Alcoholism is one of the diagnosable forms of alcohol use disorder, a condition that includes both dysfunction associated with a physical dependence on alcohol and dysfunction associated with a non-dependent pattern of drinking. Some people develop alcoholism-related symptoms at a relatively early age, while others develop them in middle age or later in life. In a study published in April 2014 in the journal European Addiction Research, researchers from three Dutch institutions explored the role that age at alcoholism onset has on the negative mental, physical and social outcomes associated with dysfunctional alcohol dependence.
People with alcoholism have long-term changes in brain function that make them reliant on alcohol to feel “normal,” as well accompanying physical and behavioral symptoms that signal an orientation toward a damaging and debilitating lifestyle centered on acquiring alcohol, consuming alcohol and recovering from the short-term effects of excessive alcohol intake. Previous generations of addiction and mental health specialists viewed the problems associated with alcoholism as distinct from the problems experienced by alcohol abusers who experience serious issues not triggered by physical alcohol dependence. However, experts in the field now know that alcoholism and alcohol abuse are deeply intertwined conditions that rarely exclude each other. The American Psychiatric Association created the alcohol use disorder diagnosis in 2013 in order to give doctors a tool for simultaneously diagnosing the presence of alcohol abuse and alcoholism in their patients.
Early Onset vs. Late Onset
Some people develop symptoms of alcoholism relatively early in life, while others develop symptoms relatively late in life. Broadly speaking, alcoholism that appears earlier in an individual’s life is known as early-onset alcoholism. Typically, people affected by this form of the condition have some sort of genetic or biological susceptibility that makes them unusually vulnerable to the addiction-producing changes associated with repeated drinking. Alcoholism that appears later in life is generally known as late-onset alcoholism. As a rule, people affected by this form of the condition don’t have an inborn predisposition toward alcohol-related problems; instead, as they grow older, they encounter situations in their local physical or mental environments that encourage or support an ongoing pattern of excessive alcohol intake. Addiction specialists and other health professionals usually take the age of alcoholism onset into account when determining the best options for treating the condition in any affected person.
Impact of Age at Onset
In the study published in European Addiction Research, the Dutch researchers examined the impact of age at alcoholism onset on the long-term health outcomes of older adults with the condition. Information for this examination came from a group of 157 adults with an average age of 63 receiving inpatient treatment for alcoholism. Some of these adults had developed alcoholism before reaching age 25, while others had developed the condition at some point during the following two decades of their lives. A third group of adults enrolled in the study only developed alcoholism at some point after reaching age 45. Respectively, the researchers characterized the development of alcoholism during these three spans of time as “early onset,” “late onset” and “very late onset.” They used a modified form of a U.S.-developed tool called the Addiction Severity Index to identify the extent of the negative alcohol-related outcomes for each of these age-related subgroups.
After comparing the Addiction Severity Index results of the three subgroups of study participants, the researchers concluded that the negative physical, mental and social consequences of alcoholism are both significant and largely the same for all older adults, regardless of when they first developed alcoholism-related symptoms. However, they also concluded that, compared to elderly late-onset alcoholics, elderly early-onset alcoholics have a larger number of chronic physical illnesses, as well as a heightened tendency for suicidal thinking. In addition, the researchers concluded that elderly very-late-onset alcoholics experience negative outcomes that basically resemble those found in their counterparts who developed alcoholism at a younger age.
Significance and Considerations
The authors of the study published in European Addiction Research note that a number of prior researchers had concluded that people affected by very-late-onset alcoholism have lower overall physical, mental and social risks than people who develop the condition earlier in life. They believe that their current findings do not support these previously registered conclusions. In line with the results of their own work, they recommend that doctors continue to carefully evaluate and treat all individuals affected by alcoholism, regardless of the stage in life during which the condition first appears.