Alcoholism in Old Age

An addiction to alcohol, including both physical and emotional elements. Elderly individuals who drink to excess may have been drinking for years, or they may begin drinking late in life because of MELANCHOLY, BEREAVEMENT, PAIN and forlornness, or for other motives. Frequently, their drinking is concealed and friends, and relatives may not understand the source of physical and behavioral issues, attributing them instead to “old age.”

Occasionally the symptoms of chronic alcoholism may be mistaken with the symptoms of ALZHEIMER’S DISEASE or DEMENTIA. These disorders shouldn’t be diagnosed in an individual who’s a heavy drinker until alcohol has been totally out of the system for at least four weeks.

Because many elderly alcoholics deny drinking in any way, the physician shouldn’t rely on self-report exclusively but also must search for other characteristic indications of alcoholism, including unexpected and unexplained INCONTINENCE, unexpected inferior grooming, and worsening GOUT or DIABETES. Specific physical changes, including a protuberant abdomen (“beer belly”), enlarged breast size in guys, and outstanding blood vessel markings, are just a couple of the external indications of alcohol excess. Specific blood tests can be helpful with identification. An unanticipated reaction to a

Medicine may also suggest that alcohol has interacted with the man’s medication.

Symptoms Of Alcoholism

The National Institute on Alcohol Abuse and Alcoholism says there are four fundamental symptoms of alcoholism.

1. The first symptom is a compulsion to drink and a craving for alcohol. Alcoholics do not just desire to drink; they desire to drink.

2. Individuals afflicted with alcoholism cannot control their drinking. They cannot restrict themselves to a couple of drinks but instead, once started, must drink until intoxication and unconsciousness occurs.

3. Alcoholics are physically determined by alcohol. If they don’t drink, they endure physical effects, like nausea, perspiration, or shakiness. If they take a drink, these physical symptoms will vanish.

4. The closing symptom of alcoholism is “endurance,” which means the alcoholic must drink more than in previous years to get exactly the same effects from the alcohol.

Because many individuals can refuse these symptoms to themselves and to others, specialists have developed “CAGE,” an acronym to help people understand if they’ve a drinking problem. Specialists say that CAGE is, in addition, an effective evaluation for old individuals. The components of CAGE are as follows:

C: “Have you ever believed that you should cut down in your drinking?

A: “Have people annoyed you by criticizing your drinking?

G: “Have you ever felt bad or guilty about your drinking?

E: “Have you ever had a drink the first thing in the morning (an eye opener) to steady your nerves or to eliminate a hangover?”

If somebody answers “yes” to two or more of the CAGE questions, then she or he should be screened further for alcoholism.

Demographics Of Alcoholics

Specialists Say That It’s Actually Not Understood How Many Elderly Alcoholics There Are Because Few Individuals Mature Than Age 63 (And Just About 15 Percent Of Those Who Are Alcoholics) Really Seek Treatment. Nevertheless, It’s Estimated That From 2 To 4 Percent Of The Aged People Does Suffer From Alcoholism. Most Elderly Alcoholics Are Men, Although Some Researchers Say That Because Trouble Drinking Is So Concealed By Old Individuals, There May Be Many More Female Alcoholics Than Is Understood. It’s Possible That Society May Be Seeing Just The “Tip Of The Iceberg” As It Pertains To This Sickness.

Alcohol Can Change Older People Otherwise

For various reasons, alcohol can affect older people differently than it affects younger individuals. As an example, elderly individuals generally have a reduced ratio of body water to body fat, which means that there’s less fluid in which to dilute the alcohol. Because of this, it’s more concentrated in the body. What this means is that a modest quantity of alcohol can lead to a higher blood alcohol level than the same number would cause in younger individuals who weighed about the same. Essentially, old individuals become intoxicated more quickly.

The liver is, in addition, generally less efficient in most elderly individuals, and the elderly alcoholic threats more liver damage than the younger man.

Alcohol may also change the brain of the elderly man faster. If an elderly man says that he or she feels “tipsy” after just a couple of drinks, he or she’s likely telling the truth.

Health Problems Caused By Alcoholism

Almost every body system is impacted negatively by alcoholism, and years of heavy drinking take its toll physically. Many serious illnesses are caused by or connected with alcoholism, including cirrhosis of the liver, alcoholic hepatitis, brain damage, OSTEOPOROSIS, and cardiac and kidney disorders. Such disorders can be quite serious; for example, about half of elderly alcoholics that have cirrhosis expire a year from identification.

