Patterson T L, Jeste D V
Department of Psychiatry at the University of California, San Diego, La Jolla 92093-0680, USA.
Psychiatr Serv. 1999 Sep;50(9):1184-8. doi: 10.1176/ps.50.9.1184.
Little attention has been paid to substance use disorders in the elderly population. Currently available diagnostic criteria are likely to significantly underestimate the prevalence of substance abuse among elderly persons because they were developed and validated in younger samples. As baby boomers age, the number of elderly persons who misuse or abuse illicit drugs and alcohol may increase because this age cohort has higher rates of use of these substances than previous cohorts. Abuse and misuse of prescription and over-the-counter drugs may also increase due to the larger numbers of baby boomers. Few studies have addressed treatment issues that may be unique to elderly substance abuse patients. Some evidence suggests that substance abuse treatment outcomes are poorer among individuals with cognitive impairment, and special treatment strategies are needed for elderly persons with dementia. To identify the magnitude of the problem, diagnostic criteria should be modified and national survey data should be analyzed to provide more accurate estimates of substance abuse and dependence among baby boomers.
老年人群中的物质使用障碍问题很少受到关注。目前可用的诊断标准很可能会显著低估老年人中药物滥用的患病率，因为这些标准是在较年轻的样本中制定和验证的。随着婴儿潮一代步入老年，滥用或误用非法药物和酒精的老年人数量可能会增加，因为这一年龄群体使用这些物质的比例高于之前的群体。由于婴儿潮一代人数较多，处方药和非处方药的滥用和误用情况也可能增加。很少有研究探讨老年药物滥用患者可能特有的治疗问题。一些证据表明，认知障碍患者的药物滥用治疗效果较差，痴呆老年人需要特殊的治疗策略。为了确定问题的严重程度，应修改诊断标准，并分析全国调查数据，以便更准确地估计婴儿潮一代中的药物滥用和药物依赖情况。
