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There’s a binge drinking boom among older people – what does it mean for the nation’s mental health?

Hospital admissions for mental disorders related to alcohol are rising amongst baby boomers

Tony Rao
Monday 14 October 2019 13:06 BST
Current guidelines recommend people don’t drink more than 14 units of alcohol per week
Current guidelines recommend people don’t drink more than 14 units of alcohol per week (iStock)

Although enjoying a glass of red wine now and again may be healthy for your heart and gut, drinking too much alcohol can put you at higher risk of developing many serious health conditions. Heavy alcohol consumption has been linked to a number of health issues, including developing certain types of cancer, stroke, heart and liver disease, and brain damage. In older people, drinking unhealthy levels of alcohol can be even more damaging to health, and may cause memory loss, high blood pressure, balance problems, and worsen mental health.

But while many might assume that alcohol is only damaging to those who regularly drink above the recommended limits, research has also shown that binge drinking can be just as harmful. Binge drinking is defined as consuming at least eight units of alcohol for men (approximately four pints of beer), and six units for women, in one sitting. Binge drinking has been shown to increase the risks of death from long-term illness, accidents, and injuries.

Current guidelines recommend people don’t drink more than 14 units of alcohol per week. That’s equivalent to seven pints of beer, or just over a bottle of wine per week.

Although binge drinking is often associated with younger people, approximately one in 10 people aged 65 and over engage in binge drinking.

Recently, researchers looked at alcohol use and risky drinking patterns in older people – specifically, its relationship to other mental disorders, such as depression and dementia. It found that one in four drinkers consumed alcohol above weekly limits and more than one in five drinkers reported binge drinking over the past 12 months.

Mental health and alcohol abuse

Hospital admissions for mental disorders related to alcohol have risen by 21 per cent over the past five years in people aged 50 and over. These admissions are due to a range of mental disorders from alcohol dependence and intoxication to memory disorders such as dementia and Korsakoff’s syndrome. Unfortunately, this is a trend that has only worsened over the past 15 years as the “baby boomer” generation has aged.

In order to understand more about the impact of alcohol consumption on mental disorders, researchers looked at 190 patients aged 65 and over who were enrolled in a mental health service for older adults. The patients had a range of mental disorders, including depression and dementia. Only a third of the patients were female.

Using the alcohol use disorders identification test (AUDIT), researchers asked participants a series of questions to rate a person’s risk of alcohol-related harm.

The study found that men were one and a half times more likely than women to have current or past alcohol-related problems – such as injury due to alcohol consumption. They also scored an average of two points less on average on a dementia screening test, which meant they were likely to be at a higher risk of developing dementia.

There was also considerable variation in drinking patterns within participants. About one in eight patients reported drinking once a month or less, with the most common pattern being one to two units per month. However, this doesn’t indicate how much someone drank on these occasions – and whether it would be classified as binge drinking. This could only be discovered using the AUDIT questionnaire, which also asks about binge drinking. Routine clinical practices that do not use the AUDIT often only ask patients the average amount they drink per week, rather than the maximum amount on any one day. This would mean missing out valuable information about binge drinking.

Providing support

This study shows that many older people aren’t receiving much support when it comes to monitoring and reducing their drinking behaviours. It showed that many older people aren’t often asked about their drinking habits – something that health care practitioners are more likely to ask younger people. By asking more often, health care workers might be able to help reduce risky drinking behaviours by providing the right support and help in reducing alcohol consumption.

The study also found that older men who regularly drink above the weekly limit or binge drink are at higher risk of developing certain types of dementia. Alcohol-related dementia is different from other types of dementia, as it damages the frontal lobes of the brain and may lead to changes in personality, such as being more impulsive and having difficulty controlling emotions.

Not only can having an expert diagnosis help with treatment, it also means alcohol-related dementia can be detected in its early stages – which might mean some of its effects can be partially reversed.

New clinical services that can assess both alcohol-related disorders and mental health disorders might be one way of ensuring that older adults receive necessary support and treatment for both mental health and disordered drinking.

The government has also created guidance to help detect and reduce alcohol-related harm to older people. Mental disorders and risky drinking can be present at the same time in older people, but the common perception is that these are problems that only affect younger people. By creating greater support and a sense of community for those suffering, it can help aid in treatment and prevent binge drinking continuing to be an undetected problem in older populations.

Tony Rao is a visiting lecturer in old age psychiatry at King’s College London. This article first appeared on The Conversation

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