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Screenings Target Population at Risk
for Alcohol Abuse: the Elderly
By Joe Fahy, Pittsburgh Post-Gazette
March 29, 2005
Dan Marsula, Post-Gazette
Alcoholism is a problem that can be hidden in older populations.
Like other senior centers, the Stephen Foster Community Center offers a variety of services to older people, including meals and exercise programs.
But on April 7, the center in Lawrenceville will provide a different type of assistance: a one-day screening to help people assess whether they are problem drinkers.
"This is a first for us," said Gretchen Fay, the center's executive director. The center is among several local senior centers taking part next month in National Alcohol Screening Day, an annual event that provides free, anonymous screening for alcohol-related disorders.
Aware that Allegheny County has an unusually high concentration of older people, officials made special efforts this year to offer the screenings in locations convenient to seniors, said Patricia Valentine, deputy director of the county Office of Behavioral Health.
Other agencies also are offering the screenings, which are not limited to elderly people.
The screenings target alcohol use, but local officials hope that people who may have abused other substances also will participate.
The screening includes a brief questionnaire to assess drinking habits. Counselors will be available to suggest follow-up care.
Fay said she was unaware if any of her patrons abuse alcohol. But she noted, "it's a problem that's easily hidden."
The National Institute on Alcohol Abuse and Alcoholism recommends that men 65 and older have no more than one drink a day, and that women in that age group drink even less.
But the institute estimates that 12 percent of older women and 15 percent of older men regularly exceed those guidelines.
While relatively few older Americans abuse alcohol, the problem often is harder to detect in the elderly population, said institute spokeswoman Ann Bradley.
Some symptoms of excessive alcohol use, such as falls and impaired memory or speech, may be confused with signs of aging, she said.
And people may have particular trouble recognizing a drinking problem in a friend or relative who is retired or living alone, said Dr. Ihsan Salloum, associate professor of psychiatry at the University of Pittsburgh School of Medicine.
Doctors may not closely question older patients about their drinking, Salloum said. Even if they do, patients may downplay or deny alcohol use.
The fact that problem drinking among older people often goes undetected is "one part of the tragedy," said Dr. Abraham Twerski, founder of Gateway Rehabilitation Center. Another problem, he said, is the lack of government subsidies for the longer treatment that older drinkers may need to recover.
Studies have suggested that alcohol may accelerate age-related changes involving balance, memory and cognition, Salloum said.
Older people can have problems even if they drink the same amount of alcohol that they safely consumed when they were younger. Elderly people tend to have less body water than young people, leading to greater concentrations of alcohol in the blood, Salloum explained. They also have decreased amounts of an enzyme that breaks up alcohol in the stomach.
Alcohol can react negatively with many medications typically used by older people. Therapeutic doses of Tylenol, for example, can lead to liver toxicity in chronic alcoholics, while use of aspirin or other painkillers can increase the risk of bleeding.
Chronic drinking also can activate enzymes in the body that reduce the potency of prescription drugs in the system, so people "end up having less of the medication than they should," he said.
Gretchen Fay acknowledged that coming forward for the screening could be difficult because of the stigma attached to alcoholism. But she hopes the welcoming atmosphere of the center will dispel concerns.
All the people served by the center are over 60, and nearly all live by themselves, often because they have outlived their spouses, she said. Some still have close ties with family members, but many consider the center a "second home," she said.
Alcohol Screening Day fits in with the center's emphasis on health and wellness programs, she said. "I hope it becomes a yearly event."
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