The Treatment of Alcohol Abuse among the Elderly

Introduction

Alcohol abuse among the elderly is an issue that has raised concern among medical practitioners and society in general. According to Ham (2007), abuse of Alcohol by aging individuals may pose serious health problems to the victims because of the reduced ability of the body system to manage the toxic substance in the Alcohol. It is important to note that the abuse of Alcohol by the elderly also affects people around them both socially and economically. When such an individual becomes physically or verbally abusive to the members of society, the effect of alcohol abuse will be felt by many people. Sometimes members of the family are forced to clean the soiled clothes of those who abuse alcohol, something that many consider demeaning. When their health deteriorates because of alcohol abuse, members of the family will be forced to spend money in order to treat them. For this reason, it is essential to treat this problem before it can bring a series of adverse effects on the victims or their families. In this research, the focus will be to identify some of the best ways through which alcohol abuse among the elderly can be treated.

The rationale for the research

Alcohol abuse among the elderly has affected society from various perspectives. When an old person consumes a high amount of Alcohol, Marshall (2000) says that the body may not be able to eliminate the alcohol content from the body within the required period. The scholar explains that this is so because most of the activities in the body system have been slowed down. It means that the alcohol content will take a longer time in the body, especially in sensitive organs such as the liver and kidneys, than is usually the case among active adults. These organs will be affected by alcoholic substances, which may lead to a series of medical complications such as liver cirrhosis. Health problems that elderly people develop will affect not only them but also their families and the government. Their families will have to pay for their treatment in order to save their lives. The government will be forced to spend more on the medical sector to meet the increasing demand for healthcare. Socially, alcohol abuse may have a series of adverse effects on the victim, society, and members of their families. When one takes Alcohol and starts misbehaving, his dignity and that of his entire family will be lost. In some cases, they may become aggressive, and this may affect other innocent members of society. For this reason, it is necessary to address this problem in order to have an organization that is free from such consequences both to the victims and people around them.

Scholars have conducted massive research in this field in order to determine the best ways that can be used to address the problem in order to protect the elderly and the people around them. According to Yoshida (2006), this field has been under active research for over two decades. However, it was evident that there are some ambiguities in some of these pieces of research. For instance, it is not yet clear who the real victims of alcohol abuse among the elderly are within society. The approach to be taken is also not, however, transparent because different experts are emphasizing other methods. Some of the recent researches have been proposing a combination of both counseling and medical treatment as the best ways of dealing with this problem. It is necessary to come up with an approach that would be universally acceptable to the experts, and this is the AimAim of the research. If this is achieved, then many people stand to benefit from the solution that shall have been developed. The elderly alcohol abusers will be protected from the socio-economic and health problems they have been facing after taking Alcohol. Their families will be liberated from the questions they have to face after their loved ones have taken Alcohol. Society will be released from the problems caused by elderly alcohol abusers. The government expenditure on health will also be reduced.

The AimAim of the review

This research will specifically focus on finding the best treatment for the problem of alcohol abuse among the elderly. The study will not involve a collection of primary sources of data from the individuals who have been victims of the problem or the experts who have been trying to address the issue from various perspectives. The research will only rely on secondary sources of data in order to find a solution to this problem. The researcher believes that by the end of this research, there will be clear information on how to deal with the situation. The following are some of the specific objectives that the researcher seeks to achieve from this review.

  • To identify any conflicting information in the current literature on how to deal with the problem of alcohol abuse among the elderly.
  • To determine why these conflicts in the existing literature are arising when experts try to explain how to address the issue.
  • To identify any misconception that any of the previous researchers could have had in their study that could have led to differing opinions.
  • To identify the level of validity in different pieces of research that will be used in order to determine the reliability of their conclusions.
  • To come up with a comprehensive plan, based on the reviewed literature, on how to address the problem of alcohol abuse among the elderly.
  • To identify some of the specific roles that can be played by the society and family members of the elderly in order to help address the problem of alcohol abuse among the elderly.
  • Propose a straightforward approach that should be taken by future researchers who will be interested in advancing knowledge in this field.

Upon completion of this research, it is expected that all of the above objectives shall be achieved. This will not only help in addressing the current problem but also play a pivotal role in guiding future scholars. It will play an essential role in driving the policymakers and families caring for elderly alcoholics.

