CONTENTS

Table of Contents
Introduction

1. Overview
2. Recognizing Alcohol Misuse and Abuse in Older Adults
3. Alcohol and Aging
4. Diagnosing Alcohol Problems in Older Adults
5. Recognizing Other Forms of Substance Abuse
6. Prevention and Early Intervention Strategies
7. Treatment
8. Outcomes and Cost Issues in Alcohol Treatment for Older Adults
9. Legal and Ethical Issues

Supplements
Resources

At Any Age, It Does Matter:
Substance Abuse and Older Adults (for Professionals)

Difficulty Identifying Older Problem Drinkers

Most older patients have not been recognized as problem drinkers by health care personnel. Studies consistently find that older adults are less likely to receive a primary diagnosis of alcoholism than are younger adults.^32-34 For example, a study of 417 patients found that house officers accurately diagnosed the disease in only 37 percent of older alcoholic patients compared with 60 percent of the younger alcoholic patients.³⁵

It can be difficult to accurately identify alcohol-related cases, because alcohol-related problems in older adults might present as physical problems. One study of hospital admissions among older patients indicated that most of the cases presented as falls. Only a small proportion were referred for rehabilitation.³⁶

Despite the difficulties, physicians and other health care professionals working in clinical settings play a key role in identifying those in need of treatment. Improved, efficient identification of older at-risk and problem drinkers during health-seeking encounters is essential.