone, you may not see them enough to know if they are exhibiting any of these signs. There is also the CAGE questionnaire, which is a screening test for potential alcohol problems. It is named for its four questions, and though cannot be used to diagnose problems, is considered a validated screening technique. The four questions, as developed by Dr. John Ewing, are as follows:

1. Have you ever felt you should Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt bad or Guilty about your drinking?
4. Have you ever felt you need a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?

If you answer ‘Yes’ to two or more of these questions, it may indicate that you have a drinking-related issue. In some modifications of this screening, answering, ‘Yes’ to the last question is enough for some clinicians to determine that you are at risk for a drinking problem.

If you think you or your senior loved one may have an alcohol abuse problem, you should talk to them about their drinking habits so that they can get the help they need.