Research questions and hypothesis

Conducting research is a complex process that involves collecting relevant data, analyzing it, and drawing conclusions from the analysis. According to Fink (2010), when a researcher gets into the field to collect data, he or she will be encountered by massive sources of information, most of which may not be focusing on the research topic. Sometimes researchers would be swayed from the case to other irrelevant information that may affect the quality of data collected from the field. Research questions play an essential role in narrowly defining the data that should be collected from the area. This helps in avoiding the possibility that the researcher may get into the process of collecting irrelevant data from the field. In this study, the researcher developed the following research questions to help in guiding the process of data collection.

To what extent are the elderly affected socially and economically from their abuse of Alcohol?

This question was formulated to help in determining the social and economic harm that the elderly expose themselves when they engage in alcohol abuse. This question was developed based on the findings of Lowinson 2005, p. 56), which revealed that many adults continue to lose their lives because of the abuse of Alcohol. The following data was taken from this source.

Fatality Rates Related to Alcohol Abuse among the Elderly in U.S. 1979-1993.
Figure 1: Fatality Rates Related to Alcohol Abuse among the Elderly in U.S. 1979-1993.

This information that was taken from CDC data clearly shows a consistent rise in the rate of fatalities among the elderly in cases that is related to alcohol abuse. However, it is essential to note that this data shows the trend from 1979 to 1993. This question will help in collecting more recent data. It will assist in determining the current direction in order to determine if the relevant stakeholders are making positive progress in order to reverse this negative trend.

What are some of the health consequences of alcohol abuse among the elderly?

The literature reviewed on this topic shows that alcohol abuse among the elderly has some severe negative impacts, especially if it is not adequately controlled. Some of the researchers noted that excessive alcohol abuse might lead to some severe health consequences, the top of which is liver cirrhosis. It is essential to confirm these claims by analyzing other scholarly articles and books in order to get exact information on this topic.

How is society affected by the abuse of alcohol among the elderly?

This question focused on the effect that alcohol abuse among the elderly has on society. According to Goldberg (2010, p. 45), the elderly rely on able-bodied adults for various needs. Some of them are always too weak to undertake some chores on their own. When they engage in alcohol abuse, managing them becomes even more stressful for their family members. This scholar notes that some of them would even become violent after taking Alcohol. The table below shows the relationship between violence, drug, and Alcohol abuse among the elderly.

Relationship between violence, drug and alcohol abuse.
Figure 2: Relationship between violence, drug and alcohol abuse.

Lowinson (2005, p. 121) noted that men tend to be more violent after taking Alcohol than women, a claim that is supported by the data in the figure above. In this study, the researcher will try to confirm if this is still the case and what can be done to address the issue.

What are some of the conflicting information about the approach to be taken when addressing the problem of alcohol abuse among the elderly?

This question is fundamental because it seeks to identify conflicting information about the approach to be taken when addressing alcohol abuse among the elderly. The internet is full of information on how this issue can be addressed, and some of them are very misleading. Through this question, the researcher will be able to identify some of the common misconceptions about the issue and come up with a useful approach that can be taken to discredit some of the leading information that is available through various sources. Society will be informed about these misconceptions and the need to ignore them in order to avoid negative consequences that they may have on one’s life.

What is the best approach to addressing the problem of alcohol abuse among the elderly?

This question is closely related to the above question. After identifying the misconceptions and conflicting information that is available on how to address alcohol abuse among the elderly, the next critical stage would be to identify the right approach that can be used. This will involve a detailed justification of why the course suggested is considered superior to other existing strategies and the stakeholders who should be involved in the process.

What are some of the specific roles that should be played by different stakeholders when addressing the problem of alcohol abuse among the elderly?

This last question is related to the question above. In this section, the researcher will investigate the role of various stakeholders in addressing the problem of alcohol abuse among the elderly. It will involve identifying these stakeholders and explaining their role in the fight against this social problem.

Each of the questions above is expected to direct the researcher into looking for specific information from the sources available in order to obtain specific answers to them. Any information that does not directly respond to the above questions will be considered irrelevant. Based on the above questions, the researcher developed some research hypotheses below.

H1. The elderly alcoholics are the worst affected group by the effects of alcohol abuse.

H2. Society is socially and economically affected by the problem of alcohol abuse by the elderly.

H3. The best way of addressing the problem of alcohol abuse by the elderly should involve both medical and psychological strategies.

