Many Elderly Alcoholics Go Undiagnosed

Knowing Risk Factors Can Help Spot the Under-Diagnosed

Older Man With Conselor
Risk Factors Can Help ID Older Alcoholics. © Getty Images

It is estimated that less than half of alcoholics over the age of 65 go undiagnosed because their symptoms of alcohol use disorders are masked by their otherwise good health and by their denial. This is even more true for elderly women who are alcohol dependent.

Undiagnosed alcoholism among the elderly could place a enormous financial burden on the Medicare program in the U.S. as more members of the baby boomer generation reach retirement age.

Penn State researchers Kristine E. Pringle and Dr. Dennis Shea believe the problem will increase significantly because the baby boomers have higher rates of substance abuse than any previous generation.

But, Pringle's research indicates there is a way for healthcare providers to identify and target this undiagnosed population.

Targeting Higher Risk Groups

"Using the risk factors we've identified in our study, healthcare providers and policy makers may be better able to target screenings and policy interventions toward the highest-risk groups who may be systematically under-diagnosed and under-treated," Pringle said.

Using data from 10,000 participants in the Medicare Current Beneficiary Survey (MCBS) and the Health and Retirement Study (HRS) the Penn State investigators were able to examine information from both diagnosed and self-reporting elderly individuals.

Older Alcoholics Under Diagnosed

The study discovered that 4.3% of the participants self-reported that they were alcoholics, but only 1.9% of the same group were diagnosed with alcohol abuse disorders.

Pringle found that the chances of being diagnosed with alcoholism can be influenced by the patient's age, gender, race, ethnicity, income, education, marital status, depression, health status, ability to drive, region, rural/urban residence, household composition and religiosity.

The researchers found, for example, that patients in excellent, very good or good health are significantly more likely to have self-reported and diagnosed alcoholism than elderly in fair or poor health.

Women Less Likely to Be Diagnosed

The study revealed that elderly men were more likely to self-report alcoholism than elderly females but only slightly more likely to be diagnosed.

"Older men are at particularly high risk for not being diagnosed but our results also support the view that older females may be denying a drinking problem since women are half as likely as men to self-report but only slightly less likely to be diagnosed," Pringle said.

"Denial may be especially problematic for other groups, including those with incomes greater than 200% of poverty and those aged 75 and older," Pringle said. "In each of these groups, the diagnosed rate is higher than the self-reported rate."

A Baby Boomer Problem

"The number of alcoholic elderly can be expected to increase due to the sheer number of baby boomers entering old age," Dr. Shea said. "To compound the problem, this generation has higher rates of substance abuse than any previous generation. The costs of alcoholism and its consequences in the elderly have the potential to create an enormous financial burden for the Medicare program.

It's imperative that both health care providers and policy makers understand which elder groups are at risk and may be under-diagnosed and therefore prime screening targets."

Pringle presented the findings in a paper, "Triangulation in Action: Prevalence and Risk Factors for Alcoholism Among Elderly Medicare Beneficiaries," at the AcademyHealth annual meeting.


Penn State. "Knowing risk factors can help identify elderly alcoholics for treatment." News June 2003

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