Epidemiologie riskanten Alkoholkonsums im höheren Lebensalter: eine Übersicht

 

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Zusammenfassung

Im Hinblick auf alkoholbezogene Störungen im höheren Lebensalter hat sich der Blickwinkel erweitert: Es werden nicht mehr nur die engen klinisch-diagnostischen Kategorien betrachtet, sondern unterschiedliche Alkoholkonsummuster. Die vorliegende Arbeit beschäftigt sich mit den verfügbaren epidemiologischen Studien zu riskanten Alkoholkonsummustern im höheren Alter. Die Befunde weisen konsistent darauf-hin, dass der riskante Konsum von Alkohol mit steigendem Alter abnimmt und insbesondere bei älteren Frauen gering ist. Nichtsdestotrotz sind einige der ermittelten Raten substantiell. Vor dem Hintergrund der steigenden Lebenserwartung und der veränderten Konsumgewohnheiten der Nachkriegsgenerationen ist ein erheblicher Anstieg der Prävalenz riskanter Gebrauchsmuster und alkoholbezogener Störungen zu erwarten. Es besteht deshalb ein dringender Bedarf, solche Konsummuster in der primären Gesundheitsversorgung zu identifizieren sowie effektive und kostengünstige Interventionen zu entwickeln.

Abstract

Earlier epidemiological research consistently shows a strong age-related decline in the prevalence of alcohol use disorders. Probable reasons for this include: increased mortality among those who suffer from alcohol use disorders, increased age-related sensitivity to the (adverse) effects of alcohol, and historical differences in exposure to and use of alcohol. However, there are strong limitations of the previous research: in particular the lack of age-validated screening tools and diagnostic criteria for the recognition of alcohol use disorders among aged individuals. This paper focusses on a newer and broader approach: at-risk drinking among elderly people. It reviews the literature relating to the epidemiological research on this field. The available findings suggest negative associations between at-risk drinking, increasing age and female gender. Nevertheless, at-risk drinking still occurs in higher age groups as well as in older women. Furthermore, given the ageing population and the increased consumption of alcohol in the post World War II generations, it is very likely that the prevalence of at-risk drinking and alcohol-related disorders among older people will considerably rise in the near future. Therefore, there is a need for the identification of at-risk drinking patterns in older people as well as for effective and efficient interventions in primary care settings.