Elderly alcoholics are also more likely to have problems with accidental harms than nonalcoholic, and additionally they have a heightened risk of hip FRACTURES. Not only does intoxication raise the risk of mishaps, but the harms can be more noticeable

Due to osteoporosis. They may be also more likely to have problems with anemia coming from iron and VITAMIN DEFICIENCIES, especially a lack of Vitamin B12. Sadly, this kind of lack can cause memory loss and equilibrium dysfunction; because these are also common symptoms of alcohol abuse, the effects can be additive. Deficiencies of Vitamin K may be present (which could result in bleeding problems), in addition to want of magnesium and phosphorus.

Alcohol interferes with the body’s ability to produce white blood cells, especially those that attack bacteria. It can damage the blood platelets and impair blood clotting. Alcoholics are more likely than nonalcoholics to endure from a bleeding issue as easy as nosebleeds or as frightening as STROKE from bleeding in the brain.

Excessive drinking may also damage the cardiovascular system. Alcoholism can cause HYPERTENSION, unusual heart rhythms, and heart muscle ailments (cardiomyopathies).

The immune system may be damaged by alcoholism, causing the alcoholic to become more exposed to bacterial diseases for example pneumonia, tuberculosis, and other diseases.

Alcoholism can result in pancreatitis, an inflammation of the pancreas that’s due to a blockage of the ducts of the pancreas and causes damage to pancreatic tissue. If the instance of pancreatitis is acute, the illness can be deadly. Symptoms of pancreatitis are vomiting and acute stomach pain, which improves when the man leans forwards. In some instances, there are not any obvious symptoms.

Alcoholics are more prone to growing cancers, especially of the head, the neck, and the esophagus. Liver cancer danger is raised for the alcoholic. If the alcoholic also smokes, as the majority does, the danger of cancer is further accelerated.

Alcoholics are more likely to have problems with sleep disorders, including insomnia or sleep apnea. This is a serious condition at which individual stops breathing for short intervals, which can be deadly. Many alcoholics try to treat sleeplessness with alcohol, which interferes with sleep routines and is quite unhealthy.

The brain is, in addition, influenced by alcohol abuse. Magnetic resonance imaging (MRI) scans have revealed both tissue damage and brain shrinkage in some

People that are alcoholics. The emotions and the cognitive capacities of the alcoholic are impacted by excessive drinking. Long-term alcoholics may additionally

Endure from WernickeKorsakoff’s syndrome, which is a short-term memory illness where the alcoholic forgets what’s just happened and can only recall events that occurred years ago. These patients frequently confabulate or “make up” info to fill in the differences of their lost recollections. They may be unable to save any new memories.

Alcoholics that have a deficiency of thiamin have problems with damage to the cerebral cortex of the brain, and they experience a number of cognitive impairments and memory losses.

The gastrointestinal system is, in addition, frequently damaged by alcoholism, and the alcoholic man is more likely than nonalcoholic to have problems with heartburn and from GASTROESOPHAGEAL REFLUX DISEASE. Alcoholics are also more at risk for esophageal cancer as a result of damage due to alcohol consumption to the mucous lining of the esophagus. Alcohol abuse may also damage the salivary glands and cause inflammations of the tongue and mouth.

The kidneys are also affected by alcoholism, which can in fact alter the arrangement of the kidneys and impair their function. Alcoholism additionally raises the quantity of calcium and magnesium that are lost in the urine.

Late Onset Drinkers

Many researchers categorize people into either lifelong problem drinkers or those who become alcoholics when they’re in their late middle age (after age 50) or their senior years. Specialists estimate that late onset drinkers represent about 3050 percent of all older problem drinkers. In addition they have a better prognosis and react better to treatment than individuals who’ve been lifelong problem drinkers. Nevertheless, they must truly seek treatment to recover from alcoholism.

Old Issue Drinkers Versus Issue Drinkers

In a study of 1,884 mature people (ages 55 to 65 at the time of the study’s start), reported in a 1996 issue of Alcohol Health & Research World, researchers found that problem drinkers and difficulty drinkers (social drinkers) revealed specific routines.

These features were found more often among older problem drinkers versus non-problem drinkers. Issue drinkers were:

• More likely to be single/widowed
  

• Have twice as much alcohol
  

• More likely to use avoidance to take care of issues
  

• Less likely to have support from family or friends
  

• Considerably more likely to have endured adverse consequences associated with drinking
  

Alcohol Interactions

Another danger of alcohol abuse is that alcohol interacts which have many distinct types of drugs that elderly individuals may be taking, including sedatives, painkillers, and muscle relaxants. Because elderly people are usually considerably more likely to be taking drugs than younger folks, they’re also more likely to experience drug interactions if they have alcohol.

