Alcoholism In The Elderly Symptoms Causes And Effects

Alcoholism in the Elderly: Symptoms, Causes, and Effects

Alcohol is a popular beverage amongst all ages. While it is very common in teens and young adults, it is rampant amid the older population too. A New York study has shown that about 62% of respondents, ranging in age from 62 to 94, admit to drinking alcohol. Of these participants, 13% of men and 2% of women reported heavy drinking.

Symptoms of Alcoholism in the Elderly

Alcoholism in elder people is not that obvious. As such, healthcare professionals (even loved ones) should be on the lookout for the following symptoms:

  • Thought and sensory input problems
  • Self-care deficits (unable to bath, brush teeth, etc.)
  • Repeated falls, injuries, or accidents
  • Frequent admissions to the Emergency Room
  • Poorly managed blood pressure
  • Digestive problems
  • Delirium during hospitalization
  • Various laboratory findings
  • Estrangement from family or friends

How Alcohol Affects the Body

It goes without saying that alcohol consumption is bad for the body. The effects are further magnified in the elderly, given the changes that already come with aging.

Alcohol’s effects on the body can also mask the signs of other health problems. For one, alcohol can cause changes in the heart and the blood vessels. This can ‘conceal’ the pain associated with a heart attack, which can delay diagnosis and subsequent treatment.

Alcohol can even worsen some pre-existing health conditions, such as:

  • Memory loss
  • Mood disorders
  • High blood pressure
  • Diabetes
  • Osteoporosis
  • Ulcers

To make matters worse, long-term drinking can lead to the following conditions:

  • Brain problems such as stroke
  • Cancers of the neck and esophagus
  • Nutritional deficiencies, specifically of folate and thiamine
  • Aspiration pneumonia
  • Tuberculosis (reactivation)
  • “Holiday heart syndrome,” or irregular heartbeats following a binge drinking affair
  • Liver damage, such as alcoholic hepatitis, fatty liver, or cirrhosis
  • Immune system disorders

Alcohol’s effects can also fool people into thinking that the elderly drinker is sick – even though he/she is not. A few drinks may make him sway. It may even lead to myopathy or muscle weakness. As such, these manifestations could make people think that he/she is suffering from aging-related balance problems.

Should he/she continue to take alcohol, these balance problems may eventually lead to falls. Such can result in arm and hip fractures. After all, older people usually have thinner, weaker bones. Studies even show that hip fractures are quite common in elderly drinkers.

Alcohol can make an old person easily confused as well. He/she might be delirious, especially during the alcohol withdrawal process. These could, later on, be misinterpreted as Alzheimer’s disease. With that being said, the elderly drinker may be subjected to unnecessary tests and treatments – just because alcohol intake makes him/her seem sick.

Alcoholism and Medication Use

Aging already affects liver function, and alcohol intake further worsens it. This is potentially problematic since elderly individuals take a variety of medications for their pre-existing illnesses. As a result, the liver is unable to metabolize drugs efficiently. As expected, this can lead to several complications. This is especially the case for meds with narrow therapeutic indices, such as Warfarin (blood thinner) and anticonvulsants (for prevention of seizures).

To make matters worse, alcohol can affect judgment in such a way that the drinker forgets (or neglects) to take his maintenance drugs. This can affect his health adversely, especially if his medications are meant to reduce high blood pressure, manage diabetes, etc.

Alcohol Intake and Safety

Elder drinkers get easily intoxicated even without a huge amount of liquor. Since alcohol can impair reaction time, coordination, and judgment, older consumers face several safety issues. According to the National Institute on Aging, alcohol is a known factor in 60% of falls. It is also associated with 50% of drownings and homicides, 40% of crashes and burns, and 30% of suicides.

Apart from falls, mature drinkers often get involved in a variety of accidents, whether unintentional or not. Car crashes are rampant in several drinking populations, much so the elderly. This is usually fatal in older people. After all, the risk of car crashes (even without alcohol) further increase in people aged 55 and above. Such might be due to the brain and eyesight changes that occur with aging.

Unfortunately, these impairments can be compounded with the effects of alcohol. After all, drinking can slow coordination, reaction time, and information process. As a result, older consumers often get involved in injurious (if not fatal) vehicular accidents.

Early-Onset Alcoholism in Old Drinkers

Old people rarely drink to socialize, just as the younger people do. Experts believe that it stems from a variety of factors that may start from the womb. After all, family history plays a role in alcoholism.

According to Dr. Sally Rigler, elderly alcoholics often start drinking at a young age. Unfortunately, chronic consumption often leads them to develop alcohol-related illnesses. These are then further compounded by the aging process. As a result, these people often become antisocial and estranged to their families. More often than not, they often encounter financial problems along the way.

Late-Onset Alcoholism in the Elderly

While most drinkers start young, some start abusing alcohol at an older age. According to Dr. Rigler, these individuals make up for 1/3 of all elderly alcoholics. Their circumstances are usually the opposite of those who start early. These individuals usually have higher educational accomplishments and incomes.

Some, on the other hand, drink due to stressful occurrences such as divorce or the death of a loved one.

Despite the late onset of alcoholism, research shows that these drinkers are more likely to recover. They often have a strong support base – and more resources – which enable them to attend treatment. Research shows that compared to early-onset drinkers, late-onset consumers are two times more likely to remain abstinent after rehab.


As with younger drinkers, alcoholism in the elderly can be treated. Much emphasis is placed on detox, which is best done in the hospital. After all, unmanaged withdrawal can lead to falls and accidents. Short-acting benzodiazepines such as Clorazepate or Midazolam are usually given to avoid excessive sedation.

After detoxification, elderly drinkers can progress to treatment. Depending on preference and health issues, he/she may opt for community-based groups, outpatient therapy, or inpatient rehab.

Anti-alcoholism drugs may be given as well. However, Disulfiram is not recommended due to the increased risk of adverse side effects.

Wrapping Up

Alcoholism occurs in over 60% of the elderly. It can worsen present conditions, and bring about new ones. Unfortunately, alcohol intake in old people can lead to falls, car crashes, even suicide. To minimize these effects, elderly alcoholics should be subjected to detox (as needed) and subsequent treatment.

Latest posts by Raychel Ria Agramon, BSN, RN, MPM (see all)

What do you think? Please share your thoughts.