The incidence and prevalence of alcoholism in the elderly population are tendentially underestimated. There are some reasons for this fact. The pathway to the diagnosis of alcoholism may be considerably compromised in the often comorbid or multimorbid patient. To live up to an advanced age seems to be a good argument against chronic substance abuse. Elderly people and their relatives are often still more reluctant to report about socially stigmatizing disorders. On top of that, the amount of social control is reduced after the end of employment and upon entering retirement. Yet, if alcohol-withdrawal symptoms occur, e.g., following an admission of the addicted patient to a hospital, the missed diagnosis of alcoholism means a delay of the correct interpretation of such complications and of the necessary treatment. Aged patients with reduced physical and mental reserve capacity are at special risk of developing further serious complications. Progressive, sometimes irreversible decay of the cognitive functions in long lasting delirious states or, as an aftermath of withdrawal, epileptic seizures are of particular importance.
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J Community Hosp Intern Med Perspect
November 2024
HCA Healthcare, Nashville, TN 37203, USA.
Background: Alcohol abuse leads to millions of hospital admissions each year in the United States. Alcohol withdrawal syndrome (AWS) is associated with several serious complications, including seizures, delirium tremens, and death. Benzodiazepines have been the mainstay of treatment for hospitalized patients with alcohol withdrawal.
View Article and Find Full Text PDFBJGP Open
January 2025
School of Public Health, Imperial College London, London, United Kingdom.
Background: People living with alcohol use disorder (AUD) who develop Type 2 Diabetes (T2DM) may be at higher risk of diabetes-complications.
Aim: Our aims were to compare diabetes-monitoring and incidence of diabetes-complications between people with and without AUD prior to T2DM diagnosis attending primary care in England.
Design & Setting: We used the Clinical Practice Research Datalink (CPRD) Aurum linked with Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality data.
BMJ
January 2025
Division of Addiction Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
The covid-19 pandemic was associated with an unprecedented increase in alcohol consumption and associated morbidity, including hospitalizations for alcohol withdrawal. Clinicians based in hospitals must be ready to identify, assess, risk-stratify, and treat alcohol withdrawal with evidence based interventions. In this clinically focused review, we outline the epidemiology, pathophysiology, clinical manifestations, screening, assessment, and treatment of alcohol withdrawal in the general hospital population.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Department of Medicine, California Pacific Medical Center, San Francisco, CA, USA. Electronic address:
Background: Biased language in provider documentation of marginalized patient populations has been shown to negatively influence patient management. There has been debate over the use of "homeless" as a descriptor of people experiencing homelessness (PEH), as it is a potentially biased term with negative connotations. This study explores the relationship between the use of the word "homeless" in Emergency Department (ED) provider documentation and admission rates, as well as intravenous (IV) vs.
View Article and Find Full Text PDFPsychogeriatrics
January 2025
Department of Anaesthesiology, Nanfang Hospital, Southern Medical University; Guangdong Provincial Key Laboratory of Precision Anaesthesia and Perioperative Organ Protection, Guangzhou, China.
Background: Previous studies have suggested a potential link between delirium and mitochondrial function. Consequently, this Mendelian randomisation (MR) study aimed to further investigate their causal relationship.
Methods: In this bidirectional MR study, the relationship between 73 proteins related to mitochondrial function and delirium, including delirium not induced by alcohol or other psychoactive substances (DEL) and delirium associated with alcohol withdrawal (AL-DEL).
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