H4. Every member of society has an important role to play when addressing the problem of alcohol abuse among the elderly.

The researcher will use secondary sources of data in order to determine if the above hypotheses are true or not.

Review of Strategy

According to Basit (2010), conducting a review requires a proper strategy that would help to identify the right sources of data, determining the validity of the authorities, and compiling a comprehensive and reliable report based on these sources. Given that this research will purely involve data collected from secondary sources, it was essential to develop a proper strategy that would help to identify the relevant authorities of data. The search strategy will be defined from two approaches. The first approach will involve the identification of published sources of information on the topic that can be found in their print form. Using the search term, ‘Treatment of alcohol abuse among the elderly,’ the researcher will visit the school library in order to search for books, which are relevant to this topic. Some terms may be included or excluded based on the circumstances during the search. For instance, the name of a city may be included to identify some of the towns that are worst affected. The term abuse may also be excluded or substituted by another term during the search. Peer-reviewed journals will equally form an essential source of information for this topic, and they too will be taken from the school library. The researcher will also use newspapers from some of the reputable media houses in the country to help back up the information that will be available from other print sources.

The researcher will heavily rely on online sources of information when collecting data. Using online sources of data will be the second approach to managing data for this research. Some of the relevant books for this research may be readily available through online sources. Most of the journal articles that will be used in this study are expected to come from online databases. Some of the databases that are reliable enough to provide relevant journal articles for this research include JSTOR, Oxford Journals, NCBI Databases, CINAHL, AMED, EMBASE, MEDLINE, and EBSCO. These are reputable databases that have reliable peer-reviewed journals that may offer the researcher a good source of information for the research. The researcher has also developed a strategy for collecting grey literature. This will be collected from the school or public libraries by directly engaging the librarians and asking for their help in identifying such materials. The researcher will also make a direct request to some of the scholars who authored such materials within this institution.

It is essential to assess the quality of the literature before including it as part of the sources in the research. The validity of the literature will be determined using a validated checklist by analyzing the method used in concluding, the sample size used, the authority that the authors command in that field, and what other scholars say about the particular literature. The plan that will be used in the synthesis of the information from the identified studies will be defined by the objectives above. The program must lead the researcher to achieve the above goals. It means that it will start by identifying the relevant literature using the search term identified above, determining the validity of the literature, and then conducting a comprehensive review of the selected literature. Of interest will be to identify the strategies proposed by each, any conflicts, the reasons for the disputes, and the way forward in addressing the issue. Although a meta-analysis may be necessary at this stage, it would not be included in this research.

Analysis and Synthesis of Data

The research will only rely on the data collected from books, journal articles, newspapers, and other relevant online sources. The analysis of this data will involve a careful analysis of the findings of these authors, identification of any conflict of the information they present, the validity of their research process, and the ethical procedures they followed. When synthesizing the data from these sources, this research will be keen to base the conclusion on the study’s validity and reliability.

Resources required

According to Fink (2010), it is always necessary to define all resources that may be required before starting the implementation process in order to determine the feasibility of the project. It is still common for such projects to fail along the way because the project’s needs were not clearly defined. The research will need some specific resources that will need to be used in order to achieve the desired result from this project. The first resource that will be required for this research will be time to conduct the investigation. There are stages that will be involved in collecting data, and at each location, it will be essential to define the time needed to complete all the activities. This is illustrated in the Gantt chart below. Books, journal articles, and magazines found in the university library will be among other resources that will be needed in this study. Stable internet connectivity and a personal computer, most preferably a laptop, will be necessary for data collection and compilation of the report. The researcher may also need an amount of money not exceeding £450 in order to subscribe to some of the databases mentioned above and to complete some of the tasks that may require some form of payment. This will include printing and binding services once the document has been finalized. The researcher will also obtain the necessary permission from relevant authorities at different stages of this research. This is not only meant to maintain ethics in the study but also to ensure that the researcher gets appropriate guidance from the authorities whenever it may be necessary.

Work plan

It is essential to understand the work plan that will be used in this research process in order to help in defining its feasibility. The research will involve a series of activities that will be conducted in a systematic manner. The Gantt chart below shows the specific actions that will be carried out in this research process. Each of the planned activities will have a particular timeframe within which it has to be accomplished. This will help in determining the total time that will be needed to complete the project.

