A Much Neglected Risk Factor In Elderly Mental Disorders
Purpose of Review: This review will provide an update on the role that alcohol plays in the presentation and management of mental disorders in the elderly.
Recent Findings: Recent community surveys from several countries have explored the relationship between the level of alcohol consumption or alcohol use disorder and the concurrence of mental health disorders in the elderly. A consistent finding is that mild to moderate alcohol consumption is protective against the development of dementia in the elderly. In other studies very heavy drinking or alcohol use disorders are associated with functional impairment, depression and suicide. Recent reviews indicate that the relationship between levels of alcohol consumption and problems such as falls and cognitive deterioration remains controversial. The elderly appear to respond to relapse prevention strategies and pharmacotherapy equally as well as those in the younger age groups.
Summary: While mild to moderate levels of alcohol consumption have a protective effect on the occurrence of dementia, the concurrence of alcohol use disorders, depression and suicide in the elderly has important implications for prevention and treatment. Pharmacotherapy and relapse prevention strategies should be made available to the elderly with alcohol use disorders.
Despite 2000 years of alcohol consumption, and several hundred years of harmful alcohol use, most publications on health effects have ignored the elderly, and most recent public concern in this field has centred on issues related to youth. In the last few years, interest has increased in the role that alcohol might play in the mental health of the elderly.
It is clear that there is a complex relationship between alcohol consumption and the mental and physical health of human beings. On the one hand, low risk, moderate alcohol consumption has been shown to reduce all cause mortality as well as mortality from coronary artery disease and cerebrovascular disease. These findings were originally observed in middle age men. However, low risk drinking has also been shown to be of benefit to older people. On the other hand, heavy alcohol consumption is a known risk factor for dementia. This is presumed to be due to the neurotoxic effect of alcohol. It is possible that alcohol, in a complex interaction with the lack of thiamine (either because of poor nutritional intake or because of the difficulty in delivering thiamine in an appropriate metabolic form to neuronal tissue), may cause brain damage. Overall older adults appear to experience alcohol-related consequences at lower levels then younger adults.
Purpose of Review: This review will provide an update on the role that alcohol plays in the presentation and management of mental disorders in the elderly.
Recent Findings: Recent community surveys from several countries have explored the relationship between the level of alcohol consumption or alcohol use disorder and the concurrence of mental health disorders in the elderly. A consistent finding is that mild to moderate alcohol consumption is protective against the development of dementia in the elderly. In other studies very heavy drinking or alcohol use disorders are associated with functional impairment, depression and suicide. Recent reviews indicate that the relationship between levels of alcohol consumption and problems such as falls and cognitive deterioration remains controversial. The elderly appear to respond to relapse prevention strategies and pharmacotherapy equally as well as those in the younger age groups.
Summary: While mild to moderate levels of alcohol consumption have a protective effect on the occurrence of dementia, the concurrence of alcohol use disorders, depression and suicide in the elderly has important implications for prevention and treatment. Pharmacotherapy and relapse prevention strategies should be made available to the elderly with alcohol use disorders.
Despite 2000 years of alcohol consumption, and several hundred years of harmful alcohol use, most publications on health effects have ignored the elderly, and most recent public concern in this field has centred on issues related to youth. In the last few years, interest has increased in the role that alcohol might play in the mental health of the elderly.
It is clear that there is a complex relationship between alcohol consumption and the mental and physical health of human beings. On the one hand, low risk, moderate alcohol consumption has been shown to reduce all cause mortality as well as mortality from coronary artery disease and cerebrovascular disease. These findings were originally observed in middle age men. However, low risk drinking has also been shown to be of benefit to older people. On the other hand, heavy alcohol consumption is a known risk factor for dementia. This is presumed to be due to the neurotoxic effect of alcohol. It is possible that alcohol, in a complex interaction with the lack of thiamine (either because of poor nutritional intake or because of the difficulty in delivering thiamine in an appropriate metabolic form to neuronal tissue), may cause brain damage. Overall older adults appear to experience alcohol-related consequences at lower levels then younger adults.
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