How are we drinking?

There is some concern that older people in many Western countries are drinking alcohol at very high rates. Public health advice is that older people should drink fewer drinks as they age because of lowered ability to process alcohol and the use of many medications. Older people who continue to use alcohol regularly are in more danger of falls and damage to their brain and liver.

In the HWR, we used the AUDIT C scoring system to ask people about how many ‘standard drinks’ they were consuming on a regular basis. The use of this measure gives us a score for drinking at hazardous levels (compared to the whole population) and for binge drinking (5 or more drinks on one occasion). This measure is quite crude because in a postal questionnaire we cannot standardise people’s perceptions of what is a standard drink. It also relies on memory and honesty (and people tend to under-report the size and number of their drinks).

Despite these measurement problems we were surprised at the level of drinking that was reported. For example, 61% of Pakeha and 51% of Maori reported drinking at AUDIT C defined ”hazardous” levels. ‘Binge’ drinking levels were higher than those found among older adults in the USA or Brazil. Older hazardous drinkers are predominantly younger, wealthier, white, partnered males. Binge drinkers are more likely to be rural, Maori and lack tertiary education.

The HWR results suggested that our ‘baby boomers’ approaching old age are drinking more than previous generations, and their intentions to moderate this behaviour as they age are unclear. There may be a lack of awareness of health implications, as we found that those with diabetes and heart disease reported drinking at similar levels to the rest of the population. Specifically, 33% of Maori and 17% of non-Maori with diabetes, and 34% of Maori and 20% of non-Maori with heart disease, reported ‘binge’ drinking at least once a month. These somewhat alarming figures suggest that, especially for those with chronic conditions, the negative effects of alcohol are either not known or ignored.

Although we must develop more sensitive and reliable measures of alcohol use, these early findings do suggest the need to find out how and why older people in New Zealand use alcohol, and what implications this has for their future health.

^{Towers, A., Stephens, C., Dulin, P., Kostick, M., Noone, J., & Alpass, F. (2011). Estimating Older Hazardous and Binge Drinking Prevalence Using AUDIT-C and AUDIT-3 Thresholds Specific to Older Adults. Drug and Alcohol Dependence. DOI:10.1016/j.drugalcdep.2011.02.008}