A global study has found that older people in wealthy countries consume more alcohol than their counterparts in middle-income countries, on average – although a higher cost of alcohol is associated with less frequent drinking – reports Columbia University. Across counties, people drink less as they get older, but at different rates and starting points.
The findings of the study, led by researchers at the Columbia University Mailman School of Public Health and the Robert N Butler Columbia Aging Center , appeared in the journal Addiction last week.
Alcohol consumption among older adults is trending higher across numerous countries, and alcohol use disorders among adults of 65 and older have more than doubled in the last 10 years, says the Columbia University material published on 1 December 2020.
Moreover, there are signs that alcohol consumption is further increasing during the pandemic. Age-related changes that slow metabolism and increase the odds of medication interactions make alcohol consumption likely more harmful among older than younger adults.
The researchers analysed survey data collected from 100,000 individuals age 50 and older in 17 countries in Europe, as well as China, Mexico, Israel, South Korea and the United States.
Average weekly alcohol consumption ranged from 0.59 units in Mexico to 6.85 units in the Netherlands. In the United States, older adults consumed 2.07 standard units per week. One standard unit is equivalent to a small shot glass of vodka or a 12 ounce glass of 5% beer.
The price of alcohol – measured by the cost of a bottle of red label Smirnoff vodka – varied from a low of $7.92 in Mexico to a high $38.06 in Ireland.
In most countries drinking decreased with age (US, China, Chile), but some countries had sharper age-related decreases (England, Ireland, Czech Republic) and others were fairly stable and had brief increases in drinking after age 50 (Denmark, France).
This variation across age and countries is explained both by the health and socio-economic status of older adults living in each country and country-level factors like economic development and alcohol prices.
Heavy drinking among older adults was highest in the Czech Republic and lowest in Israel, with levels of heavy drinking in most countries declining by age or slightly increasing then declining by older ages. Economic development and the cost of alcohol did not influence levels of heavy drinking, which may be driven by factors such as gender and cultural norms.
Heavy drinking is defined for men as having more than three drinks per day or binging more than five drinks in a single occasion, and for women as having more than two drinks per day or binging more than four drinks in a single occasion.
“Public concern over drinking largely focuses on young people, but alcohol is also a serious threat to the health of older adults. In fact, the majority of alcohol-related deaths occur among older people,” says first author Esteban Calvo, assistant professor of epidemiology in the Robert N Butler Columbia Aging Center.
“While some studies purport to show a benefit to drinking in old age, these findings are likely distorted by the fact that older drinkers tend to remain drinking if they are healthy, while recent abstainers (as opposed to lifetime abstainers) may only quit when they are sick.”
“As countries develop economically and older people living there can afford to drink more, these countries should consider policies to regulate alcohol consumption, potentially combining minimum alcohol prices, taxation, sale and marketing regulations, and cessation programmes,” adds senior author Katherine M Keyes, associate professor of epidemiology at Columbia Mailman School.
Cross‐country differences in age trends in alcohol consumption among older adults: a cross‐sectional study of individuals aged 50 years and older in 22 countries
Addiction. Published on 25 November 2020
Authors
Esteban Calvo, Kasim Alle, Ursula M Staudinger, Alvaro Castillo-Carniglia, José T. Medina and Katherine M Keyes
Abstract
Age‐related changes in physiological, metabolic and medication profiles make alcohol consumption likely to be more harmful among older than younger adults.
This study aimed to estimate cross‐national variation in the quantity and patterns of drinking throughout older age, and to investigate country‐level variables explaining cross‐national variation in consumption for individuals aged 50 years and older.
Design and setting
Cross‐sectional observational study using previously harmonized survey data. Twenty‐two countries surveyed in 2010 or the closest available year.
Participants
A total of 106,180 adults aged 50 years and over.
Measurements
Cross‐national variation in age trends were estimated for two outcomes: weekly number of standard drink units (SDUs) and patterns of alcohol consumption (never, ever, occasional, moderate and heavy drinking). Human Development Index and average prices of vodka were used as country‐level variables moderating age‐related declines in drinking.
Findings
Alcohol consumption was negatively associated with age (risk ratio = 0.98; 95% confidence interval = 0.97, 0.99; P‐value < 0.001), but there was substantial cross‐country variation in the age‐related differences in alcohol consumption [likelihood ratio (LR) test P‐value < 0.001], even after adjusting for the composition of populations.
Countries’ development level and alcohol prices explained 31% of cross‐country variability in SDUs (LR test P‐value < 0.001) but did not explain cross‐country variability in the prevalence of heavy drinkers.
Conclusions
Use and harmful use of alcohol among older adults appears to vary widely across age and countries. This variation can be partly explained both by the country‐specific composition of populations and country‐level contextual factors such as development level and alcohol prices.
[link url="https://www.publichealth.columbia.edu/public-health-now/news/older-adults-wealthier-countries-drink-more-alcohol"]Columbia University material – Older adults in wealthier countries drink more alcohol[/link]
[link url="https://onlinelibrary.wiley.com/doi/10.1111/add.15292"]Article in the journal Addiction: Cross‐country differences in age trends in alcohol consumption among older adults: a cross‐sectional study of individuals aged 50 years and older in 22 countries[/link]