Keele University, Newcastle under Lyme, Staffordshire ST5 5BG, UK.
University College London, London, UK.
Age Ageing. 2018 Mar 1;47(2):164-167. doi: 10.1093/ageing/afx191.
Alcohol consumption constitutes a substantial burden of disease. Older people are being admitted to hospital for alcohol problems in increasing numbers. A recent systematic review reports cautious supportive evidence for primary prevention interventions in reducing excessive alcohol consumption in older drinkers, but does not focus on treatment of dependent drinkers. The evidence base for treatment interventions for dependent drinkers is comparatively limited, but it is growing. In addition to brief interventions, specialist outpatient treatment and inpatient treatment have been evaluated.The responses of older people to treatment are promising: they want to abstain, they have the capacity to change, they respond well to brief advice and motivational enhancement therapy, they achieve improvements at least as comparable to younger counterparts-and sometimes better-and they do have the prospect of long-term recovery.There is a need to develop services tailored to the needs of older substance misusers. Education of the workforce, including medical students and other health care professionals, is the key. Collaboration and coordination of services, training, research and policy are essential.There are very few designated services for older substance misusers in the UK and only 7% of older people who need treatment for alcohol problems access them. There is a massive gap in the whole gamut of research from basic to clinical research in this vulnerable patient population: this has to be developed if management is to be effective and up to date.
饮酒会导致严重的疾病负担。越来越多的老年人因酗酒问题住院。最近的一项系统评价报告对减少老年饮酒者过度饮酒的初级预防干预措施提供了谨慎的支持证据，但并未关注对依赖型饮酒者的治疗。依赖型饮酒者治疗干预措施的证据基础相对有限，但正在不断发展。除了简短干预措施外，还评估了专科门诊治疗和住院治疗。老年人对治疗的反应很有希望：他们想戒酒，有改变的能力，对简短建议和动机增强疗法反应良好，他们至少能取得与年轻患者相当的改善，有时甚至更好，而且他们确实有长期康复的前景。需要根据老年物质滥用者的需求来制定专门的服务。对劳动力（包括医学生和其他医疗保健专业人员）进行教育是关键。服务、培训、研究和政策的协作与协调至关重要。在英国，针对老年物质滥用者的指定服务非常少，只有 7%的需要治疗酒精问题的老年人能够获得这些服务。在这个弱势群体中，从基础研究到临床研究的整个研究范围都存在巨大差距：如果要进行有效的、最新的管理，就必须开展这些研究。
