Problem Drinking Growing Among Seniors

Sep 22 2017

Problem Drinking Growing Among Seniors

Older Americans represent the fastest-growing group of problem drinkers, according to a new study from researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The study, published in JAMA Psychiatry, compared data from a national survey taken in 2001 and 2002 and again in 2012 and 2013, covering about 40,000 adults. Drinking had increased in every age group, the researchers found.

The rate of alcohol use disorders (AUD) among the study population was up 49.4 percent, from 8.5 percent in 2001/2002, to 12.7 a decade later. Among women, AUDs increased 83.7 percent, 92.8 percent among African Americans, 81.5 percent among those age 45 to 64, and 106.7 percent among those 65 and older.

About 55 percent of those over 65 reported they had drunk alcohol within the previous year – a 22 percent increase, the largest increase of any age group. And, the proportion of seniors engaged in “high-risk drinking,” was up 65 percent over the earlier period, to 3.8 percent of respondents.

The researchers define problem drinking as: for a man, consuming five or more drinks per day (each containing 14 grams of alcohol) at least weekly during the past year; and, for a woman, four drinks in a day.

The researchers also reported that alcohol use disorders (aka alcoholism), as defined in the psychiatric Diagnostic and Statistical Manual, more than doubled in a decade, to more than 3 percent of senior citizens.

“The trajectory over time is remarkable,” Dr. Marc Schuckit, a psychiatrist and addiction specialist at the University of California, San Diego, told the New York Times. “You have to say there’s something going on.”

The study’s lead author, NIAAA epidemiologist Bridget Grant, says the continuing growth of the over-65 population “portends problems down the road,” even if the rate of problem drinking doesn’t increase.

The investigators didn’t look into possible causes for the increase among older Americans, but Grant said anxiety over job loss and other economic changes following the last recession could be one reason. Also, improved health later in life means people are less likely to reduce their consumption in their 60s and early 70s.

In an editorial he wrote to accompany the study, Shuckit pointed out that two drinks a night, considered normal consumption for a 40-year old, has more effect on a 70-year old. Older people’s blood alcohol level increases more quickly than a younger drinker’s; aging livers metabolize alcohol more slowly, and seniors’ brains are more susceptible to alcohol’s effects.

Alcohol can exacerbate a number of common chronic diseases among seniors, including hypertension, diabetes and heart disease. Alcohol increases the risk of stroke, and several types of cancer. Alcohol can also interfere with and reduce the effectiveness of many prescription medications.

The health effects of heavier drinking may already be showing up, Grant says. Emergency room visits for alcohol-related falls have increased. Deaths from cirrhosis of the liver have grown for the first time since the 1960s, she says.

Grant would like to see more efforts made to educate older Americans about the potential harm caused by excessive drinking.

Along with seniors, the national survey also identified “substantial” increases in alcohol consumption among several other groups: women, racial/ethnic minorities, and the socioeconomically disadvantaged.

Heavier drinking among those groups “constitutes a public health crisis and portends increases in chronic disease co-morbidities in the United States,” the researchers wrote.