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We sit down with Michael Pessman, a gerontologist, to discuss the unique risks older adults face with alcohol consumption. We’ll explore the enhanced physical and mental health benefits of participating in Dry January, as well as the challenges of adopting new habits later in life. Join us as we dive deep into the importance of inclusive messaging in campaigns like Dry January and how we can support older adults in embracing a healthier lifestyle. We’ll provide insights on promoting sobriety across generations and fostering a sense of community for all ages.

Michael Pessman is a gerontologist.

He discusses the KevinMD article, “Dry January’s untold value for older adults: a health revolution beyond youth.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Michael Pessman. He’s a gerontologist. Today’s KevinMD article is “Dry January’s untold value for older adults: a health revolution beyond youth.” Michael, welcome back to the show.

Michael Pessman: Thank you, Kevin. It’s a pleasure to be here.

Kevin Pho: So Michael’s been on in the past. Go to KevinMD.com/podcast to search for his prior episode and hear his story. But today let’s get right into his most recent KevinMD article, “Dry January’s untold value for older adults.” Michael, what’s this article about?

Michael Pessman: Sure, happy to dive into this. Thank you for the platform, Kevin.

There’s a lot of buzz, as you may have known, about dry January and younger folks. Many, many articles from December to January promoting this idea, kind of a break, taking time off from alcohol just to see how the body reacts. There is not that much, virtually none, targeted towards older adults partaking in what I see could be a life-changing experience.

And a lot of the research suggests that people live longer as they age if they avoid alcohol, or at least decrease sort of their consumption, what they’re used to taking. So it just prompted me as a gerontologist to write about this topic.

Kevin Pho: So tell us some of the unique risks that older adults face in relation to alcohol consumption.

Michael Pessman: Sure. Well, it’s important to note that there’s 58 million older adults over the age of 65 living in the U.S., so it’s 17.3 percent of our population here in America. So it’s a large number of people.

And in the article I talk about how 39 percent of that 58 million, which is 22 million, drink one or two drinks a day. So it’s a large number. 80 percent of people over the age of 65, which we’re talking 46 million, have taken medication in the last year that may interact dangerously with alcohol. So that’s a concern.

As a gerontologist, I want to see people age well, live well, get happier as they get older, not have problems. And so to have a voice to kind of point this out, this is what the research backs it up, so it’s quite disparaging. And I think it’s really important that all older people at least consider, I don’t advocate sobriety 100 percent, but just taking a break to see how your body reacts to that, and maybe it could be beneficial.

Kevin Pho: So in the exam room or a clinic, what are some typical questions a clinician can ask to potentially uncover an issue with alcohol in an older adult?

Michael Pessman: Very good question, Kevin. I think paying attention to sleep patterns, kind of asking how that older person has been sleeping.

The two biggest factors that younger people report as a benefit of stopping drinking alcohol is, number one, they save money, number two, they sleep better. So I’m thinking that would carry over to older adults. For some reason, even though alcohol is a depressant, people have a lot of trouble sleeping. So I think I would start there, and because it’s not compassionate to ask if people drink, but starting the conversation about sleep kind of can guide you down that way.

And just asking, some people might think three or four drinks a day is not a big deal for someone who’s age 80, but it actually can be. So paying attention to clues, that sort of thing.

Kevin Pho: So tell us a success story where an older adult stopped drinking in January. How did that affect their well-being, and did some of those benefits carry past January?

Michael Pessman: That’s a very good question. I appreciate that. Yes, and during my research on the article I actually visited a local AA group that caters to older adults. So I got to talk firsthand. I didn’t quote them in my article, but I got to speak directly to people that have benefited.

I talked to a gentleman who lost his wife and loved his wife, were married for 65 years, and alcohol was never a problem. And then when his wife died it became a problem, because he did not want to talk about the pain, he wanted to just treat the pain with alcohol. And he found his way to a 12 step and is now living sober. I believe he has a year and a half, if I’m not mistaken. But he had read about the dry January movement. It is in the news quite a bit, just not pertaining to older people. And there was a lady too that had lost her mother and was drinking because of that.

So it can get out of hand, and the stories I hear in sobriety are amazing. People have changed their lives entirely, and they’re happy.

There’s a big push, as you might have known, our surgeon general talks about loneliness, not just in older people but all ages actually. But in older people, loneliness can kill. It can result in a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, actually premature death.

