Managing older people's alcohol misuse in primary care.

> ‘It would be too optimistic to suppose that the relative under-representation of subjects in the older age groups … is just explained by older people having generally got the treatment they required … it seems likely that this finding is in part a hint of the diminished life expectancy of the alcoholic.’ > > (Professor Griffith Edwards, 19671) Over the past 50 years, increased life expectancy has changed the demographic structure of the UK population. This has had profound consequences for corresponding changes in lifestyle and health. Four years ago, we highlighted the alarming trend of rising alcohol misuse among older people in the UK.2 Even using more refined ways of measuring the burden of alcohol-related illness, hospital admissions that are wholly attributable to alcohol for people aged ≥65 years in England have nearly doubled over the past 6 years (Figure 1).3 A rise of over >90% in the number of admissions for people aged ≥65 years far outstrips the rise in overall numbers of people in this age group.4 Therefore, strategies are clearly needed to address alcohol misuse by identifying and targeting appropriate areas for clinical intervention Figure 1. Trends in alcohol specific admissions to hospitals in England. Alcohol use and misuse in older people is easy to overlook in primary care settings. There may be unintentional ageism by carers, where sleep problems are attributed to someone being ‘always a poor sleeper’, or appetite problems labelled as a lifelong fastidiousness with food. Older people may be stigmatised and under-report their alcohol intake for fear of being …