Alcohol Consumption Limits Associated with Alcohol Problems in Older Adults

Guidelines from the National Institute on Alcohol Abuse and Alcoholism recommend no more than 4 alcoholic drinks in a day or 14 drinks per week for men under age 65 and no more than 3 drinks in a day or 7 drinks per week for women and persons over age 65. This community-based cohort study examined the association between drinking and alcohol problems* among 719 adult drinkers aged 55 to 65 years at baseline and followed for 20 years.

• Sixty-five percent of men and 49% of women consumed ≥2 drinks per day or ≥7 drinks per week at baseline. Twenty years later, these proportions declined to 49% of men and 27% of women. Of these, 22% of men and 8% of women experienced drinking problems.

• At baseline,
  • at a cut-off point of ≥2 drinks per day or ≥7 drinks per week, 34% of men and 21% of women had drinking problems; below those limits, 4% of men and 2% of women had drinking problems.
  • at a cut-off point of ≥3 drinks per day or ≥14 drinks per week, 41% of men and 27% of women had drinking problems; below those limits, 6% of men and women had drinking problems.

• At 20-year follow-up,
  • at a cut-off point of ≥2 drinks per day or ≥7 drinks per week, 22% of men and 8% of women had drinking problems; below those limits, only 2% of men and no women had drinking problems.
  • at a cut-off point of ≥3 drinks per day or ≥14 drinks per week, 70% of men and 15% of women had drinking problems; below those limits, only 3% of men and 1% of women had drinking problems.

Comments:

A substantial proportion of older adults drink above recommended limits. These findings suggest that older adults drinking below conservative drinking limits (no more than 2 drinks in a day or 7 drinks per week) are unlikely to have alcohol problems, but that drinking above those limits is only modestly predictive of alcohol problems. Clinicians should routinely assess for drinking-related consequences among the substantial proportion of older adults who consume above these limits.

Peter D. Friedmann, MD, MPH

Reference:

Moos RH, Schutte KK, Brennan PL, et al. Older adults’ alcohol consumption and late-life drinking problems: a 20-year perspective. Addiction. 2009;104(8):1293–1302.