Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 468

Alcohol abuse is common, with 18% lifetime prevalence in all ages, including the geriatric population. Not many studies are done on the prevalence of alcohol use disorder in the geriatric population. In a New York community, 6% of people over age 60 had more than two drinks daily.²⁰ 30% of older hospitalized patients on a medical ward and 50% of those on a psychiatry unit had alcohol use disorder.²¹ A standard drink is 14 g of alcohol; about 1% of people drinking 30–60 g/day will develop alcoholic cirrhosis, and 6% of those drinking 120 g daily will develop cirrhosis.²²

Alcoholic liver disease includes steatosis or increased liver fat, alcoholic hepatitis, and cirrhosis. Alcoholic hepatitis is an acute liver decompensation in long‐term alcoholics that is sometimes reversible but often fatal. Alcoholic cirrhosis is fibrosis and destruction of the liver as a consequence of alcohol consumption. Alcoholic liver disease should be suspected when the AST is twice the ALT (patients often lie about alcohol consumption). Of the 31,000 deaths in the US yearly from cirrhosis, 48% are caused by alcohol.^23,24 The treatment of alcoholic liver disease must include abstinence from alcohol; often, multiple methods must be used, including counselling, medications (naltrexone, baclofen, acamprosate, and others), and joining recovery groups such as Alcoholics Anonymous.