Dr Joss Bray MRCPsych MRCGP, is the Medical Director for Addictions Services,The Huntercombe Group in the United Kingdom
This year World Mental Health Day focuses on the potential for older people to enjoy a full and active life in their later years. However, an area of rising concern, particularly within the UK, is the increasing tendency for over 65s to drink levels of alcohol that are potentially harmful to their health.
According to a recent study by the University of Sunderland, 28% of men over 65 years and 14% of women over 65 now drink alcohol more than five times per week in England. Heavy drinking within this age group is strongly linked with depression and anxiety and loss of mental alertness as well as longer term physical health problems.
Society does not sufficiently recognise alcohol use amongst older people as an issue that needs to be addressed. Often, the person lives on their own so they are not asked about their alcohol consumption. In addition they themselves are probably not even aware of their own usage.
There are many reasons as to why older people tend to drink more than they should. When they live in an isolated environment this can lead to feelings of depression and anxiety and so they self-medicate with alcohol. Being a natural depressant itself, drinking alcohol only heightens these feelings further, causing the person to drink even more as they wrongly believe it will help. Furthermore, alcohol damages brain cells and affects people’s memory all of which get worse with age naturally – drinking alcohol simply accelerates this decline further.
With their consumption hidden, this means that the dangers associated with too much alcohol are also concealed until the problem becomes severe.
Alcohol affects over 65s differently to younger generations. Older people cannot metabolise and process the toxins in alcohol through their systems as efficiently as younger people. As they become even older, people tend to become less physically robust which means that when they drink the same as younger people this can cause additional health problems. Another factor is that older people often take prescribed medicines that can become ineffective or create extra complications when mixed with alcohol.
We are used to tackling alcohol abuse amongst younger people rather than older generations. As a result, public health messages have not been as effective for the older age group, particularly as many don’t think they are drinking too much. They tell themselves that as they are not falling over in the street and embarrassing themselves then they aren’t drinking to excess. This therefore goes back to our first problem of hidden use.
Sometimes those who have realised they need help may be embarrassed about openly visiting support services such as drug and alcohol counsellors. They perhaps feel there is some stigma in doing so. It is therefore helpful that GPs can make referrals to specialists who can provide psychological support.
Call to action
As the UK is becoming a rapidly ageing population it’s time to start taking action now when it comes to addressing mental health and alcohol use in older people. As healthcare professionals, we need to start making questions surrounding alcohol consumption the norm when people come in for appointments. However, it’s vital that friends and family are also encouraged to ask questions as they may be able to provide intervention sooner. These questions will only be asked if awareness about this issue is communicated publically. Tailored information aimed at this age group needs to be relayed more effectively so that the user as well as their peers realise that they may need to take action.