White Aaron M, Orosz Andras, Powell Patricia A, Koob George F
National Institute on Alcohol Abuse and Alcoholism, United States.
National Institute on Alcohol Abuse and Alcoholism, United States.
Alcohol. 2023 Mar;107:19-27. doi: 10.1016/j.alcohol.2022.07.005. Epub 2022 Aug 5.
Alcohol use is increasing among adults 65 and older and the size of this population is expanding rapidly. Aging is associated with systemic inflammation, sleep disturbances, cancers, cognitive decline, and increased risk of injury and death from falls and other accidents. Alcohol misuse exacerbates and accelerates these age-related changes. Older drinkers are more sensitive to acute alcohol-induced impairments in memory, coordination, reaction time, and driving performance. Oxidative stress and DNA damage resulting from chronic heavy alcohol consumption contribute to an increased risk of cancer, liver disease, and cardiovascular disease. Medication use increases with age and many medications prescribed to older adults can interact negatively with alcohol. The rapid expansion of the population aged 65 and older, combined with higher levels of alcohol use and AUD in the Baby Boomer cohort than the preceding generation, could significantly increase the burden of alcohol on the healthcare system resulting from AUD and alcohol-related injuries and diseases. Screening and brief intervention for hazardous alcohol use among older patients along with education regarding potential interactions between alcohol and medications could substantially reduce the risk of harms from alcohol but currently is underutilized.
65岁及以上成年人的饮酒率正在上升,且这一人群规模正在迅速扩大。衰老与全身炎症、睡眠障碍、癌症、认知衰退以及跌倒和其他事故导致的受伤和死亡风险增加有关。酒精滥用会加剧并加速这些与年龄相关的变化。老年饮酒者对急性酒精引起的记忆、协调、反应时间和驾驶能力损害更为敏感。长期大量饮酒导致的氧化应激和DNA损伤会增加患癌症、肝病和心血管疾病的风险。用药量会随着年龄增长而增加,许多开给老年人的药物会与酒精产生不良相互作用。65岁及以上人口的迅速增长,再加上婴儿潮一代的饮酒率和酒精使用障碍(AUD)水平高于上一代,可能会显著增加医疗系统因AUD以及与酒精相关的伤害和疾病而承受的酒精负担。对老年患者进行有害酒精使用的筛查和简短干预,以及开展关于酒精与药物之间潜在相互作用的教育,可大幅降低酒精造成伤害的风险,但目前这种做法未得到充分利用。