Some drugs, when taken alongside alcohol, can lead to a disulfiram like reaction.

Disulfiram (Antabuse) is a drug that’s given to treat some alcoholics. If the alcoholic have even a tiny number of alcohol while taking disulfiram, he or she becomes violently sick with acute flushing, nausea, vomiting, and sweating.

Treatment Of Alcoholism

An elderly man who has been a long-term alcoholic and who abruptly stops drinking may endure such effects as delirium tremens, a serious type of withdrawal that can lead to seizures and even death. Because of this, the elderly man who’s going through “detoxification” (removal from alcohol) should get treatment in a hospital or inpatient facility that’s experienced with treating elderly alcoholics.

The aging alcoholic may be experiencing malnutrition, which ought to also be treated.

Generally, the man who becomes alcoholic late in life has a much better prognosis for healing than the man who has been a significant consumer of alcohol since young adulthood.

Many individuals of all ages have found success through volunteer programs offered by Alcoholics Anonymous. The major premise of Alcoholics Anonymous is that the individual must give up all alcohol. Alcoholics work through “12 steps” in their attempts to attain sobriety. They meet regularly and work to help each other stay off alcohol.

Because so many elderly folks have issues with melancholy and loneliness, the social support provided by such organizations can be quite helpful. But if elderly people have difficulties with transport and freedom, they may find it hard to attend regular meetings. Another issue is that many elderly folks refuse to admit they have an issue with alcohol.

Drugs For Alcoholism

Antabuse (disulfiram) was the drug that was most used previously to treat alcoholism. It’s still used by some doctors, frequently in combination with other drugs; yet, it’s usually not recommended for elderly patients due to the severity of the effects it can cause. This drug is used as an aversive treatment. When individuals taking Antabuse additionally have alcohol, they become violently sick with nausea and vomiting, even when the quantity of alcohol that was consumed was quite little. Trexan (naltrexone) is a newer drugs to treat alcoholism and has been used for this function since the early 1990s. This drug inhibits the actions of alcohol on the brain. Consequently, if a man taking Trexan have alcohol and then beverages, she or he is not going to get a pleasurable feeling they had previously. Trexan is also given to those who are hooked on opiates because it blocks the activity of the opiate on the brain.

A vital issue is that in order for Antabuse or Trexan to work, the patient must really take them and conformity with the drug regimen can be spotty. If the individual can be treated in a hospital or practice, then staff can administer the drug, but many folks cannot afford inpatient treatment and health insurance may not provide coverage.

Benzodiazepines are a category of drugs used to treat patients experiencing alcohol withdrawal, although no studies have been performed on their effectiveness among elderly patients. Generally speaking, however, physicians use shorter acting benzodiazepine drugs to prevent the lengthy sedative effect. As can be seen from the drug interaction graph, benzodiazepines socialize with alcohol if the individual continues to drink. This type of medication may also have important side effects, for example, threat of habituation or addiction.

Alternative Medicine/Complementary Alternative Medicine (Cam)

Drugs And Treatments That Are Considered Nontraditional, Such As The Use Of Herbs And Nutritional Supplements, Acupuncture, Hypnosis, And Other Remedies That Are Seldom The First Choice Of Most Western Doctors Who Are Treating Patients.

Some specialists consider that alternative medicine has become incredibly popular in the West because many individuals are dissatisfied with remedies and treatments used for common and long-term issues, for example ARTHRITIS, OBESITY, HEADACHE, and other issues that supply incomplete, temporary, or insufficient relief.

A vital misconception about alternative medicine that’s shared by many individuals from all walks of life is the belief that alternative medications are naturally safe because they’re “natural.” The reality is that some herbs and nutritional supplements can be dangerous or even deadly for a number of people. Moreover, a common error that many patients make isn’t telling their doctors about the natural materials they are taking. The appointed drugs that the patient already takes may socialize with the alternative treatment, fostering or reducing its effect or altering it in another manner.

Examples Of Drug Interactions

Ginkgo biloba is a blood thinner, and individuals who are taking ginkgo biloba in addition to a blood thinner, for example Coumadin (warfarin), could have problems with internal bleeding and even death. The valerian root, occasionally taken as a sleep treatment, can socialize with ant seizure drugs. Some herbs also interact with alcohol; for example, the drowsiness related to alcohol is accentuated when the individual also takes chamomile, echinacea, or valerian. These are just a couple of the many potential interactions which could happen.

Hence, in all instances, seniors or their caregivers should make sure to tell the elderly man’s doctors about any vitamins, herbal, or other alternative treatments the patient is taking.