Timeline
Activities June (1-30) July (1-15) July (15-Aug 31) Sept (1-15) Sept (16- Oct 31) Nov (1- Dec 7)
Proposal development X
Approval of Proposal X
Collecting literatures X X
Review of literatures X X
Compiling the report X
Typing the report X X

The first activity will be proposal development. The researcher will develop a research proposal that will define all the actions that will take place in this research process. Given the nature of this research, the development of the request may take one month because it will also involve identifying all the resources that will be used in the study. Approval of the proposal is expected to be completed within 14 days, after which the researcher will start collecting the needed data. The next activity will be reviewing the literature, which will then be followed by compiling the report. Typing and proof-reading of the information will take approximately 30 days and a week long.

Ethics

According to Dening (2013, p. 54), it is essential to maintain ethics when conducting a piece of research. The research will be used by various people for different purposes. This informative report will be valuable to the policymakers in understanding some of the pertinent issues concerning alcohol abuse among the elderly. The report will identify the stakeholders and their roles in addressing alcohol abuse among the elderly. For this reason, the information presented in this document must be credible. It must be founded on factual information from authoritative sources. This will ensure that the story does not mislead people who may rely on it to take various actions. It means that the researcher will need to maintain ethics at every stage of this research. This section will critically evaluate how this research upheld ethics in various locations.

One way of maintaining ethics will be to avoid bias when collecting information. According to Goldberg (2010, p. 34), some scholars always ignore literature that seems to go contrary to their values. This is unethical behavior because it ignores the importance of such contrary opinions. In this study, the researcher was keen to analyze conflicting views in order to have a holistic view of this issue. This way, it was possible to explain where the scholars with conflicting views went wrong in coming up with their conclusion. This also helps in addressing some of the controversies that may confuse policymakers and other stakeholders.

According to Dening (2013, p. 78), it is always ethical to identify some of the weaknesses of research in order to help the users of the report to understand the extent to which they can apply to the document. There are cases where the consumers of such information require a high level of accuracy because of the consequences associated with their decision. They need to know the story of the accuracy of a report and the sources of data that led to the conclusion made in the news. In this study, most of the data will be collected from relevant literature, and other secondary sources found online. For this reason, the researcher identifies the main weakness of this report to be the fear that some information in the account may not reflect the actual events happening today. However, the researcher tried to address this problem by collecting data from current newspapers and journal articles to capture the most recent information available in online sources.

Understanding the Origin of the Problem

When examining the case of alcohol abuse among the elderly, it is essential to determine the origin of the problem in order to devise an appropriate solution. It is based on this that the work of Barrick & Connors (2002) is essential since it delves into the attitudes that lead to alcohol abuse among the elderly and how it initially comes about. Barrick & Connors explains that one of the first reasons behind alcohol abuse in the demographic being examined in this paper is connected to the concept of Alcohol acting as a coping mechanism. Senior citizens, by virtue of their advanced ages, are often subject to a variety of stressful situations that people from younger demographics are not impacted by (at least until they reach the same period) (Barrick & Connors 2002). These stressors can be categorized under the following:

Feelings of Loneliness

People of advanced ages, are often not included in the same social activities that they once were a part of when they were younger. This is in part due to health concerns, the inability to be as physically active as well as current social predilections regarding interactions with the elderly (Millard & McAuley 2008). Senior citizens often feel left out and, as a result, they turn towards Alcohol as a means of coping with the loneliness that they feel. This is often one of the most common reasons behind alcohol abuse among the elderly since, in one form or another, most elderly individuals encounter such a situation (Millard & McAuley 2008).

Death of a Spouse

Another of the reasons behind alcohol abuse can be connected to the subsequent death of a spouse. This is another common reason behind the use of alcohol as a coping mechanism since spouses of advanced ages have often developed a profound emotional connection with one another (Livingston & King 1993). Experiencing the death of their significant other, especially in cases where it is drawn out due to a debilitating illness, can often result in a considerable level of emotional turmoil, which can drive an elderly individual to use Alcohol as a means to “dull the pain” so to speak. It should be noted, though, that such behavior is understandable to a certain extent since coping with the death of a loved one, especially one that has been with you for a prolonged period of time, is a harrowing experience. However, the problem with utilizing Alcohol as a means of coping with death is that it becomes habit-forming over time (Livingston & King 1993).

