ALCOHOL ABUSE AMONG OLDER AMERICANS IS RISING
In the summer, Henry Wrenn Mele ck likes to sit on the stoop of his building on the Upper West Side of Manhattan, observing the passing urban parade.
One day in late July ,“one of my neighbors could see something was wrong ,” he recently recalled .“I was sort of rolling around, obviously in a lot of pain. He said, ‘I have to call 911,’ and he did.”
Wren n-Me le ck ,63, an independent music publisher and dealer in rare guitars, spent three weeks in a hospital, being treated for trauma from a fall he does not recall. But the underlying problem was “40 years of being a very serious alcoholic ,” he said .“My body finally said no more .”
Discharged from the hospital after detoxing, Wrenn-Meleck went to the New Jewish Home in Manhattan for physical therapy. He also entered its geriatric substance abuse recovery program where, he found, he was one of the younger participants.
Epidemiologists at the National Institute on Alcohol Abuse andmonth reported a jar ring trend: Problem drinking is rising fast among older Americans.
Their study, published in JAM A Psychiatry, compared data from a national survey taken in 2001 and 2002 and again in 2012 and 2013, each time with about 40,000 adults. Drinking had increased in every age group, the researchers found.
Those older than 65 remained far less likely to drink than younger people —about 55 percent of older participants told inter viewers they had imbibed in the past year. Still, that was a 22 percent increase over the two periods, the greatest rise in any age group.
More troubling, the proportion of older adults engaged in “high-risk drinking” jumped 65 percent, to 3.8 percent. The researchers’ definition: for am an, downing five or morestandard drinks in a day( each containing 14 grams of alcohol) at least weekly during the past year; for a woman, four such drinks in aday.
And “alcohol use disorders ”( we used to call it alcoholism ), as defined in the psychiatric Diagnostic andStatistical Manual, more than doubled in a decade, afflicting over 3 percent of older people.
“The trajectory overtime is remarkable ,” said Dr. Marc S chuck it, a psychiatrist and addiction specialist at the University of California, San Diego, who wrote an editorial accompanying the new report .“You have to say there’ s something going on.”
Even if the rate of alcohol problems among older people doesn’ t climb further, the sheer numbers will increase .“The growth in that population port ends problems down the road ,” said Bridget Grant, an epidemiologist at NI AAA and the lead author of the study.
Why this spike in late-lifedrinking? Grant’ s team didn’ t investigate causes, but she speculates that anxiety caused by the recession, which hit right between the two surveys, may have played a part.
Other experts point to demographic differences. People in their 60 sand early 70s are less frail than in previous generations, so they continue their drinking patterns. Moreover, baby boom er shave been more exposed to, and are less disapproving of, drug and alcohol use.
“It’ s a lot more acceptable ,” said Dr. David Os lin, a psychiatrist specializing in addiction at the University of Pennsylvania .“We no longer have those folks who grew up with Prohibition, with abstinence as a value.”
Even if older people are healthier, they’ re still prone to late-life physical changes that make drinking riskier. While two drinks a night at age 40 might not bean issue, two daily drinks at 70 is more complicated.
With each drink, an older person’ s blood alcohol level will rise higher than a younger drink er’ s, S chuck it noted; older people have less muscle mass, and the liver metabolizes alcohol more slowly. Aging brains growto its sedative properties, too.
“It has a greater effect ,” he said .“If I drink now the same way I did at 40, I’ d better be careful.”
Most older people also have acquired common chronic diseases exacerbated by alcohol, like hypertension, diabetes and heart disease. Alcohol is also associated with a higher risk of stroke and several kinds of cancer. And alcohol can play havoc with the medications people take to control those conditions.
“Read your drug labels ,” Os lin said. “Alcohol interferes or inter acts with literally hundreds of prescription medications.”
He has grown accustomed to enlightening patients who think they can safely drink wine at dinner because they don’ t take their pills until the next morning.
“That medication is in your system 24/7,” he said. Drinking can render it less effective or even dangerous.
We may already be seeing the health consequences, Grant pointed out. The nation’ s sharp declinedisease and strokes has begun to level off. Emergency room visits for alcohol-related falls, particularly disabling for seniors, have increased.
So have deaths from liver cirrhosis. “It’ s the first time we’ ve seen those rates go up since the 1960s ,” Grant said .“It’ s shocking.”
She advocates a national educational campaign to alert older people to the dangers of excessive drinking—or, for some, any drinking.
Primary care doctors also need to pay attention, Os lin said. Though the U.S. Preventive Services Task Force has recommended screening all adults for alcohol misuse ,“I don’ t know how many do.”