Why is alcohol and ageing an issue?
Our ageing population is increasing with people living longer than before.
In just ten years, by 2025, there will be 19% more people aged 65 years and older and 40% more people aged 85 years and older in the UK (ONS, 2012)
“Living longer is potentially a huge opportunity both for individuals and for society. But as well as adding years to life, we need to make sure we are adding life to years – enabling us all to enjoy a good later life” Centre for Ageing Better, 2015.
Whilst many of us will remain independent with good support structures into our later years, some may struggle that little bit more. Ageing and older age are associated with a number of life changes and losses which can trigger or increase alcohol problems. It is estimated that 1 in 3 adults aged over 65 with an alcohol problem will have developed this in later life. From a recent Drink Wise, Age Well survey we carried out, the most frequently reported reasons for drinking more included retirement, bereavement, loss of purpose, less opportunities to socialise and change in financial circumstances.
For some adults aged over 50 they may have been drinking alcohol at higher risk levels for some time but as they get older this can start to cause even more complex problems affecting their health and well-being. They may require help from a number of different agencies and it‘s important that consideration is given to both their age and health impacts of alcohol use when providing support.
Stigma associated with alcohol use
Worryingly, our Drink Wise, Age Well survey discovered that there is a lot of stigma and shame associated with alcohol use in the over 50s population including:
- more than half (51%) of people aged 50 and over in the UK think that people with alcohol problems have themselves to blame
- 26% of people aged 50 and over and 29% aged 65 and over would not tell someone if they had an alcohol problem
- 23% of people aged over 50 would not know where to get help or advice if there were experiencing problems with alcohol use
The risk revealed in the findings above is that people aged over 50 may believe they cannot tell anyone about their drinking, and as time goes on may be becoming increasingly isolated and at risk of harm.
Knowledge of recommended guidelines
There is also a significant lack of awareness in the over 50s population about recommended alcohol limits with three quarters unable to correctly identify what they are.
Without the knowledge of what recommended alcohol limits and lower risk drinking is, people may not even be aware of how much they are drinking and the potential harm it is causing.
Recognising and responding
Working in a community, housing or social and health care setting, you will often be the first contact that a person who is drinking problematically has. Your role may be vital in supporting them to get the information and help they need. It’s important that you can recognise and respond when someone is experiencing problems with their alcohol use. However, for some frontline staff and professionals this is a difficult topic to broach and they may feel that starting the discussion about alcohol use will cause offense. Our aim is to help you ‘start the conversation’ and when you do, give the right advice.
So why can alcohol use cause more problems as we get older?
The answer to this question comes under a number of areas:
- Along with wrinkles and grey hairs an ageing fact of life is that muscle is replaced by body fat as we get older. Alcohol is not drawn into body fat as well as it is drawn into muscle, therefore, blood alcohol concentration is higher in older age making us more susceptible to the effects of alcohol.
- As we get older we have a reduced ability to metabolise and excrete alcohol and are particularly sensitive to toxic effects of alcohol on the brain.
- One of the effects of alcohol is loss of co-ordination. This fact along with general decreased balance and mobility as we age may result in more falls and injuries.
- Alcohol misuse can exacerbate or accelerate the onset of conditions which are associated with ageing (such as cognitive impairment, high blood pressure/hypertension).
- It is more likely as we age that we will be prescribed different medications. Alcohol can interact negatively by reducing or compounding the effect of medications.
- Due to some of the reasons above ageing may increase the likelihood that someone will experience harm even if they drink within the recommended guidelines.
Psychological and mental health
- As our survey has shown, people aged over 50 may be more likely to hide an alcohol problem and less likely to ask for help because of high levels of shame and embarrassment. There may be a generational attitude of not sharing personal problems and maintaining pride.
- Some people may struggle with the ageing process which can lead to feelings of depression. In our Drink Wise Age well study 36% of those identified as high risk (heavy) drinkers said they were drinking because they felt down or depressed. Of those who had started to drink more in recent years a loss of purpose in life was identified as a reason by 20% surveyed.
- Losses, life changes and transitions associated with ageing will come to us all. However, for some this can result in isolation, loss of independence, loneliness and psychological distress and may contribute to increased alcohol use in later life.
- Being isolated means having less social contact. Therefore, where there are problems with alcohol they are more likely to go unnoticed.
- As we get older we are more likely to drink every day and at home alone.
Barriers to seeking help
- Those that have been drinking problematically for many years and have a lot of complex needs, may have had previous unsuccessful experiences of treatment and be reluctant to try again.
- Barriers such as decreased mobility and lack of transport may mean some people find it difficult to access services
- Ageist attitudes and prejudicial assumptions mean that some frontline workers and professionals may not identify alcohol problems in people over 50 or take action when they do.
- 74% of people surveyed by Drink Wise, Age well wereunable to identify what recommended drink guidelines are and more than half could not confidently calculate alcohol units. Therefore, some people may not even be aware of when their drinking is causing them harm.
What is important to remember is that although older adults are less likely to access help and support for their alcohol use, when they do they are more likely to make a positive change than younger people.
When we get older it is more likely that we will be prescribed medication for a number of reasons. As we age our metabolism and the ability of our liver to process medications can slow down so it is very important that we carefully consider how alcohol can affect some medications.Download PDF (185.5KB)
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