Skip to main content

Advertisement

Log in

Late-life depression and alcoholism

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

The relationship between alcohol use and later-life depression is complex. At-risk and problem drinking elevates the risk of depressive symptoms. The co-occurrence of alcohol use disorders and depression increases the potential for poor mental and physical health outcomes in older adults. Many older adults who are experiencing problems related to alcohol use do not meet alcohol abuse/dependence criteria. Depressive symptoms among older adults often are overlooked or misdiagnosed. The role of at-risk and problem alcohol use in depressive symptoms and vice versa may be underestimated. After a review of the literature, clinical recommendations for addressing late-life alcohol misuse and depression are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Gallo JJ, Lebowitz BD: The epidemiology of common latelife mental disorders in the community: themes for the new century. Psychiatr Serv 1999, 50:1158–1166.

    PubMed  CAS  Google Scholar 

  2. US Dept of Health and Human Services: Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: US Dept of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.

    Google Scholar 

  3. National Institute of Mental Health. Older adults: depression and suicide facts. Available at: http://www.nimh.nih.gov/publicat/elderlydepsuicide.cfm. Accessed November 1, 2006.

  4. Adams W, Barry KL, Fleming MF: Screening for alcohol use in older primary care patients. JAMA 1996, 279:1964–1967.

    Article  Google Scholar 

  5. Robins LN, Helzer JE, Weissman MM, et al.: Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Med 1984, 41:949–958.

    CAS  Google Scholar 

  6. Blow FC, Barry KL: Advances in alcohol screening and brief intervention with older adults. In Advances in Medical Psychotherapy, 1999–2000, vol. 10. Edited by Lichtenberg PA. Dubuque, IA: Kendall Hunt; 1999:107–124.

    Google Scholar 

  7. Blow FC. Substance Abuse Among Older Adults. Rockville, MD: US Dept of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment; 1998. Treatment Improvement Protocol (TIP) Series, No. 26.

    Google Scholar 

  8. Office of Applied Studies, SAMHSA: Summary of findings from the 2002 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, US Dept of Health and Human Services; 2002.

    Google Scholar 

  9. Oslin DW: Late-life alcoholism: issues relevant to the geriatric psychiatrist. Am J Geriatr Psychiatry 2004, 12:571–583.

    Article  PubMed  Google Scholar 

  10. Callahan CM, Tierney WM: Health services use and mortality among older primary care patients with alcoholism. J Am Geriatr Soc 1995, 43:1378–1383.

    PubMed  CAS  Google Scholar 

  11. Barry KL, Blow FC, Walton MA, et al.: Elder-specific brief alcohol intervention: 3-month outcomes [abstract]. Alcohol Clin Exp Res 1998, 22:32A.

    Google Scholar 

  12. Joseph CL, Ganzini L, Atkinson R: Screening for alcohol use disorders in the nursing home. J Am Geriatr Soc 1995, 43:368–373.

    PubMed  CAS  Google Scholar 

  13. Oslin DW, Streim JE, Parmelee P, et al.: Alcohol abuse: a source of reversible functional disability among residents of a VA nursing home. Int J Geriatr Psychiatry 1997, 12:825–832.

    Article  PubMed  CAS  Google Scholar 

  14. National Institute on Alcohol Abuse and Alcoholism: Alcohol and Aging. Alcohol Alert. vol 40. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism; 1998:1–5.

    Google Scholar 

  15. National Institute on Alcohol Abuse and Alcoholism: Drinking in the United States: Main Findings from the 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES). Rockville, MD: National Institute on Alcohol Abuse and Alcoholism; 1998. [NIH publication no. 99-3519.]

    Google Scholar 

  16. Onder G, Pedone C, Landi F, et al.: Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Soc 2002, 50:1962–1968.

    Article  PubMed  Google Scholar 

  17. Bartels SJ, Liberto J: Dual diagnosis in the elderly. In Substance Disorders Among Persons with Chronic Mental Illness. Edited by Lehman AF, Dixon L. New York: Harwood Academic Publishers; 1995:139–157.