Alternative medicines are offered in “health food” shops throughout America in addition to in supermarkets and drugstores and from many mail-order vendors. A proliferation of alternative medications and treatments are additionally offered to consumers world-wide on the internet. In general, alternative medicine encompasses such groups as:

• Herbal treatments
  
• Supplementary vitamin or mineral treatment
  
• Homeopathic treatments
  

Herbal Treatments

A broad assortment of roots, teas, berries, and other things are sold as herbal treatments. The market for herbal treatments is estimated at about $5 billion in America alone.

The crucial impetus to the increase in sales of herbal treatments in America was the passage of the Dietary Supplement Health and Education Act of 1994. Based on this legislation, herbal treatments and vitamin supplements were then controlled differently from both over-the-counter and prescribed drugs.

In contrast to how herbs and nutritional supplements are approved and marketed in America, pharmaceutical companies wishing to sell new prescribed drugs must offer substantial evidence in the kind of clinical studies to the Food and Drug Administration (FDA) before their products may be offered to the people. These studies must signify not only that a brand new drug is safe but also it is efficacious and that it enhances the state it treats—in other words, the new drug really does what it’s said to do and in a safe and successful way.

By comparison, the Dietary Supplement Health and Education Act of 1994 in America made the scenario rather distinct for the sale of herbs and supplementary minerals and vitamins. If so, the federal government, as opposed to the drug company, must supply evidence of an issue. Additionally, to remove an herb or supplement from the marketplace, the authorities must show that it’s dangerous. The herb or supplement may be unsuccessful, but if it’s not really dangerous, then it is going to stay in the marketplace. To show that a drug is dangerous can be hard to reach. Naturally, the FDA can and does issue press releases when it considers that an alternative treatment may be dangerous.

It’s true that manufacturing companies should restrict their medical claims under the law, but as of this writing, there is apparently little investigation or enforcement of this demand, perhaps due to the absolute volume of the thousands of products available on the market.

Another problem of concern to consumers is that the purity of herbal treatments and nutritional supplements has been challenged in some instances, as have their real contents. Some arbitrary studies have shown that some herbal treatments are adulterated with materials not described on the packaging; others have shown that there’s little or none of the sub

Position that’s purported to be contained.

Occasionally, herbal treatments contain high doses of materials which will be dangerous, including ephedra (ma huang). In an individual who already has hypertension, cardiac ailments, DIABETES, or other medical complications, taking ephedra and similar drugs can be quite dangerous and even deadly.

Supplementary Vitamins

People must always check with their doctors first before instituting any new drug regimen, including vitamin or mineral treatment. Some seniors may gain

Significantly from vitamin supplementation; for example, seniors have a heightened danger of a serious Vitamin B12 deficiency. (Seniors shouldn’t take Vitamin B12 without consulting with their doctor because taking this vitamin may be unneeded.) It’s also vital that you tell the physician because as patient demands change, doses of medications may have to be fixed.

Homeopathic Treatments Homeopathy is a system that was developed by German physician Samuel Hahnemann in the early 19th century. This doctor had quit practicing medicine, but he continued testing on herbs. Hahnemann noted that substantial amounts of the drug quinine made healthy people feverish and unstable with malarialike symptoms. Considerably smaller doses, nevertheless, helped individuals who really had malaria.

Most physicians in the United States mark down the worth of homeopathic treatments although doctors in Germany and other European nations accept them.

Hahnemann formulated his theory of the “law of similars,” which was based on his unique belief that substantial amounts of some materials may cause sickness, but really tiny amounts of the very same material may provide relief. For instance, belladonna, a lethal drug for most individuals, is used by homeopaths in tiny amounts to treat migraine headaches. Some people have said they’ve got migraine relief from homeopathic doses of belladonna. It’s uncertain whether they feel better because they believe they’ll feel better (the placebo effect) or if belladonna really has some curative powers.

Other Alternative Treatments

Some professionals advocate relaxation treatment, acupuncture, hypnosis, massage, chiropractic, Ayurveda, yoga, aromatherapy, TAI CHI, and an extremely extensive collection of alternatives to enhance health and general wellness. In the instance of of seniors, these treatments may be quite helpful with muscle pain, BACK PAIN, arthritis, and generalized anxiety. Seniors wishing to use alternate treatments should talk to their doctors, and if there isn’t any medical reason to prevent such alternate treatments, the treatments may be helpful. By way of example, tai chi was revealed to be incredibly successful in enhancing equilibrium among patients who’ve PARKINSON‘S DISEASE.

To get additional information on alternate treatments and complementary medicine, contact the National Institute s of Health Office of Alternative