Fear and Anxiety

Aside from loneliness and the death of a spouse, another of the issues that cause elderly individuals to turn to alcohol as a coping mechanism are feelings of fear and Anxiety. Simply put, the elderly are often subject to a variety of treatments, medications, and life-sustaining procedures that places a considerable level of stress on their mind. This is due to the fear of their impending death as well as the Anxiety that develops as a direct result of such thoughts. The end result is that they turn towards the use of alcohol as a means of “deadening” the fear and apprehension that they are dealing with.

Aside from the use of alcohol as a coping mechanism, other factors that cause the elderly to turn towards alcohol abuse consist of the following:

Long term habits

while not necessarily applicable to all elderly individuals, there are some that have been prolific drinkers for decades. These ingrained habits result in alcohol abuse later on in life as they succumb to alcoholism. The inherent problem when it comes to dealing with Alcohol as a lifelong habit is that drinking has become such an ingrained aspect of their lives that treatment for alcohol abuse among such individuals is often challenging given the decades in which their system has grown dependent on Alcohol. It should also be noted that despite various means of treatment, ranging from interventions, support groups, psychological counseling, etc., the success rate has been relatively low for elderly individuals that have such an ingrained habit.

One of the reasons behind this can be seen in the work of Livingston & King, which explained that while standard methods of alcohol intervention can have a modicum level of success on younger individuals, elderly alcohol abusers have a sense of “finality” in that they believe that since they are going to die anyway, then it would be acceptable to imbibe Alcohol in the manner in which they choose since they have already lived a long and fulfilling life. Of course, the inherent problem with this way of thinking is that it causes havoc on their health and can react negatively with the various prescription drugs that they already take, resulting in them dying several years or even a decade earlier than they should due to kidney problems and damage to their liver.

Admitting that they have a problem

Through the work of Blondell (1999), it was seen that the elderly are less likely to seek professional help early on, which makes the problems associated with alcohol abuse even worse. Blondel explains that the social stigma associated with alcohol abuse is just as prevalent among elderly communities as it is in younger ones. As a result, people are often reluctant to admit that they have a problem and seek professional help. It should also be noted that Cummings, Bride & Rawlins-Shaw (2006) discovered that the elderly develop their own biases regarding their “problem,” which is similar to that of many alcoholics. This bias effectively creates the idea that their problem “is not so bad” and that it is relatively minor as compared to the assortment of issues that they have to deal with (i.e., the death of a friend, the expense of medications, their impending death, etc.) (Alcohol abuse hidden among elderly population 2001).

When taking all the factors that have been mentioned into consideration, it can be seen that there are a plethora of reasons that can cause an elderly individual to develop an alcohol abuse problem. As such, it is only by addressing the root causes in the following section that they can truly be resolved in the long term.

Addressing the Issue

After going over everything that has been stated so far, the following strategies have been devised to address the issue of alcohol abuse among the elderly. Do note that in no way does this encompass all possible methods of addressing the problem; instead, it focuses on those most pertinent in resolving the issue based on origins that have been stated in this paper.

How to address Alcohol as a Coping Mechanism

The inherent issue with Alcohol as a coping mechanism is that it does not address the underlying psychological turmoil that comes about through feelings of loneliness, the death of a spouse, or the fear and Anxiety that the elderly feel at times. From an individual perspective, Alcohol can be compared to placing a band-aid over a deep puncture wound. On the surface, everything may seem fair; however, it does not address the underlying problem and, in effect, makes it worse over time. It is based on this perspective that Caputo, Vignoli, Leggio, Addolorato, Zoli & Bernardi (2012) state that psychological counseling in the form of one on one therapy, group therapy, or merely having an outlet for the problems an elderly person faces on a daily basis can do wonders in resolving the need for Alcohol to cope with the problems they encounter. Psychological counseling, as explained by Krach (1998), involves addressing the underlying problem by bringing it to the surface. All too often, people bury their concerns and state that they can take care of it alone.

The problem with such a strategy is that this actually causes their inner turmoil to increase and often brings about a state of depression. To address such an issue, it is advisable to transition an elderly subject into a state where they are willing to talk about their problems and from there help them to realize that Alcohol is not the best method that they can use in order to cope with the issues that they feel they are going through. This can be achieved by placing the individual in question into a comfortable setting where it is emphasized that sharing their life, their problems, and their fears will not be met with ridicule or contempt. Such a strategy can often be done through the use of support groups in elderly communities or through the placement of an in-house therapist within a nursing home in order to talk to the patients through a schedule of meetings (McInnes & Powell 1994). What is essential, as indicated by Saunders, Copeland, Dewey, Davidson, McWilliam, Sharma, Sullivan & Voruganti (1989), is that a sense of normalcy and regularity is implemented into their daily schedule through these counseling sessions.