    Google Scholar 

  18. Barry KL, Oslin DW, Blow FC: Alcohol Problems in Older Adults: Prevention and Management. New York: Springer; 2001.

    Google Scholar 

  19. Vestal RE, McGuire EA, Tobin JD, et al.: Aging and ethanol metabolism. Clin Pharmacol Ther 1977, 21:343–354.

    PubMed  CAS  Google Scholar 

  20. Chermack ST, Blow FC, Hill EM, Mudd SA: The relationship between alcohol symptoms and consumption among older drinkers. Alcohol Clin Exp Res 1996, 20:1153–1158.

    Article  PubMed  CAS  Google Scholar 

  21. Doll R, Peto R, Hall E, et al.: Mortality in relation to consumption of alcohol: 13 years’ observations on male British doctors. BMJ 1994, 309:911–918.

    PubMed  CAS  Google Scholar 

  22. Boffetta P, Garfinkel L: Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study. Epidemiology 1990, 1:342–348.

    Article  PubMed  CAS  Google Scholar 

  23. deLabry LO, Glynn RJ, Levenson MR, et al.: Alcohol consumption and mortality in an American male population: recovering the U-shaped curve—findings from a normative aging study. J Stud Alcohol 1992, 53:25–32.

    CAS  Google Scholar 

  24. Broe GA, Creasey H, Jorm AF, et al.: Health habits and risk of cognitive impairment and dementia. Aust N Z J Public Health 1998, 22:621–623.

    PubMed  CAS  Google Scholar 

  25. Dufour MC, Archer L, Gordis E: Alcohol and the elderly. Clin Geriatr Med 1992, 8:127–141.

    PubMed  CAS  Google Scholar 

  26. Thun MJ, Peto R, Lopez AD, et al.: Alcohol consumption and mortality among middle-aged and elderly US adults. N Engl J Med 1997, 337:1705–1714.

    Article  PubMed  CAS  Google Scholar 

  27. Conigliaro J, Lofgren RP, Hanusa BH: Screening for problem drinking: impact on physician behavior and patient drinking habits. J Gen Intern Med 1998, 13:251–256.

    Article  PubMed  CAS  Google Scholar 

  28. Romanoski AJ, Folstein MF, Nestadt G, et al.: The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders. Results from the Eastern Baltimore Mental Health Survey Clinical Reappraisal. Psychol Med 1992, 22:629–655.

    Article  PubMed  CAS  Google Scholar 

  29. Alexopoulos GS, Meyers BS, Young RC, et al.: “Vascular depression” hypothesis. Arch Gen Psychiatry 1997, 54:915–922.

    PubMed  CAS  Google Scholar 

  30. Parmelee PA, Katz IR, Lawton MP: Incidence of depression in long-term care settings. J Gerontol 1992, 47:M189–M196.

    PubMed  CAS  Google Scholar 

  31. Horwath E, Johnson J, Klerman GL, Weissman MM: Depressive symptoms as relative and attributable risk factors for first-onset major depression. Arch Gen Psychiatry 1992, 49:817–823.

    PubMed  CAS  Google Scholar 

  32. Harman JS, Reynolds CF 3rd: Removing the barriers to effective depression treatment in old age. J Am Geriatr Soc 2000, 48:1012–1013.

    PubMed  CAS  Google Scholar 

  33. NIH consensus conference. Diagnosis and treatment of depression in late life. JAMA 1992, 268:1018–1024.

    Article  Google Scholar 

  34. Centers for Disease Control and Prevention. Suicide deaths and rates per 100,000. Available at: http://www.cdc.gov/ncipc/data/us9794/suic.htm. Accessed November 1, 2006.

  35. Kraemer HC, Kazdin AE, Offord DR, et al.: Coming to terms with the terms of risk. Arch Gen Psychiatry 1997, 54:337–343.

