Alcohol Use and the Elderly

For most adults, moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.) These amounts are known as one standard unit.

Certain people should not drink at all, however:

• Women who are pregnant or trying to become pregnant

• People who plan to drive or engage in other activities that require alertness and skill (such as driving a car)

• People taking certain over-the-counter or prescription medications

• People with medical conditions that can be made worse by drinking

• Recovering alcoholics

• People younger than age 21.

Elderly people do not have to eliminate alcohol; but should limit themselves to one standard unit per day. Alcohol's effects do vary with age. Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol's effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking.

Older people also tend to take more medicines than younger people. Mixing alcohol with over-the-counter or prescription medications can be very dangerous, even fatal. In addition, alcohol can make many of the medical conditions common in older people, including high blood pressure and ulcers, more serious. Physical changes associated with aging can make older people feel "high" even after drinking only small amounts of alcohol. So even if there is no medical reason to avoid alcohol, older men and women should limit themselves to one drink per day.

However, there is now evidence that shakes at least one of the pillars on alcohol limitations for the elderly. Thousands of individuals were studied over time, and there was no indication that mortality (death rate) was affected, if the elderly had more than one drink a day.

Additionally, the following results were also observed:

• Activity of daily living (ADL) were not affected. ADL’s were defined as reported difficulty with one or more of five ADLs: dressing, including putting on shoes and socks; walking across a room; bathing or showering; getting in or out of bed; and using the toilet, including getting up or down;

• Instrumental activity of daily living difficulty (IADL) was not affected. IADL was defined as reported difficulty with one or more of five IADLs: preparing a hot meal; shopping for groceries; making telephone calls; taking medications; managing money;

• Cognitive function was not impaired. Cognitive functions which were evaluated were orientation, memory, and mathematical ability.

Finally, an interesting side effect was observed for alcohol abstainers. The fact that, for all outcomes except cognitive function, the nondrinker group was associated with significantly higher relative risks of negative outcomes is in keeping with prior observations about the higher mortality and disease-specific risks associated with abstainers in older age groups.

Journal of the American Geriatrics Society
http://www.medscape.com/viewarticle/553367?src=mp