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Problem Alcohol Consumption and Older Australians

By Professor John B Saunders, Consultant Physician to South Pacific Private and Addiction Medicine Specialist

Problems due to alcohol in young people have attracted considerable publicity in recent times, in part because of the tragic deaths of some youngsters who have been attacked in public by intoxicated individuals. Governments have taken action to respond to widespread community concern about this. Is alcohol consumption a problem for older people?

There has been almost no focus on this but some experts describe it as the “hidden epidemic”.

Australia remains a country with one of the highest levels of alcohol consumption in the world and every year thousands die as the result of its effects.  Deaths more commonly occur in older people but these are less commonly due to violence and more usually due to the toxic effects of alcohol on the body and the brain.  Alcohol’s toxicity affects every organ and body system and it has an impact especially on the liver, the stomach and other digestive organs such as the pancreas (which produces digestive enzymes and insulin). Excessive alcohol consumption can also cause heart disease, muscle disease, disease of the sex organs, and a range of disorders of the blood and the metabolism (chemical systems) of the body. Further to this, excessive consumption can cause widespread brain damage, resulting in memory loss, disorganised thinking and actions, the effects of which can resemble dementia. Excessive consumption can also result in abusive and foolish behaviours which may cause great distress to family members and lead to breakdowns in marriages and interpersonal relationships more generally.

How much is too much? 

Current guidelines for safe drinking are quite strict. The National Health and Medical Research Council states that people should not drink more than two standard drinks per day, and many authorities would encourage people to have at least two alcohol-free days per week. These limits apply to the population at large and they are certainly applicable to those aged 65 years or more as in this age group other changes to the body occur, which are important to be aware of.

These changes include:

·         Thinning of the bones, known as osteoporosis, which makes the older person more likely to sustain a fracture after having a fall.

·         The development of arthritis, which can impair muscle strength and lead to reduced mobility.

·         The aging process makes the brain more susceptible to the toxic effects of alcohol on it.

·         Older people are more likely to be on medications and many take multiple medications for various disorders, with which alcohol can interact to produce unwanted effects.

·         Diabetes is more prevalent in older people and alcohol can further impair glucose tolerance and the effectiveness of medications for diabetes.

·         Alcohol may cause the older person to become more rigid in their thinking and not be willing to consider alternative ways of dealing with a personal issue.

Alcohol consumption therefore makes the older person more vulnerable because of the natural changes to the body and brain that occur in addition to the direct toxic effects which can occur at any age.

At higher levels of consumption alcohol can result in dependence on it. In this situation changes to areas of the mid-brain, including the alertness system and reward system, produce an increasingly powerful “internal drive” to drink alcohol, despite the consequences. In this situation the older person may progressively neglect their work and normal daily activities in favour of drinking, as alcohol becomes more central to their thoughts and daily life. In some cases the person may neglect their diet, become malnourished and may even not attend to basic self-care including personal hygiene. At this stage of alcohol dependence, where the person is actually addicted to alcohol, the downhill course can be rapid.  People may need to be admitted to hospital as an emergency and unfortunately if the problem is left to this stage, some of the effects may not be reversible.

It is much better for the older person whose alcohol consumption may be becoming excessive to seek advice and treatment rather than action being deferred until serious problems have arisen.

This is where involvement in a treatment program such as that provided by South Pacific Private Hospital can be so valuable.  The hospital provides state of the art treatment in an environment which is comforting and attractive.  Family members may make enquiries about treatment for an older relative and a family program is available following initial treatment to support families in the older person’s ongoing care.

If you would like to register or have questions please feel welcome to connect with the team 02 9919 0506 or by emailing info@southpacificprivate.com.au