    PubMed  CAS  Google Scholar 

  36. Conwell Y, Brent D: Suicide and aging. I: Patterns of psychiatric diagnosis. Int Psychogeriatr 1995, 7:149–164.

    Article  PubMed  CAS  Google Scholar 

  37. Conwell Y, Duberstein PR, Cox C, et al.: Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996, 153:1001–1008.

    PubMed  CAS  Google Scholar 

  38. Grant BF, Harford TC: Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey. Drug Alcohol Depend 1995, 39:197–206.

    Article  PubMed  CAS  Google Scholar 

  39. Devanand DP: Comorbid psychiatric disorders in late life depression. Biol Psychiatry 2002, 52:236–242.

    Article  PubMed  CAS  Google Scholar 

  40. Speer DC, Bates K: Comorbid mental and substance disorders among older psychiatric patients. J Am Geriatr Soc 1992, 40:886–890.

    PubMed  CAS  Google Scholar 

  41. Schuckit MA: Genetic and clinical implications of alcoholism and affective disorder. Am J Psychiatry 1986, 143:140–147.

    PubMed  CAS  Google Scholar 

  42. Blixen CE, McDougall GJ, Suen L: Dual diagnosis in elders discharged from a psychiatric hospital. Int J Geriatr Psychiatry 1997, 12:307–313.

    Article  PubMed  CAS  Google Scholar 

  43. Blow FC, Cook CA, Booth BM, et al.: Age-related psychiatric comorbidities and level of functioning in alcoholic veterans seeking outpatient treatment. Hosp Community Psychiatry 1992, 43:990–995.

    PubMed  CAS  Google Scholar 

  44. McKenna C, Ross C: Diagnostic conundrums in substance abusers with psychiatric symptoms: variables suggestive of dual diagnosis. Am J Drug Alcohol Abuse 1994, 20:397–412.

    PubMed  CAS  Google Scholar 

  45. Atkinson R: Depression, alcoholism and ageing: a brief review. Int J Geriatr Psychiatry 1999, 14:905–910.

    Article  PubMed  CAS  Google Scholar 

  46. Oslin DW: Treatment of late-life depression complicated by alcohol dependence. Am J Geriatr Psychiatry 2005, 13:491–500.

    Article  PubMed  Google Scholar 

  47. Waller SJ, Lyons JS, Costantini-Ferrando MF: Impact of comorbid affective and alcohol use disorders on suicidal ideation and attempts. J Clin Psychol 1999, 55:585–595.

    Article  PubMed  CAS  Google Scholar 

  48. Cornelius JR, Salloum IM, Mezzich J, et al.: Disproportionate suicidality in patients with comorbid major depression and alcoholism. Am J Psychiatry 1995, 152:358–364.

    PubMed  CAS  Google Scholar 

  49. Korper SP, Council CL, eds: Substance Use by Older Adults: Estimates of Future Impact on the Treatment System. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2002. DHHS Publication No. SMA 03-3763, Analytic Series A-21.

    Google Scholar 

  50. Grant BF: Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey. J Stud Alcohol 1997, 58:464–473.

    PubMed  CAS  Google Scholar 

  51. Cloninger RC: Feeling Good: The Science of Well-Being. New York: Oxford University Press; 2004:xxiii, 374.

    Google Scholar 

  52. D’souza RF, Rodrigo A: Spiritually augmented cognitive behavioral therapy. Australas Psychiatry 2004, 12:148–152.

    Article  PubMed  Google Scholar 

  53. Oslin DW, Grantham S, Coakley E, et al.: PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use. Psychiatr Serv 2006, 57:954–958.

    Article  PubMed  Google Scholar 

  54. Oslin DW, Sayers S, Ross J, et al.: Disease management for depression and at-risk drinking via telephone in an older population of veterans. Psychosom Med 2003, 65:931–937.

    Article  PubMed  Google Scholar 

  55. Oslin DW, Ross J, Sayers S, et al.: Screening, assessment, and management of depression in VA primary care clinics. The Behavioral Health Laboratory. J Gen Intern Med 2006, 21:46–50.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frederic C. Blow PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blow, F.C., Serras, A.M. & Barry, K.L. Late-life depression and alcoholism. Curr Psychiatry Rep 9, 14–19 (2007). https://doi.org/10.1007/s11920-007-0004-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-007-0004-z

Keywords

Navigation