Binge Drinking Rising Among Older US Adults, Study Finds

Nicola M. Parry, DVM

August 01, 2019

It is estimated that more than 1 in 10 adults aged 65 years or older in the United States are binge drinkers, a study published online July 31 in the Journal of the American Geriatrics Society indicates.

"Binge drinkers were more likely to be male, have a higher prevalence of current tobacco and/or cannabis use, and have a lower prevalence of two or more chronic diseases compared to nonbinge drinkers," write Benjamin H. Han, MD, MPH, from the New York University School of Medicine, New York City, and colleagues.

Studies have demonstrated that unhealthy alcohol use is increasing among older adults. In addition to being a risk factor for many health problems, unhealthy alcohol use also has important implications for public health.

Han and colleagues performed a cross-sectional analysis study to estimate the prevalence of binge drinking among older American adults and to examine factors that might increase the risk for this behavior.

They examined data from 10,927 US adults aged 65 years or older who participated in the US National Survey on Drug Use and Health from 2015 to 2017.

The researchers focused on participants' responses about alcohol use and binge drinking in the past month. For defining binge drinking, the researchers used the National Institute on Alcohol Abuse and Alcoholism's (NIAAA's) definition of five or more drinks on the same occasion for men, and four or more for women.

More than 1 in 10 respondents (10.6%; 95% confidence interval [CI], 9.9% – 11.2%) were current binge drinkers.

Binge drinkers were more likely than nonbinge drinkers to be men (58.3%; 95% CI, 54.3% – 62.1%) and to have used other substances, such as tobacco (21.1%; 95% CI, 18.8% – 23.6%) or cannabis (5.5%; 95% CI, 4.3% – 7.1%), in the past month.

Binge drinkers were also less likely to have two or more chronic diseases (29.0%; 95% CI, 25.4% – 32.8%). The most common chronic diseases among binge drinkers were hypertension (41.4%), cardiovascular disease (23.1%), and diabetes (17.7%).

In the multivariable analysis, the researchers adjusted for factors that included age, race/ethnicity, income, education, marital status, drug or substance use, mental health, and emergency department use during the past year. Binge drinkers were more likely to be non-Hispanic African American than white (adjusted prevalence ratio [aPR], 1.44; 95% CI, 1.16 – 1.80), to use tobacco (aPR, 1.52; 95% CI, 1.33 – 1.74), to use cannabis (aPR, 1.41; 95% CI, 1.11 – 1.80), and to have visited the emergency department in the past year (aPR, 1.16; 95% CI, 1.00 – 1.33).

In contrast, binge drinking was less common among women than men, among those educated to college level compared to high school level, and among those with two or more chronic diseases compared with those who had fewer than two.

The authors note that the reduced prevalence of binge drinking among adults with more chronic diseases mirrors findings reported in previous studies. This is probably a result of selection bias that occurs in observational studies of alcohol use, because people tend to stop drinking as the severity of their illness increases.

"This is referred to as the 'sick quitter' hypothesis," write Han and colleagues, "where alcohol may have contributed to poor health and, therefore, the selection biases lead researchers to compare a population of healthy older drinkers to unhealthy nondrinkers."

The authors emphasize the need for clinicians to assess for binge drinking behavior, especially among their older patients who may not be aware of the associated health risks, of the NIAAA's low-risk drinking limits, or of how alcohol may interact with prescribed medications.

"[I]t is time to advocate for more effective means of educating, screening, and intervening to prevent alcohol-related harms in older adults," they conclude.

The study was supported by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. The authors have disclosed no relevant financial relationships.

J Am Geriatr Soc. Published online July 31, 2019. Abstract

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