- Written by Peg O’Connor Peg O’Connor
Drinking in older populations has been on the rise since the baby boomers joined the senior ranks.
Seniors’ drinking is often measured and discussed using the same language as collegiate drinking. This choice in terminology is significant; it reveals there are more potential age-related dangers to alcohol consumption than addiction alone and that each group may tend to minimize them.
While most older adults imbibe alcohol at low to moderate rates, a significant percentage (27%) drink in high-risk ways, according to a Harvard study. High-risk drinking in elders is defined as three or more drinks during one occasion or more than seven drinks per week.
Elders are also binge drinking, which is having five or more drinks per occasion. A drink is 12 ounces of beer, 4-5 ounces of wine, or 1.5 ounces of hard liquor.
Aging bodies are more sensitive to alcohol and respond differently from younger bodies. Seniors’ metabolism slows, so alcohol sits in organs longer. Moreover, older adults have less muscle to absorb alcohol.
As people age, they experience a decrease of water in their bodies, resulting in a higher percentage of alcohol in their blood compared to a younger person. Dehydration also compounds the risks of alcohol consumption; alcohol contributes to dehydration and affects kidney function.
Finally, many of the most common medications seniors take warn against consuming alcohol. Some medications may become less effective, while the side effects are amplified. This is most clearly seen in medications that can cause dizziness or drowsiness.
Approximately 10-15% of people do not start drinking until they are older. Some seniors are just beginning to drink, while others who already drink begin to drink more.
Older adults often experience important existential changes that may factor into new patterns of consumption.
With retirement may come a loss of identity; they may feel as if they have lost an important part of themselves. Formerly productive people sometimes feel they have nothing to offer or that no one wants or values their contributions.
Long-term homes are left or lost, while independence may become interdependence or dependence. Financial insecurity is a major stressor, especially in times of inflation, when it becomes difficult if not impossible to afford basic needs.
Death of spouses and friends can lead to social isolation. Family dynamics change as well. Adult children may move farther away or move back home.
Numerous older adults are finding themselves as the “club sandwich” generation. “Younger seniors” may find themselves caring for their own very elderly parents, their adult children, and their grandchildren. Many are bearing massive burdens and may seek relief with a drink to unwind, get away from it, or reward themselves.
College students often believe they are invulnerable and do not worry about the risks of alcohol. Aging seniors, on the other hand, have begun to experience new and unwanted vulnerabilities, causing them to worry less about the risks.
Older adults may no longer see a difference between the short and long terms and believe drinking is one of their last pleasures, especially if they have already given up or lost so much.
The University of Michigan Alcohol Research Center developed a screening test for older adults (see below). People may take this screening privately, giving themselves permission to be honest in their answers.
Concerned family members or friends can gently introduce the screening tool, asking if they could discuss the questions together. How people discuss these questions matters enormously; it is best to strike a concerned tone rather than a judgmental one. At this early point, the focus needs to be on the person who may have a problem and not how that problem affects others.
One of the greatest challenges is identifying helpful resources, especially with a geriatric focus. Ideally, one’s primary care physician should be well informed of available services.
An excellent online resource is the Substance Abuse and Mental Health Services Administration (samhsa.gov), which has links to senior-related concerns.
Peg O’Connor, Ph.D., is a recovering alcoholic of 34 years and is now a professor of philosophy in addiction studies at Gustavus Adolphus College. She is the author of Higher and Friendly Powers: Transforming Addiction and Suffering (Wildhouse Publications) and writes a column, “Philosophy Stirred, Not Shaken,” for Psychology Today. pegoconnorauthor.com
Short Michigan Alcoholism Screening Test – Geriatric Version (SMAST-G)
Write 1 for yes, 0 for no.
1. When talking with others, do you ever underestimate how much you drink? _____
2. After a few drinks, have you sometimes not eaten or been able to skip a meal because you didn’t feel hungry? _____
3. Does having a few drinks help decrease your shakiness or tremors? _____
4. Does alcohol sometimes make it hard for you to remember parts of the day or night? _____
5. Do you usually take a drink to relax or calm your nerves? _____
6. Do you drink to take your mind off your problems? _____
7. Have you ever increased your drinking after experiencing a loss in your life? _____
8. Has a doctor or nurse ever said they were worried or concerned about your drinking? _____
9. Have you ever made rules to manage your drinking? _____
10. When you feel lonely, does having a drink help? ____
TOTAL SMAST-G-SCORE (0-10) _______
SCORING: Two or more “yes” responses indicate a problem with alcohol.
Source: University of Michigan Alcohol Research Center