Severity and Treatment of Alcohol Withdrawal in Elderly Versus Younger Patients

Brower, Kirk J.; Mudd, Sharon A.; Blow, Frederic C.; Young, James P.; Hill, Elizabeth M.

doi:10.1111/j.1530-0277.1994.tb00903.x

Cited by 94 publications

(36 citation statements)

References 11 publications

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“…Heavy, recent drinking would likely correlate with more sleep disturbance among alcoholic patients. Fourth, the severity of acute alcohol withdrawal, which can differ as a function of age (Brower et al, 1994), may be associated with worse sleep during subacute withdrawal (Gillin et al, 1990b). Because the severity of acute withdrawal was not measured in this study, no conclusions can be drawn regarding the association between withdrawal severity and impaired sleep in the alcoholic groups.…”

Section: Discussionmentioning

confidence: 92%

Effects of age and alcoholism on sleep: a controlled study.

Brower

Hall

2001

J. Stud. Alcohol

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Objective-Sleep problems are common, costly, and potentially fatal in older adults. Sleep problems are also commonly associated with alcoholism. Yet, few studies have examined the combined effects of alcoholism and aging on sleep. The purpose of this study was to investigate the main and interactive effects of diagnostic group and age group on sleep.Method-Male and female alcohol-dependent patients (N=139) and non-alcoholic controls (N=87) completed full-montage polysomnography, structured psychiatric diagnostic interviews, validated rating scales, and alcohol histories at the University of Michigan between 1989 and 1996. The sample was divided for analytic purposes into older (55+ yr) and younger (<55 yr) subgroups.Results-After controlling for gender, race, body mass index, and psychiatric-related sleep symptoms, alcoholics and older adults had significantly decreased total sleep time and increased stage 1 sleep percentage, respiratory distress, and periodic limb movements. Older adults also had decreased delta sleep percentage and shorter rapid eye movement (REM) sleep latencies. Significant interactions were found between alcoholism and age group for stage 1 sleep percentage, sleepdisordered breathing, and periodic limb movements with older alcoholics having the most disturbances. Older alcoholics also had the highest mean values for sleep latency and the lowest mean values for sleep efficiency and delta sleep percentage when compared to the other three groups.Conclusions-Older alcoholics have increased sleep disturbances when compared to younger alcoholics and non-alcoholics of both age groups. Care providers should screen for sleep problems among older adults with alcohol problems.

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Section: Discussionmentioning

confidence: 92%

Effects of age and alcoholism on sleep: a controlled study.

Brower

Hall

2001

J. Stud. Alcohol

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“…Brower et al (1994) reported a more protracted and severe alcohol withdrawal syndrome in the elderly compared with younger people with equal drinking severity. However, a prospective study of admissions to a specialist detoxification unit did not find a relationship between the severity of alcohol withdrawal and age (Wetterling et al, 2001).…”

Section: Alcoholmentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

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The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short-and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. KeywordsSubstance misuse, addiction, guidelines, pharmacotherapy, comorbidity 1 Imperial College London, CNWL NHS Foundation Trust, London, UK 2 Gether NHS Foundation Trust, Gloucester, UK 3 Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UKOther invited participants at the consensus meeting who contributed to the discussion and commented on the guidelines were Drummond C, Farrell M, Gilvarry E, Strang J. John, a user representative, read and commented on the written guidelines. Prof W van den Brink reviewed the written guidelines.

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“…Acute alcohol withdrawal syndrome is more pro tracted and severe in elderly people than in younger patients with drinking problems of equal severity (Brower et al, 1994). Outpatient detoxification may not be appropriate for older adults who are fragile, live alone with limited family support or who have multiple medical problems and prescribed medi cations (Liskow et al, 1989).…”

Section: Detoxificationmentioning

confidence: 99%

Alcohol use disorders in elderly people: fact or fiction?

Dar¹

2006

Adv. psychiatr. treat

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). His clinical responsibilities include the Max Glatt Unit (a regional inpatient detoxification unit attached to the hospital) and a community alcohol team. His special interests include substance misuse problems in special populations and the economics of service provision. AbstractThe number of older people is increasing in populations throughout the world. Alcohol use disorders in elderly people are a common but underrecognised problem associated with major physical and psychological health problems. Owing to the negative attitudes and inadequate training of healthcare professionals, alcohol misuse is not always being detected or effectively treated. Current diagnostic criteria and common screening instruments for alcohol use disorders may not be appropriate for elderly people. Older people are as likely to benefit from treatment as younger people and the basic principles of treatment are much the same. Better integrated and outreach services are needed. Training of healthcare professionals in this area and pragmatic research should be prioritised to improve detection, treatment and service provision for this vulnerable and neglected population.

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Severity and Treatment of Alcohol Withdrawal in Elderly Versus Younger Patients

Cited by 94 publications

References 11 publications

Effects of age and alcoholism on sleep: a controlled study.

Effects of age and alcoholism on sleep: a controlled study.

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Alcohol use disorders in elderly people: fact or fiction?

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