Octogenarians and nonagenarians are often inexplicably excluded from research on alcoholism in adults, when reality indicates that it is a problem that widely affects people of these ages. Internists have carried out a study whose preliminary results indicate that one in five hospitalized patients over 80 years of age (22%) has an active consumption of alcohol and 12%, a problematic consumption. And it is already known that drinking can cause dementia, damage to the liver, pancreas, cardiac arrhythmias or risk of cancer.
Pero the doctors of the Spanish Society of Internal Medicine (SEMI), have taken a step further and, in an exercise of some professional courage, they have asked more than a thousand colleagues about their use of alcohol, tobacco and other substances during the pandemic with sincerely striking results: almost 10% admit to smoking and of them, and Almost 60% of the internists surveyed acknowledged consuming alcohol, which brings up that famous saying of ‘I sell advice that I don’t have. ‘
But let’s go in parts. Last week, internists concluded the VI Meeting of the SEMI Alcohol and Alcoholism Working Group, which was held virtually and brought together 150 internists online. The meeting was opened by the first vice president of SEMI, Dr. Juana Carretero, and by Dr. Miguel Marcos Martín, coordinator of the SEMI Alcohol and Alcoholism Working Group, who hHe spoke of the “rebound during the pandemic of drug use and psychiatric pathology.” Carretero, for his part, emphasized the “great and serious problem posed by alcohol”, making mention of alcoholism in the elderly and the importance of preventing alcoholism.
In the framework of this meeting, data were presented on alcoholism in people over 80 admitted to hospitals, a population that is normally relegated to research on toxic habits. The objective was to carry out, precisely, a comprehensive evaluation of the possible influence of alcohol consumption on previous complications, neurological alterations, degree of functional dependence / cognitive deterioration / frailty and complications during hospital admission for any cause in these patients.
The first preliminary data already approximates relevant keys and trends and shows that it has been detectedo active alcohol consumption in 22% of patients analyzed, that 11.5% meet the criteria for problematic consumption and that 3.5% present dependence. It has also been found that only 25% of the medical records analyzed (1 out of 4) collect the parameters related to alcohol consumption.
Alcohol consumption among doctors
During the online meeting, data on alcohol consumption during the pandemic were also evaluated and analyzed, both among the general population and in the group of internists. Precisely, this study prepared to know the toxic habits of Spanish internists during the pandemic and with the participation of 1,015 professionals, shows that el 8.8% reported being a smoker. Of them, 71.9% increased their smoking habit or started smoking. On the other hand, in addition, 57.4% of the internists surveyed acknowledged consuming alcohol, with a median of 3 standard drink units (UBE; each UBE is equivalent to 10 grams of alcohol) weekly; of these, 35.8% started with alcohol consumption or increased it in the pandemic.
Also, until 1.5% claimed to have consumed what the study calls ‘recreational use substances’ (including marijuana or hashish). On the other hand, 188 (18.6%) claimed to have required drugs to combat insomnia and 58 (5.7%) took antidepressants. From this, it is concluded that the pandemic it accentuated the consumption of toxins and psychotropic drugs in the group of Spanish internists.
During the virtual meeting, the data from a survey among internists on the knowledge of toxic substances were also presented, with 194 responses (77.5% attending physicians). 77% of the participants consider syour knowledge about it fair or bad, although 85% admit to asking their patients about toxins. This percentage drops to 68% if the patient is older than 85 years. 83% know how to identify risky alcohol consumption, although 75% indicate that they do not use any type of questionnaire in their usual clinical practice to assess alcoholism and 65% do not usually ask about other toxins other than alcohol and tobacco if they do not have a clinical suspicion of consumption.
Dr. Dolores García de Lucas addressed the binomial ‘Alcohol and diabetes’. He indicated that alcoholism in diabetics “conditions adherence to therapy and diet, glycemic controls and the use of insulin (even if prescribed), as well as regularity of exercise.” According to García de Lucas, “excessive alcohol consumption in elderly patients with DM2 increases micro and macrovascular complications and it is related to the development of hypertension, atrial fibrillation and favors hypoglycemia, frailty and sarcopenia «.
For her part, Dr. Belén Alonso Ortiz has indicated, in relation to ‘Alcohol, frailty and multipathological patient’, that associated in one way or another with alcohol, some tthree million preventable deaths per year and that alcoholism is related to more than 200 diseases “.
According to the European Health Survey 2020, 49% of the population between 75 and 84 years old admit to having consumed alcohol in the last 12 months, something that is also affirmed by 30% of people aged 85 and over. Among the main risks of alcohol consumption in older patients are: increased risk of falls, accelerated decline in quality of life, increased risk of cardiovascular events, increased risk of bleeding (especially in anticoagulation) and increased risk of cardiac arrhythmias ..
Alcohol consumption is associated with multiple short- and long-term health problems, mainly including cognitive impairment (dementia), neuropathy, digestive disorders, damage to the liver, pancreas, cardiac arrhythmias or risk of cancer. Stopping drinking alcohol not only produces a greater sense of health and well-being but also prevents the development of the aforementioned diseases: cancer, dementia, liver cirrhosis, pancreatitis or cardiac arrhythmias such as atrial fibrillation.