Alcoholism in the elderly

Alcohol abuse and dependence can be both cause and result of many problems of physical and mental health in old age. In order to develop a comprehensive understanding of the complex and mutually dependent relationships between aging and alcoholism, biologic as well as psychosocial factors must be taken into consideration. Sleep physiology, sexuality, and sensory function have received considerable attention in respect to the changes occurring with increasing age. These areas of functioning seem to be particularly vulnerable when the impact of chronic alcohol abuse is added to the effects of normal aging. The aging brain is another sensitive target for the influence of alcohol, and alcoholism has the potential to significantly aggravate cognitive deterioration. In susceptible individuals, the psychosocial stresses of growing old may erode self-esteem and precipitate depressive disorders. Thus, certain aspects of aging may become pathogenic factors in the development of alcoholism. Our current knowledge in this respect, however, is rather hypothetical and needs validation. Further systematic research is required. The momentum to generate interest in the science of aging, and thus stimulate research into age-related problems, may be provided by demographic developments. The number of Americans aged 65 and older is projected to increase markedly over the next four decades. A substantial part of this growing segment of our population suffers from alcohol dependency. The percentage of alcoholics is particularly high among the elderly in institutionalized care settings. An investment in efforts to better understand the interaction between aging and alcohol, and to develop more effective primary and secondary prevention concepts, could prove most rewarding.