Altgewordene Suchtkranke

Abstract

During the past 20 years substance-related and addictive disorders in old age have markedly increased and this increase is going to continue. It is quite common to make a distinction between early onset (EO) and late onset (LO) of these disorders. EO-addicts are in a more disadvantageous position due to constitutional and psychosocial burdens and the cumulating harmful medical, mental and social consequences of addiction place them at a further disadvantage during the course of the disorder. In old age they are at a disadvantage compared to others of the same age with LO addiction problems because of more and more severe chronic medical conditions, psychiatric comorbidity, less personal and social resources, dysfunctional coping style, and social problems. They present with lower treatment adherence and the treatment is difficult due to the combination of typical addictive behavior, psychiatric comorbidity, somatic diseases and in many cases also cognitive impairment. Treatment goals must be mostly individually defined and abstinence is rarely a realistic goal. Even the treatment has to be carried out mostly individually and often unconventionally. This article gives a review of the characteristic features of the course, presentation and adverse consequences of addictive disorders in EO addicts who have reached old age. The article covers alcohol, prescription drugs, illicit drugs and smoking as well as behavioral addictions.

Aging in nucleus accumbens and its impact on alcohol use disorders

“…These results are consistent with the decrease in NMDARs expression in the nAc reported in previous studies ( Nicolle, Bizon, & Gallagher, 1996 ; Ossowska et al, 2001 ). Since long-term synaptic plasticity is believed to be a major mechanism for learning and memory and addictive behaviors in the nAc ( Fusi, Drew, & Abbott, 2005 ; Kandel, 2001 ; Kauer & Malenka, 2007 ), LTD reduction in accumbal MSNs could play a key factor in the alteration of cognitive functions, motor functions, and addictive behaviors seen during aging ( Menecier & Fernandez, 2012 ; Wolter, 2018 ).…”

Presencia de factores de riesgo de maltrato en ancianos asistidos en extrahospitalaria en Segovia

“…Rosa María Cárdaba García e Inés Cárdaba García Presencia de factores de riesgo de maltrato en ancianos asistidos en extrahospitalaria en Segovia Tabla 1. Tabla cruzada de factores de riesgo principales y edad frecuencia de aparición en la muestra, pero en los casos en los que se presenta, ponderan muy alto 30 . Es interesante deestacar que la demora en solicitar ayuda es alta, son muchos los hiperfrecuentadores, y algunos están malnutridos y se caen de forma repetida.…”

Alterspsychiatrie ist Teil ganzheitlicher Altersmedizin, kein Teilbereich der Psychiatrie – Kontra

“…So werden altgewordenen Patienten mit Schizophrenien häufiger somatisch komorbid erkrankt sein und die Wirksamkeit langjährig etablierter psychopharmakologischer Therapiestrategien wird beim individuellen Patienten variabler sein; psychosoziale Belange werden in anderen Konstellationen bedeutsam werden und das Hilfesystem zur Teilhabe wird auf ältere Menschen erweitert und angepasst werden müssen [9]. Spezifische Behandlungsformen für langjährig Abhängigkeitserkrankte werden sich von Angeboten für im Alter erstmals an einer Abhängigkeit Erkrankten unterscheiden und differenziell implementiert und erprobt werden müssen [10]. Eine Psychiatrie der Suchterkrankungen, die die somatischen Krankheitsfolgen im Alter nicht im Blick hat, riskiert…”