Trevisan (2014) delves deeper into this by explaining that “going through the motions” so to speak of having a scheduled existence that also has the benefit of addressing their underlying fear, Anxiety, and depression would do wonders in terms of removing the root causes of their alcohol abuse problems. Put merely, Trevisan states that the addition of emotional turmoil via the root causes of alcohol abuse creates an unscheduled existence that actually enticed further disruptive behavior (i.e., depression), which results in even more alcohol abuse. It is only when people are correctly “grounded,” so to speak that they are able to get their emotional and psychological state in order to the extent that they no longer need to depend on Alcohol as a means of coping with their problems. This particular approach is actually useful in addressing the other issue with alcohol abuse wherein the elderly do not want to admit that they even have a problem when it comes to their alcohol consumption (Onen, Onen, Mangeon, Abidi, Courpron & Schmidt 2005). An open and accepting environment often lets people become more introspective and, as such, helps them to come to an understanding regarding what they are doing to themselves. Do note that the aforementioned strategy is not as effective when it comes to alcohol abusers that have been drinking heavily for decades since it has become more of an ingrained habit for them rather than a coping mechanism for something that they are only recently experiencing.

List of References

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Basit, T 2010, Conducting research in educational contexts, Continuum International Publishing Group, New York.

Blondell, RD 1999, ‘Alcohol Abuse and Self-Neglect in the Elderly’, Journal Of Elder Abuse & Neglect, vol. 11, no. 2, p. 55.

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Cummings, S, Bride, B, & Rawlins-Shaw, 2006, ‘Alcohol Abuse Treatment for Older Adults: A Review of Recent Empirical Research’, Journal Of Evidence-Based Social Work, vol. 3, no. 1, pp. 79-99.

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Ham, R 2007, Primary care geriatrics: A case-based approach, Mosby Elsevier, Philadelphia.

Krach, P 1998, ‘Myths & Facts…About alcohol abuse in the elderly’, Nursing, vol. 28, no. 2, p. 25.

Livingston, G, & King, M 1993, ‘Alcohol abuse in an inner-city elderly population: The Gospel Oak survey’, International Journal Of Geriatric Psychiatry, vol. 8, no. 6, pp. 511-514.

Lowinson, J 2005, Substance abuse: A comprehensive textbook, Lippincott Williams & Wilkins, Philadelphia.

Marshall, R 2000, Alcoholism: Genetic culpability or social irresponsibility: the challenge of innovative methods to determine final outcomes, University Press of America, Lanham.

McInnes, E, & Powell, J 1994, ‘Drug and alcohol referrals: are elderly substance abuse diagnoses and referrals being missed?’, BMJ: British Medical Journal (International Edition), vol. 308, no. 6926, p. 444.

Millard, A, & McAuley, 2008, ‘Alcohol and the Over 65s: Service Gaps Seen From Home Care in Scotland’, Journal Of Social Work Practice In The Addictions, vol. 8, no. 3, pp. 417-420.

One, S, Onen, F, Mangion, J, Abidi, H, Courpron, P, & Schmidt, J 2005, ‘Alcohol abuse and dependence in elderly emergency department patients’, Archives Of Gerontology & Geriatrics, vol. 41, no. 2, pp. 191-200.

Saunders, P, Copeland, J, Dewey, M, Davidson, I, McWilliam, C, Sharma, V, Sullivan, C, & Voruganti, L 1989, ‘Alcohol use and abuse in the elderly: Findings from the Liverpool longitudinal study of continuing health in the community’, International Journal Of Geriatric Psychiatry, vol. 4, no. 2, pp. 103-108.

Trevisan, LA 2014, ‘Elderly Alcohol Use Disorders: Epidemiology, Screening, and Assessment Issues’, Psychiatric Times, vol. 31, no. 5, pp. 1-4.

Yoshida, R 2006, Trends in alcohol abuse and alcoholism research, Nova Science Publishers, Hauppauge.

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