Our population is ageing. In fact the Australian Bureau of Statistics predicts the number of people aged 85 and above is expected to double in the next 20 years and double again in the future. The term ‘older people’ can be defined in various ways. Most developed world countries have accepted the chronological age of 65 years as a definition of ‘elderly’ or older person. (1)
Much has been written in relation to alcohol use and misuse of young people aged 12-30 years. There is much advice on interventions and strategies to help reduce risky drinking, death and injury. However alcohol use at the other end of the life span receives little attention, and we have limited information on the factors that influence alcohol consumption in older people.
Although older people are not as visible in their consumption of alcohol, Australian data indicates that they are more likely to consume alcohol daily than younger people (2). Is that a problem?
Naturally, as we age our bodies change and change occurs in individual cells and in whole organs (3). Our metabolism slows and our tolerance of alcohol lessens, so this may mean alcohol has a more potent effect on an older person compared to a younger person consuming the same amount of alcohol (4).
The current NHMRC Australian guidelines ‘to reduce health risks from drinking alcohol’ do not provide a limit on daily or weekly consumption of alcohol for older people. Instead, it advises older adults to consult their health practitioner to discuss the most appropriate level of alcohol consumption for them. It suggests they take account of the effect of drinking on certain health conditions or medications, as well as possible harms associated with older people drinking.
Some research has indicated that drinking small amounts daily or regularly improves heart health in middle aged and older people, but that conclusion is challenged by public health oriented researchers who believe that research is flawed (5)
The department of veteran affairs fact sheet advise that:
Older people who drink alcohol are advised to:
- Consider drinking less than the levels set in the guidelines for the general population (four standard drinks in a session will likely pose an unacceptable risk in a frail elderly person); and
- Further reduce their drinking or stop it altogether, if they are taking medications, in order to avoid harmful interactions with those medications
Substantial work is required to improve our understanding of older people‘s use of alcohol including the role of cultural differences. We need to understand the social, economic, physical and mental health harms associated with older people drinking. There is also further work required to identify whether there is a level of drinking that is “safe” or low risk for older people. Better understanding of these factors would facilitate the development of age-specific treatment programs and effective health promotion activities for older people.
There are few programs or services that are specifically designed to respond to the alcohol treatment needs of older people, and fewer still that have been evaluated. Also, few practitioners feel able to speak with authority on this issue.
Older people need the best health advice just as much as younger people. Older people are living longer, and it is in their interest, and the interest of everyone else, that they remain healthy as long as possible.
We look forward to more research being undertaken into how alcohol issues affect older people and how older people can ensure that any drinking they do does not compromise their health or their enjoyment of life.
1. Definition of an older or elderly person. World Health Organisation. [Online] 2016. [Cited: 9 March 2016.] http://www.who.int/healthinfo/survey/ageingdefnolder/en/.
2. Substance misuse: Management in the older population. Hunter, B and Lubman, DI. 5, 2010, Australian family Physician, Vol. 28, pp. 649-60.
3. Merck Manual Consumer version. [Online] [Cited: 17 June 2016.] http://www.merckmanuals.com/home/older-people%E2%80%99s-health-issues/the-aging-body/changes-in-the-body-with-aging.
4. Older Australians’ drinking on the rise and they don’t know the risks . The conversation. [Online] [Cited: 17 June 2016.] https://theconversation.com/older-australians-drinking-on-the-rise-and-they-dont-know-the-risks-50660.
5. Stockwell T. et al Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality, Journal of Studies on Alcohol and Drugs, 77(2), 185–198 (2016).