The Effects of Alcohol Use on Geriatric Patients With Gad

Cristina Ivan, Amber B. Amspoker, Michael R. Nadorff et al. (2014), "Alcohol Use, Anxiety, and Insomnia in Older Adults with Generalized Anxiety Disorder," American Journal of Geriatric Psychiatry, 22(9), 875-883

The purpose of this randomized controlled trial was to analyze alcohol consumption rates among older primary care patients who suffered from generalized anxiety disorder (GAD) and the link between these consumption rates and various demographic factors, as well as worry, insomnia, and anxiety to determine the moderating effects of alcohol consumption on the relationship between anxiety and insomnia. The researchers posited that increased levels of alcohol consumption would correspond to higher levels of insomnia and anxiety and exacerbate the anxiety-insomnia relationship.

Method.

Participants. A total of 223 60-year-or-older English-speaking subjects with GAD drawn from civilian and Department of Veterans Affairs geriatric centers participated in this study; the study is silent concerning the numbers of male and female subjects.

Instruments. The following instruments were also used in this study: (a) the Primary Care Evaluation of Mental Disorders tool, (b) the six-item Screener 21 and the full Structured Clinical Interview for DSM-IV Disorders (SCID), (c) the Insomnia Severity Index, (d) the Penn State Worry Questionnaire - Abbreviated, (e) Generalized Anxiety Disorder Severity Scale, and (f) the State-Trait Anxiety Inventory - Trait subscale, Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A).

What materials were used? The researchers evaluated alcohol usage of the participants for the previous month using general questions based on past studies of alcohol use among older adults and a specific question concerning whether the participants had consumed any alcohol in the past month and what average amount was consumed on a weekly basis. For the purposes of this study, the researchers defined alcohol usage levels in accord with previous studies as follows: (a) ?7 drinks per week = moderate drinking, (b) 8-14 drinks per week = at-risk drinking; and >14 drinks per week = heavy drinking.

Procedures. Participants were consented in person and telephonic interviews were used for baseline measures, and a random sample of taped recording of these interviews was used to estimate inter-rater agreement levels. Frequency and correlation analyses were conducted on these baseline data to identify relationships between the variables described above.

C. Results.

In line with previous studies of geriatric populations, a majority of the participants reported some alcohol use, and older adults with GAD tend to consume more alcohol than their non-afflicted counterparts. Nevertheless, older adults with GAD who limit their alcohol consumption rates to moderate or below do not experience difficulties with sleep. In fact, the researchers emphasize that, "A modest amount of alcohol may minimize the association between anxiety/worry and insomnia among this group" (Ivan et al., 2014, p. 876). When alcohol is specifically used as a sedative, though, older adults suffering from GAD may experience fragmented and non-restorative sleep patterns.

D. Discussion and Evaluation.

When people are anxious or worried, having a drink or two is a frequent response but far too many people are unable to limit their consumption levels in this way. After a lifetime of these types of unhealthy coping mechanisms, it is not surprising that some older adults, particularly those already suffering from generalized anxiety disorder, would also experience some adverse effects from higher levels of alcohol use.

E. Attachment.

American Journal of Geriatric Psychiatry

Volume 22, Issue 9