Dufour M C, Archer L, Gordis E
National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland.
Clin Geriatr Med. 1992 Feb;8(1):127-41.
Moderate drinking for the elderly of both genders is no more than one drink per day, where a drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits. Age does not affect the rate of absorption or elimination of alcohol. Lean body mass decreases and adipose tissue increases with age, however, resulting in a corresponding decrease in the volume of total body water. With a smaller volume of distribution, an alcohol dose identical to that administered to a younger individual of the same size and gender will produce a higher blood alcohol concentration in the elderly. Low-dose alcohol stimulates appetite and promoters regular bowel function. In the well-nourished nonalcoholic elderly, the negative impact of alcohol consumption on nutrition is minimal. Alcohol consumption improves mood by increasing feelings of happiness and freedom from care while lessening inhibitions, stress, tension, and depression. Although in the laboratory low-dose alcohol improves certain types of cognitive function in young men, in other types of task performance, alcohol induces impairment, which worsens with age. The effects of alcohol on sleep are primarily detrimental, worsening both insomnia and breathing disturbances during sleep. Although the role of alcohol consumption in mortality from heart disease has not been investigated in the elderly, moderate drinking appears safe. Under some circumstances low-dose alcohol may produce analgesia whereas in others it may worsen pain. The elderly use a significant proportion of both prescription and over-the-counter medication, a large variety of which interact with alcohol. Alcoholic beverage consumption may exacerbate cognitive impairment and dementias of other etiology. Although some studies suggest that moderate use of alcohol by institutionalized senior citizens appears to produce benefits including improved socialization, separation of the effects of the social situation from those specifically attributable to alcohol remains to be accomplished. Older individuals who want to drink, have no medical contraindications, and take no drugs (prescription or over-the-counter) that interact with alcohol, may consider one drink a day to be a prudent level of alcohol consumption. Patients should be counseled to avoid alcohol consumption immediately prior to going to bed in order to avoid sleep disturbances. They also should be cautioned against potential drug-alcohol interactions and told to avoid alcohol ingestion prior to activities such as driving. The decision to recommend a particular level of alcohol consumption in any given patient must, however, be carefully tailored not only to that individual's specific medical needs but to his or her social and environmental circumstances as well.
对于老年男女而言，适度饮酒是指每天饮酒不超过一杯，一杯的定义为12盎司啤酒、5盎司葡萄酒或1.5盎司烈酒。年龄并不影响酒精的吸收或代谢速度。然而，随着年龄增长，瘦体重减少而脂肪组织增加，导致总体液量相应减少。分布容积变小后，给予与相同体型和性别的年轻个体相同剂量的酒精，老年人的血液酒精浓度会更高。低剂量酒精可刺激食欲并促进正常肠道功能。在营养良好的非酒精性老年人中，饮酒对营养的负面影响极小。饮酒可通过增强幸福感和无忧无虑的感觉、减轻抑制感、压力、紧张感和抑郁情绪来改善情绪。虽然在实验室中低剂量酒精可改善年轻男性的某些类型认知功能，但在其他类型的任务表现中，酒精会导致功能受损，且这种损害会随着年龄增长而加剧。酒精对睡眠的影响主要是有害的，会加重失眠和睡眠期间的呼吸障碍。虽然尚未对老年人饮酒与心脏病死亡率之间的关系进行研究，但适度饮酒似乎是安全的。在某些情况下，低剂量酒精可能产生镇痛作用，而在其他情况下可能会加重疼痛。老年人使用大量的处方药和非处方药，其中很多药物会与酒精相互作用。饮用酒精饮料可能会加重认知障碍和其他病因导致的痴呆。尽管一些研究表明，机构养老的老年人适度饮酒似乎有好处，包括改善社交，但将社会状况的影响与酒精特有的影响区分开来仍有待完成。想要饮酒、没有医学禁忌且未服用（处方或非处方）与酒精相互作用药物的老年人，可将每天一杯视为适度饮酒水平。应建议患者睡前避免饮酒以避免睡眠障碍。还应告诫他们注意潜在的药物 - 酒精相互作用，并告知他们在驾驶等活动前避免饮酒。然而，在任何特定患者中推荐特定饮酒水平的决定，不仅必须根据该个体的具体医疗需求，还必须根据其社会和环境情况进行仔细调整。
