ALBANY, N.Y., March 21 (UPI) -- A recent report by the National Center on Addiction and Substance Abuse at Columbia University in New York found the rate of college students who drink at least 10 times a month was up 25 percent, garnering a flurry of news coverage.
But alcohol abuse among the elderly is a more clandestine epidemic. About one-sixth of U.S. adults over 60 drink too much, and one-third of these are adults who had not overdone drinking until later in life, according to the Elder Law Journal.
Excessive drinking among the elderly goes largely unnoticed because it most often occurs behind closed doors. Seniors are often alone, plagued by depression, ill health, disability or the sense of loss of independence. Many seek solace in alcohol, even though the elderly are at a higher risk than younger adults from alcohol-related injuries.
For example, Academy Award-winning film actor William Holden died at 63 as the result of a fall in his California home in 1981. A heavily intoxicated Holden appeared to have slipped on a throw rug, hit his head on a small table, and bled to death. The actor, who has starred in movies such as the 1954 version of "Sabrina" and "Sunset Boulevard," was alone, and it took several days before he was found dead. Forensic evidence suggests he was conscious for about 30 minutes after his head injury, but he may not have realized its severity.
Holden suffered from alcoholism and depression for many years, spurred in part by a 1966 car accident in Italy that resulted in a fatality. Holden was convicted of driving under the influence, charged with vehicular manslaughter and received an eight-month suspended sentence. However, his friends said he was overcome by remorse, which then led to even heavier drinking.
While excessive drinking is unsafe at any age, drinking in the elderly can result in a host of physical, cognitive, social and drug problems.
For example, gastroesophageal reflux disease, depression or insomnia can worsen the effects of alcohol, while mixing alcohol with arthritis medications may cause stomach bleeding.
A study in the journal Alcoholism: Clinical & Experimental Research in 2005 confirmed moderate drinking acts as a "blood thinner."
Studies have shown moderate drinkers tend to have lower rates of heart disease but higher rates of bleeding-type strokes than abstainers. The contrasting effects of alcohol are similar to the effects of blood thinners like aspirin, which prevent heart attacks at the risk of some additional bleeding strokes.
Heart attacks are caused by blood clots that form in clogged arteries, and blood thinners can hasten bleeding from injured arteries, according to study author Dr. Kenneth J. Mukamal of Beth Israel Deaconess Medical Center in Boston.
Alcoholics often have reduced levels of serotonin, a brain chemical believed to regulate sleep, dreaming, mental illness, craving and eating. Because alcohol increases serotonin levels, some researchers speculate alcohol-dependent individuals use alcohol to self-medicate and bring their serotonin up to a "normal" level, according to a study in Alcoholism: Clinical & Experimental Research in 2000.
This finding is consistent with studies that show a strong relationship between various moods and craving for alcohol, according to lead author of the 2000 study, Mona Moorhouse, a dietician at the Royal Ottawa Hospital.
Negative moods, such as stress, anger and depression, can be major cues for craving. People tend to drink more when they're in good moods or bad moods, relative to a neutral mood, but there's a particularly strong link between bad moods and drinking.
Drinking can also mask medical symptoms in the elderly. Many frail elderly have balance problems and difficulty walking and can be mistaken for someone who is drunk. Slurred speech is a sign of stroke, and someone may not get medical attention if people around them think they are drunk.
Older women are more likely than older men to self-medicate with alcohol and prescription drugs in order to deal with loneliness, financial insecurity or loss of a spouse, according to the book "Women Under the Influence" by the National Center on Addiction and Substance Abuse.
"This latest book as well as our 1998 report 'Under the Rug' shows alcohol abuse is commonly diagnosed in the elderly -- especially women -- by physicians, family and friends as well as society as a whole," Lauren R. Duran of CASA told UPI's Caregiving.
Symptoms include depression, memory loss, irritability, stomach upset and trouble sleeping. Physicians, families and friends often "can't believe that grandma is abusing alcohol," Duran said.
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Alex Cukan is an award-winning journalist, but she has also been a caregiver since she was a teenager. UPI welcomes comments and questions about this column. E-mail: [email protected]
