Adès J, Lejoyeux M
Service de psychiatrie, hôpital Louis-Mourier, Colombes.
Rev Prat. 1994 Jun 1;44(11):1439-42.
Alcohol and drug abuse are the two main addictions in the elderly subject. Prevalence of alcohol dependency is 14% in those over 65 years of age and 17% in elderly psychiatric patients. The distribution of alcoholism between the sexes becomes equal with age. After 65 years of age, the sex-ratio is 1 female to 1.3 male subjects. The elderly alcoholic population consists of both subjects having become alcoholics at a young age and those in whom alcoholic behaviour appeared at a late age. In one third of elderly alcoholics such dependency appeared after 60 years of age. The main risk factors for alcoholism in the elderly subject are lonliness, death of the spouse and the presence of an invalid or bedridden spouse. In the elderly, tolerance to and dependence on alcohol are rare and appear late. Somatic complications are particularly severe (cirrhosis, liver cancer, gastritis, acute pancreatitis and myocardial involvement). Psychiatric complications include anxiety, depression and especially suicide. Alcoholism is the third most frequent cause of organic cerebral dementia, following Alzheimer disease and vascular dementia. Drug dependency is very often linked to alcoholism and consists of tranquillizers and less often of antalgics.
酒精和药物滥用是老年人群体中的两大主要成瘾问题。65岁以上人群中酒精依赖的患病率为14%，老年精神病患者中为17%。酗酒在两性间的分布随年龄增长而趋于平等。65岁以后，男女比例为1名女性对应1.3名男性。老年酗酒人群包括年轻时就成为酗酒者的人和晚年才出现酗酒行为的人。三分之一的老年酗酒者在60岁以后出现这种依赖。老年人群体酗酒的主要危险因素是孤独、配偶死亡以及有残疾或卧床不起的配偶。在老年人中，对酒精的耐受性和依赖性很少见且出现较晚。躯体并发症尤其严重（肝硬化、肝癌、胃炎、急性胰腺炎和心肌受累）。精神并发症包括焦虑、抑郁，尤其是自杀。酗酒是继阿尔茨海默病和血管性痴呆之后导致器质性脑痴呆的第三大常见原因。药物依赖常常与酗酒有关，主要是镇静剂，较少是镇痛药。