Literatur

• 1 Helzer JE, Burnham A, MacEvoy LT. Alcohol abuse and dependence. In: Robins LN, Regier DA, Hrsg. Psychiatric disorders in America. The epidemiologic Catchment Area Study. New York: Macmillan 1991: 81-155
  Google Scholar
• 2 Adams WL, Cox NS. Epidemiology of problem drinking among elderly people.  International Journal of Mental Health and Addiction. 1995;  30 1693-1716
  PubMedGoogle Scholar
• 3 Dilling H, Weyerer S. Psychische Erkrankungen in der Bevölkerung bei Erwachsenen und Jugendlichen. In: Dilling H, Weyerer S, Castell R, Hrsg. Psychische Erkrankungen in der Bevölkerung. Stuttgart: Enke 1984: 1-122
  Google Scholar
• 4 Helmchen H, Baltes MM, Geiselmann B. et al .Psychische Erkrankungen im Alter. In: Mayer KU, Baltes PB, Hrsg. Die Berliner Altersstudie. Berlin: Akademie Verlag 1996: 185-219
  Google Scholar
• 5 Lakhani N. Alcohol use amongst community-dwelling elderly people – A review of the literature.  Journal of Advanced Nursing. 1997;  25 1227-1232
  CrossrefPubMedGoogle Scholar
• 6 Schäufele M, Weyerer S, Zimber A. Prävalenz von Alkoholmissbrauch und -abhängigkeit bei älteren Heimbewohnern – Eine Studie in 20 Mannheimer Alten- und Altenpflegeheimen. In: Havemann-Reinecke U, Weyerer S, Fleischmann H, Hrsg. Alkohol und Medikamente, Missbrauch und Abhängigkeit im Alter. Freiburg: Lambertus Verlag 1998: 148-156
  Google Scholar
• 7 Schäufele M, Weyerer S. Psychopharmakagebrauch und Sturzhäufigkeit bei Alten- und Pflegeheimbewohnern – Eine prospektive epidemiologische Studie in Mannheim.  European Journal of Geriatrics. 1999;  1 124-131
  PubMedGoogle Scholar
• 8 Dufour M, Fuller RK. Alcohol in the elderly.  Annual Review of Medicine. 1995;  46 123-132
  CrossrefPubMedGoogle Scholar
• 9 Lynskey MT, Day C, Hall W. Alcohol and other drug use disorders among older-aged people.  Drug and Alcohol Review. 2003;  22 125-133
  PubMedGoogle Scholar
• 10 Blow FC, Barry KL. Older patients with at-risk and problem drinking patterns – New developments in brief interventions.  Journal of Geriatric Psychiatry and Neurology. 2000;  13 115-123
  PubMedGoogle Scholar
• 11 Saunders PA, Copeland JR, Dewey ME. et al . Alcohol use and abuse in the elderly: findings from the Liverpool Longitudinal Study of Continuing Health in the Community.  International Journal of Geriatric Psychiatry. 1989;  4 103-108
  CrossrefPubMedGoogle Scholar
• 12 Walton AM, Mudd SA, Blow FC. et al . Stability in the drinking habits of older problem-drinkers recruited from nontreatment setting.  Journal of Substance Abuse Treatment. 2000;  18 169-177
  CrossrefPubMedGoogle Scholar
• 13 Peytremann-Bridevaux I, Bradley KA, Bryson CL. et al . Alcohol screening results in elderly male veterans – Association with health status and mortality.  Journal of the American Geriatrics Society. 2004;  52 1510-1517
  CrossrefPubMedGoogle Scholar
• 14 Levenson MR, Aldwin CM, Spiro III A. Age, cohort and period effects on alcohol consumption and problem drinking – Findings from the Normative Aging Study.  Journal of Studies on Alcohol. 1998;  59 712-722
  PubMedGoogle Scholar
• 15 Johnson I. Alcohol problems in old age – A review of recent epidemiological research.  International Journal of Geriatric Psychiatry. 2000;  15 575-581
  CrossrefPubMedGoogle Scholar
• 16 Mann K, Mundle G, Heinz A. Alkoholismus und Alkoholfolgekrankheiten. In: Förstl H, Hrsg. Lehrbuch der Gerontopsychiatrie und –psychotherapie. Stuttgart: Georg Thieme Verlag 2003: 516-524
  Google Scholar
• 17 Patterson TL, Jeste DV. The potential impact of baby-boom generation on substance abuse among elderly persons.  Psychiatric Services. 1999;  50 1184-1188
  PubMedGoogle Scholar
• 18 Curtis JR, Geller G, Stokes EJ. et al . Characteristics, diagnosis and treatment of alcoholism in elderly patients.  Journal of the American Geriatrics Society. 1989;  37 310-316
  PubMedGoogle Scholar
• 19 Khan N, Davis P, Wilkinson TJ. et al . Drinking patterns among older people in the community – Hidden from medical attention?.  New Zealand Medical Journal. 2002;  115 72-75
  PubMedGoogle Scholar
• 20 O’Connell H, Chin A-V, Cunningham C. et al . Alcohol use disorders in elderly people- redefining an age old problem in old age.  British Medical Journal. 2003;  327 664-667
  CrossrefPubMedGoogle Scholar
• 21 Moos RH, Brennan PL, Schutte KK. et al . High-risk alcohol consumption and late-life alcohol use problems.  American Journal of Public Health. 2004;  94 1985-1991
  CrossrefPubMedGoogle Scholar
• 22 National Institute on Alcohol Abuse and Alcoholism (NIAAA) .The physician guide to helping patients with alcohol problems. Bethesda: NIAAA 1995
• 23 Bühringer G, Augustin R, Bergmann E. et al .Alkoholkonsum und alkoholbezogene Störungen in Deutschland. Baden-Baden: Nomos 2000
• 24 Augustin R, Kraus L. Alkoholkonsum, alkoholbezogene Probleme und Trends. Ergebnisse des Epidemiologischen Suchtsurvey 2003.  Sucht. 2005;  51 29-39
  PubMedGoogle Scholar
• 25 British Medical Association .Alcohol: guidelines on sensible drinking. London: British Medical Association 1995
• 26 US Department of Agriculture/US Department of Health and Human Services – DA/HHS .Nutrition and your health: dietary guidelines for Americans. Washington DC: US Department of Agriculture 1990
