Barbara Resnick, PhD, CRNP, FAAN, FAANP

Disclosures

Topics in Advanced Practice Nursing eJournal. 2001;1(1) 

In This Article

Alcohol, Smoking, and Diet

Regular alcohol use, at least 1 ounce of alcohol daily, is not uncommon in older adults, particularly those in continuing care retirement communities.[17,54] Moderate alcohol use has been reported to have a protective effect on heart disease, increase high-density lipoprotein cholesterol,[55,56] decrease platelet aggregation,[57] and offer social activities to older adults.[54] The reported cardiovascular risk reduction was especially true for adults above the age of 50 years.[58]

While identification of alcohol abuse and the associated risk of drug-drug interactions, falls, and fractures with alcohol intake are important to consider when caring for older adults,[59,60] the positive benefits of moderate alcohol use must also be recognized. Healthcare providers should discuss the pros and cons of alcohol use with older patients and help them decide whether to consume alcohol and/or how much to consume.

The prevalence of smoking in the old-old age group is generally less than what is commonly reported in all adults.[17,61] However, older adults who smoke and have survived into their 90s may not see the advantage of smoking cessation. Therefore, counseling to reduce nicotine use to a minimum may be more important than working toward complete cessation of smoking in this group. Reduced nicotine intake can have positive health benefits such as decreased peripheral vascular disease.[62]

While the long-term benefits of strict adherence to dietary guidelines for older adults are unclear, these individuals should be encouraged to eat a well-balanced diet and maintain their body weight within 10% of their age-adjusted normal weight.[63] In particular, older adults should optimize their intake of fiber, calcium, and vitamin D. Ideally, these individuals should try to eat 24 grams of fiber and take 1500 mg of calcium and 800 IU of vitamin D daily.

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