Alcohol Use Disorder in Older Adults: Challenges in Assessment and Treatment

Alcohol use disorder (AUD) is a common, under-recognized, and under-treated health concern in older adults. Its prevalence is expected to reach unprecedented levels as the U.S. population ages; consequently, it is poised to place a significant burden on the healthcare system. Given the growing body of evidence regarding the patterns of use in this age group and the serious consequences of its misuse, it is critical that nurses and other healthcare providers assess for AUD in order to identify older adults in need of treatment. Yet, differences in symptom presentation, problems in isolating the symptoms of AUD from other healthcare complaints associated with aging, as well as the denial and fear of stigma that is especially pervasive in this age group, are major barriers to its identification and subsequent treatment. Furthermore, the lack of consistent use of evidence-based, age-specific screening instruments to identify those at risk is another significant obstacle to successful treatment. Healthcare providers in primary care are especially well-positioned to perform a systematic assessment utilizing appropriate instruments to identify AUD and initiate age-specific interventions, including the use of alcohol screening and brief interventions (ASBIs). The use of ASBIs, along with other targeted interventions such as mutual help groups (MHGs), such as Alcoholics Anonymous, can be key in encouraging insight, dismantling denial, and supporting treatment success, lifelong recovery, and overall quality of life in this vulnerable group.