• 27 The American Geriatrics Society . Clinical guidelines for alcohol use disorders in older Adults. 2003;  , retrieved September 01, 2005, from http://www.americangeriatrics.org/products/positionpapers/alcohol.shtml
  PubMed
• 28 Fink A, Morton SC, Beck JC. et al . The Alcohol Related Problems Survey – Identifying hazardous and harmful drinking in older primary care patients.  Journal of the American Geriatrics Society. 2002;  50 1717-1722
  CrossrefPubMedGoogle Scholar
• 29 Adams WL, Barry KL, Fleming MF. Screening for problem drinking in older primary care patients.  Journal of the American Medical Association. 1996;  276 1964-1967
  CrossrefPubMedGoogle Scholar
• 30 Ewing JA. Detecting alcoholism – The CAGE questionnaire.  Journal of the American Medical Association. 1984;  252 1905-1907
  CrossrefPubMedGoogle Scholar
• 31 Saunders JB, Aasland OG, Babor TF. et al . Development of the Alcohol Use Disorders Identification Test (AUDIT) – WHO collaborative project on early detection of persons with harmful alcohol consumption II.  Addiction. 1993;  88 791-804
  CrossrefPubMedGoogle Scholar
• 32 Philpot M, Pearson N, Petratou V. et al . Screening for problem drinking in older people referred to a mental health service: a comparison of CAGE and AUDIT.  Aging and Mental Health. 2003;  7 171-175
  PubMedGoogle Scholar
• 33 Bush K, Kivlahan DR, Mcdonell MB. et al . The Audit Alcohol Consumption Question (Audit-C). An effective brief screening test for problem drinking.  Archives of Internal Medicine. 1998;  158 1789-1795
  CrossrefPubMedGoogle Scholar
• 34 Dawson DA, Grant BF, Stinson FS. et al . Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population.  Alcoholism: Clinical and Experimental Research. 2005;  29 844-854
  CrossrefPubMedGoogle Scholar
• 35 Moore AA, Hays RD, Greendale GA. et al . Drinking habits among older persons – Findings from the NHANES I epidemiologic follow up study (1982–1984): National Health and Nutrition Examination Survey.  Journal of the American Geriatrics Society. 1999;  47 12-16
  PubMedGoogle Scholar
• 36 Hajat S, Haines A, Bulpitt C. et al . Patterns and determinants of alcohol consumption in people aged 75 years and older: results from the MRC trial of assessment and management of older people in the Community.  Age and Ageing. 2004;  33 170-177
  CrossrefPubMedGoogle Scholar
• 37 Aira M, Hartikainen S, Sulkava R. Community prevalence of alcohol use and concomitant use of medication – A source of possible risk in the elderly aged 75 and older?.  International Journal of Geriatric Psychiatry. 2005;  20 680-685
  CrossrefPubMedGoogle Scholar
• 38 Mirand AL, Welte JW. Alcohol consumption among the elderly in a general population, Erie county, New York.  American Journal of Public Health. 1996;  86 978-894
  CrossrefPubMedGoogle Scholar
• 39 Adams WL. Alcohol use in retirement communities.  Journal of the American Geriatrics Society. 1996;  44 1082-1085
  PubMedGoogle Scholar
• 40 Chermack ST, Blow FC, Hill EM. et al . Relationship between alcohol symptoms and consumption among older drinkers.  Alcoholism: Clinical and Experimental Research. 1996;  20 1153-1158
  CrossrefPubMedGoogle Scholar
• 41 Naimi TS, Brewer RD, Mokdad A. et al . Binge drinking among US adults.  Journal of the American Medical Association. 2003;  289 70-75
  CrossrefPubMedGoogle Scholar
• 42 Royal Colleges of Physicians PaGP .Alcohol and the heart in perspective – Sensible limits reaffirmed. London: Royal Colleges 1995
• 43 Breslow RA, Faden VB, Smothers B. Alcohol consumption by elderly Americans.  Journal of Studies on Alcohol. 2003;  64 884-894
  PubMedGoogle Scholar
• 44 Livingston G, King M. Alcohol abuse in an inner city elderly population – The Gospel Oak Survey.  International Journal of Geriatric Psychiatry. 1993;  8 511-514
  CrossrefPubMedGoogle Scholar
• 45 Blow FC, Walton MA, Barry KL. et al . The relationship between alcohol problems and health functioning of older adults in primary care settings.  Journal of the American Geriatrics Society. 2000;  48 769-774
  PubMedGoogle Scholar
• 46 Gordon T, Kannel WB. Drinking and its relation to smoking, BP, blood lipids and uric acid -The Framingham Study.  Archives of Internal Medicine. 1983;  143 1366-1374
  PubMedGoogle Scholar
• 47 Fillmore KM. Prevalence, incidence and chronicity of drinking patterns and problems among men as a function of age – A longitudinal and cohort analysis.  British Journal of Addiction. 1987;  82 77-83
  CrossrefPubMedGoogle Scholar
• 48 Adams WL, Garry PJ, Rhyne R. et al . Alcohol intake in the healthy elderly.  Journal of the American Geriatrics Society. 1990;  38 211-216
  PubMedGoogle Scholar
• 49 Moos RH, Schutte K, Brennan P. et al . Ten-years patterns of alcohol consumption and drinking problems among older women and men.  Addiction. 2004;  99 829-838
  CrossrefPubMedGoogle Scholar
• 50 Fleming MF, Mundt MP, French MT. et al . Brief physician advice for problem drinkers – Long-term efficacy and benefit-cost analysis.  Alcoholism: Clinical and Experimental Research. 2002;  26 36-43
  PubMedGoogle Scholar

Korrespondenzadresse

Dr. sc. hum. M. SchäufeleDipl.-Psych. 

Arbeitsgruppe Psychiatrische Epidemiologie und Demografischer Wandel

Zentralinstitut für Seelische Gesundheit

Postfach 122120

68072 Mannheim

Email: martina.schaeufele@zi-mannheim.de