So drinking actually increases loneliness, because people don’t get out around their friends in this demographic. It may be different if they’re younger. I feel people drink in bars in the younger demographic. And even in the group that I attended, the AA group, people drank at home, they reported they were not out socially. So they had a certain amount of shame because of the problem they had. So talking about that, particularly a clinician being sensitive to that, because it may be very shameful for the older patient that they may be dealing with.

Kevin Pho: And specific to the dry January movement, is there a social component to that one as well?

Michael Pessman: Not in this. People reported drinking mostly at home, and because it’s not a widely discussed topic among older people.

With younger people, I feel that there’s a lot of people doing it. I have a lot of younger friends that are talking about that while we were in January, and I feel that support can be very important. And there’s just not that same support in the older generations as there is in the younger. So I do advocate for a call to more inclusive messaging, that not just targeting younger people, but making it more inclusive to include older adults.

Kevin Pho: Michael, talk about the challenges that older adults face when changing what I assume to be lifelong habits with alcohol. What are the challenges they face, and how can they navigate some of these sometimes lifelong habits?

Michael Pessman: Sure, very good question. I think that first, just recognizing that one or two drinks a day for someone over age 65 is a problem, and recognizing that first, and asking for help. Maybe asking, or at least mentioning this to a son or a daughter or a child or close friends, seeing what other people think, and asking for help. Asking maybe for cognitive therapy, visit a therapist.

In the case where I visited the 12 step, it was a very robust meeting. There were a lot of people over the age of 65, I was amazed, and they found a sense of community in that. But I think just first recognizing, and being able to ask for help, knowing where to go. Maybe a trusted servant at a church that they attend, someone religious can help guide. A lot of these meetings, I’ve come to find out, are at a church. I didn’t know that until I started researching this.

Kevin Pho: I’m a primary care physician, as you know, and I see a lot of older adults in my clinic. And if there was a patient whom I suspected that alcohol may be an issue, what are some resources or first steps that you would recommend for me to offer that patient?

Michael Pessman: Very good question. I think having a frank conversation, approaching it from a wellness hat, so to speak, just asking as a matter of fact how much alcohol a person consumes on a weekly basis. Just asking those questions, being very polite, considerate. I think that’s a very good starting point.

And you may be surprised, people are willing to answer that question. They may not think that one or two drinks, or three or four drinks a day, is a problem. And hearing that from a physician, someone who’s in authority, that might be a life-changing, life-altering moment for them.

So having that courage, Kevin. I feel like a lot of times doctors don’t have, they’re very busy people, and sometimes these conversations can’t be had just because there’s so much going on with their health, mainly. So I appreciate that question.

Kevin Pho: So if I have a patient in front of me who admits to drinking three to four times per day and is open to help with that issue, what are some first resources that I can give them?

Michael Pessman: I think their local AA phone number. Here in Chicago I Googled, AA is headquartered on a famous street downtown, and I called there to get a list of meetings that were in my zip code that I could walk to. It’s a great resource, and I know, talking with them, they don’t just deal with just alcoholism but also other narcotics. So it’s kind of a wide casting net.

They’re very helpful, very compassionate. I was a first-time caller, they made me feel at ease. I know I live in an urban area and a lot of older adults may not, but I do feel that this particular organization does have different offices and they’re very willing to help, and they are manned Monday through Friday. They have a hotline that they talk to people. So I would say that’s a very first good recommendation.

Also, to get a therapist, to have encouraged that person to see a therapist, because they can offer possibly next level. I think that in talking to the people that I spoke with, I went to two different meetings, they all really raved about their therapists in conjunction to these meetings and the support they get there.

Kevin Pho: We’re talking to Michael Pessman. He’s a gerontologist, and today’s KevinMD article is “Dry January’s untold value for older adults: a health revolution beyond youth.” Michael, as always, we’ll end with your take-home messages to the KevinMD audience.

Michael Pessman: OK. I appreciate your time. And I just advocate for asking those questions, having those challenging conversations, and listening to clues. And as I mentioned, lack of sleep can be a very big indicator that there’s alcohol use going on in someone older.

Kevin Pho: Michael, thanks again for sharing your perspective and insight, and thanks again for coming back on the show.

Michael Pessman: My pleasure. Have a good day.