Alcohol and ageing, a risky combination

A significant number of older adults have ongoing problems with alcohol. In this report by SADE OGUNTOLA, experts warn that indulging in late-life drinking can contribute to increase in illnesses, death and health care costs.

 

ALCOHOL consumption is embedded in Nigerian culture and most individuals drink accompanied, because they prefer drinking in contexts in which they find people like themselves.

For many older people, drinking is an important and enjoyable part of social life. However, older people who drink need to reassess their drinking regularly because the ageing process makes the body and its functioning more prone to the debilitating effects of alcohol.

Beer, wine, hard liquor are delicious. Unfortunately, alcohol consumption carries some risk. In fact, alcohol and age are a risky combination.

“Alcohol intake is not advisable for anybody, especially because of its effect on organs such as the liver and the brain. Ageing makes everything weak, so we do not want them to drink alcohol,” Dr Bayo Akinosun, a consultant chemical pathologist, University College Hospital (UCH), Ibadan, said.

There are indications that there has been a rapid increase in alcohol consumption across all age groups in Nigeria. Unrecorded alcohol consumption was estimated to be 3.5 litres of pure alcohol per capita for population older than 15 in Nigeria for the year after 1995.

Alcohol consumption continues to increase in Nigeria as a result of the aggressive marketing activities of the leading players and drinking is widely considered a part of social activities, in outdoor-open space such as at motor-parks, by roadsides and street corners.

Drinking too much alcohol over a long time can also affect health in different ways, including causing liver ailments, gait problems and brain damage.

In 2015, The Ibadan Study of Ageing looked at alcohol consumption in a community sample of elderly Nigerians and the association of 7-day excessive alcohol consumption to several common health conditions.

The study, which involved Professor Oye Gureje and Dr Victor Lasebikan in the African Journal of Medicine and Medical Sciences found that past week excessive alcohol consumption was more likely to be associated with chronic backache or neck pain, cognitive impairment and living in urban areas.

Dr Akinyemi Aje, a consultant cardiologist, added : “That is why in cardiology, we tell people to avoid taking alcohol. No one takes a glass of red wine and stops even though it is commonly said that a glass of red wine is good for the heart. That is not common, people just drink once it is available.”

Dr Aje said alcohol is better avoided in the elderly because many of them have multiple medical conditions that intake of alcohol may worsen for many reasons, including poor drug compliance and alcohol-drug interaction.

Alcohol-drug interaction can cause confusion, instability while walking, nausea or other problems.

Many medicines can be dangerous or even deadly when mixed with alcohol. This includes prescription drugs, over-the-counter medicines, and herbal remedies. Many older people take medicines every day and night  and are more likely to take a medicine that interacts with alcohol.

Unfortunately, alcohol also can make certain age-related health problems like memory problems become worse. According to Dr Temitope Farombi, a consultant neurologist at the Chief Tony Anenih Geriatric Centre, UCH, Ibadan, “alcohol can cause their brain function to decline, especially in an intoxicated state.”

Moreover, “alcohol can worsen any brain abnormality. As a result of prolonged exposure to alcohol, the brain can shrink and this can come with irreversible memory impairment,” Dr Farombi declared.

Also, she stated that alcohol can also lead to balance problems. Older adults who drink are at higher risk for hip and arm fractures, alcohol-related falls, automobile collisions, or other kinds of accidents. Older people have thinner bones than younger people, so their bones break more easily.

A Hawaii research study found that heavy alcohol users who had been sober an average of seven years had worse balance than those without previous alcohol problems.

Unfortunately, in recent years, alcohol abuse and dependence have more than doubled among older people despite such challenges as reduced income, failing health, loneliness, and the loss of friends and loved ones that can arise.

This is despite the expert’s finding that both the brain and the liver are more sensitive to the toxicity of alcohol with age, affecting response to liquor.

Alcohol is converted to acetaldehyde, which is responsible for a lot of the negative effects of alcohol like headaches, flushing and dizziness. It is then converted to acetic acid, which is excreted in the urine. The system works well in younger people.

But just like anything else, as people begin to get into their 60s or 70s, the enzymes that break alcohol down do not work so well. Some of that may be the result of the normal ageing process, but part of it may be due to illness. Hepatitis C, for instance, can affect the liver’s ability to clear alcohol and other drugs,

Only a few studies have examined the connections between patterns of alcohol consumption and alcohol-related problems among older adults. But their findings show that higher consumption levels are associated with a greater likelihood of subsequent alcohol-related problems.

The finding also added that adults over age 55 to 60, who consume five or more drinks on one day, or more than seven drinks per week, are more likely to experience alcohol-related symptoms than are older adults who consume less alcohol.

Also, a study published in the Journal of Epidemiology & Community Health found that people who drank excessively were 33 per cent more likely to have age-related grey rings around the corneas of their eyes. That condition, called arcus senilis doesn’t typically occur until at least age 60.

There is no “safe” level of alcohol consumption. Any amount of drinking is associated with increased risk of a number of diseases; the often-reported protective effects will not apply to the majority of people and where they do apply, they refer to very low levels of drinking. So, any amount of alcohol consumption carries some risk.

Keep in mind that alcohol contains calories and may contribute to unwanted weight gain, a risk factor for high blood pressure. Also, alcohol can interfere with the effectiveness and increase the side effects of some blood pressure medications.

UK’s Department of Health recommendations appear to be moving away from this long-held belief that a small amount of alcohol was good for the heart. The review found that the benefits of alcohol for heart health only apply for women aged 55 and over – and even then it’s in very small amounts.

The guidelines said: “There is no justification for recommending drinking on health grounds – or for starting drinking for health reasons.”

It also says that evidence in support for drinking alcohol in small amounts to maintain good health was “weaker than it was at that time in 1995”.

There are other ways of preventing heart disease, such as giving up smoking, regular exercise, a healthy diet, or taking small quantities of aspirin.   A combination of these approaches achieves better results than any one strategy on its own.