Supporting over 50s

In your day to day work, if you regularly come into contact with an older adult who is drinking at risky levels it’s worth considering the below.

  • Alcohol screening tools aren’t always sensitive to the needs of older drinkers. The AUDIT screening tool is probably the most validated for use across populations including older adults but you may have to reduce scoring to take into account age related issues.
  • The Michigan Alcohol Screening test for older adults (MAST-G) is also sensitive as it takes into account psycho-social factors that are specific to ageing.
  • Ensure your assessment takes into account age- related factors including mobility, social isolation, medication and self-care.
  • Consider where you see the person; do they require home visits; are they able to travel to appointments and can they afford to?
  • Consider their environment and what social supports they have? Older adults who’re drinking may be more susceptible to elder abuse so you may want to carry out a safeguarding assessment.
  • Is the home environment safe and do they require any adaptations and alarms?
  • Consider what supports family members may need as it can be an incredibly stressful time to care for someone who is drinking. They may benefit from referral to family support services for their own needs to be met.

Health issues to consider

  • Alcohol can cause the heart to either beat too quickly or beat irregularly. These irregularities are called arrhythmia’s and can have serious consequences for health particularly as we get older.
  • Long-term, heavy drinking can weaken the heart muscle. This causes a condition called alcoholic cardiomyopathy
  • Alcohol use can lead to a false sense of warmth. This can be dangerous to older adults who may be facing fuel poverty or struggle to heat their homes as this false feeling of warmth could actually lead to hypothermia.
  • Drinking alcohol can lead to reduced co-ordination and balance. This can increase the likelihood of falls and injuries. Injuries caused by falls are the most common cause of death in people over the age of 75.
  • Alcohol can lead to reduced reaction times. In older adults this can be dangerous, especially if they live alone. They could find it more difficult to focus or concentrate on tasks and may not be able to react to situations as quickly as required.
  • Long term, heavy alcohol use interferes with absorption of calcium and bone formation and causes muscles to waste away increasing risks to Osteoporosis, gout and weakness.
  • The risk of Type 2 Diabetes increases with age and this risk can be exacerbated by alcohol use. Also diabetes is a common side effect of chronic pancreatitis, which is often brought on by heavy drinking
  • Korsakoff’s syndrome is caused by lack of thiamine (vitamin B1), which affects the brain and nervous system. People who drink excessive amounts of alcohol are often thiamine deficient. This is because their diet can be poor and lacking in essential vitamins, alcohol interferes with the absorption of key vitamins including thiamine and frequent vomiting may mean the body gets rid of essential vitamins. Korsakoffs can lead to short-term memory loss and difficulty in acquiring new information or learning new skills. The condition can be halted if the person stops drinking and eats a healthier diet, but may not be reversed.
  • Drinking too much alcohol over a long time can lead to some kinds of cancer (including breast and oesophagus cancers), liver damage and immune system disorders.
  • Alcohol and Medication: Older Adults are much more likely to be on a number of medications for other health conditions. There are many risks with alcohol including compounding or reducing the effect of the medication and these are summarised in the fact sheet and video below.

If you are a health professional, Consultant Addiction Psychiatrist, Dr Julia Lewis from Aneurin Bevan University Health Board highlights the questions you should ask older adults in relation to their alcohol use when prescribing medication:


Find out more on how to respond to someone who is drinking problematically.

  • Alcohol and Medications
    Alcohol and Medications

    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.

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