Elsevier

Drug and Alcohol Dependence

Volume 170, 1 January 2017, Pages 198-207
Drug and Alcohol Dependence

Full length article
Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005–2014

https://doi.org/10.1016/j.drugalcdep.2016.11.003Get rights and content

Highlights

  • No studies have reported recent trends in alcohol use among older adults.

  • Binge drinking and alcohol use disorders are increasing among older adults in the United States (US).

  • Older women reported large increases in binge drinking and alcohol use disorders in the US.

  • Older binge drinkers reported significant increases in chronic disease in the US.

Abstract

Background

Alcohol use is common among older adults, and this population has unique risks with alcohol consumption in even lower amounts than younger persons. No recent studies have estimated trends in alcohol use including binge alcohol use and alcohol use disorders (AUD) among older adults.

Methods

We examined alcohol use among adults age ≥50 in the National Survey on Drug Use and Health (NSDUH) from 2005 to 2014. Trends of self-reported past-month binge alcohol use and AUD were estimated. Logistic regression models were used to examine correlates of binge alcohol use and AUD.

Results

The prevalence of both past-month binge alcohol use and AUD increased significantly among adults age ≥50 from 2005/2006 to 2013/2014, with a relative increase of 19.2% for binge drinking (linear trend p < 0.001) and a 23.3% relative increase for AUD (linear trend p = 0.035). While males had a higher prevalence of binge alcohol use and AUD compared to females, there were significant increases in both among females. In adjusted models of aggregated data, being Hispanic, male, and a smoker or illicit drug user were associated with binge alcohol use, while being male, a smoker, an illicit drug user, or reporting past-year depression or mental health treatment were associated with AUD.

Conclusions

Alcohol use among older adults is increasing in the US, including past-month binge alcohol use and AUD with increasing trends among females. Providers and policymakers need to be aware of these changes to address the increase of older adults with unhealthy drinking.

Introduction

Alcohol is the most commonly used psychoactive substance by older adults (Moore et al., 2009), and the most common substance involved among older adults entering substance abuse treatment (Arndt et al., 2011, Han et al., 2009). Older adults (typically ≥65) can have particular vulnerabilities to alcohol due to physiological changes in aging (Oslin, 2000), increasing chronic disease burden (Moore et al., 2006), and medication use (Moore et al., 2007). This can place older adults at a higher risk for adverse outcomes from alcohol, and alcohol use can complicate the management of chronic disease (Moos et al., 2005). Higher quantities of alcohol use by older adults have been associated with functional impairments (Moore et al., 2003) and increased mortality risk (Holahan et al., 2014, Moore et al., 2007). This has led the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to lower recommended drinking thresholds for adults age 65 and older (NIAAA, 2016).

Recent epidemiological studies on alcohol use by middle-aged and older adults from the 2005 to 2007 National Survey on Drug Use and Health (NSDUH), estimated the prevalence of past-year alcohol use to be 51% for adults age ≥50, 56% for adults age 50–65, and 43% for adults age ≥65. The study also found the prevalence of alcohol dependence to be 2.7% and alcohol abuse to be 3.4% for adults age ≥50 (Blazer and Wu, 2011). The prevalence of binge drinking for males was estimated to be 19.6% and for females it was estimated to be 6.3% (Blazer and Wu, 2009). Cross-sectional data from the 2005 to 2006 National Health and Nutrition Examination Survey of non-institutionalized Americans estimated 14.5% of older drinkers (age ≥50) consumed alcohol above the recommended limits by the NIAAA, and 11.7% reported past-year binge drinking (Wilson et al., 2014). A recent cross-sectional study of the 2010 Behavioral Risk Factor Surveillance System found a lower prevalence of binge alcohol use among adults age 45–64 at 13.3% and for adults ≥65 prevalence was estimated to be 3.8% (Centers for Disease Control [CDC], 2012). However, it was noted that the frequency of binge drinking was highest among binge drinkers age ≥65 with an average of 5.5 episodes a month compared to all other age groups (CDC, 2012).

Given the aging Baby Boomer generation, which has higher reported rates of substance use compared to any generation preceding it (Johnson and Gerstein, 2000, Kuerbis et al., 2014), we hypothesize that there have been increases in alcohol use, including binge drinking and alcohol use disorders among older adults. One study noted increases in the rates of alcohol-related hospital admissions for older adults from 1993 to 2010 (Sacco et al., 2015). However, no studies have examined recent trends or changes in demographic shifts for alcohol use among older adults as the Baby Boomer generation continues to age.

Understanding demographic trends of alcohol use and alcohol use problems in older adults is vital for targeted public health screening and interventions. The aim of this study was to estimate the prevalence and to examine demographic trends of self-reported alcohol use – in particular binge alcohol use and alcohol use disorders among older adults, and to determine correlates of use among older adults. To do this, we examined cross-sectional data from the most recent ten years (2005–2014) of a nationally representative sample of non-institutionalized individuals in the US – the NSDUH, focusing on adults age 50 and older.

Section snippets

Study population

Data were utilized from the ten most recent cohorts (2005–2014) of NSDUH, an annual cross-sectional survey of non-institutionalized individuals in the 50 US states and the District of Columbia (Substance Abuse and Mental Health Services Administration [SAMHSA], 2013). A different cross-section of participants is sampled each year and thus the years are independent of each other. NSDUH is a nationally representative probability sample of individuals living in households and the sample was

Results

Sample characteristics and alcohol use across cohorts are presented in Table 1. Tests for trends suggest that between 2005/2006 and 2013/2014, there were significant increases in prevalence of past-year alcohol use (from 60.0% to 63.0%, p < 0.001) and past-month alcohol use (from 47.1% to 49.9%, p < 0.001). The prevalence of past-month binge alcohol use among adults age 50 and older significantly increased from 2005/2006 to 2013/2014 from 12.5% to 14.9% (p < 0.001), representing a 19.2% relative

Discussion

The prevalence of alcohol use among older adults is increasing in the US; however, little is known about recent trends, demographic changes, and correlates of use. We found a significant increase in prevalence of past-month binge drinking and past-year alcohol use disorders in the US among older adults from a ten year period from 2005/2006 through 2013/2014, with large relative increases in AUD among adults age ≥65 and binge drinking among adults age 50–64. The results in this study indicate

Conflict of interest

No conflict declared.

Contributors

All authors are responsible for this reported research. B. Han conceptualized and designed the study, helped interpret results, drafted the initial manuscript, and revised the manuscript. J. Palamar designed the study, conducted the statistical analyses, helped interpret results, and critically reviewed the manuscript. A. Moore helped interpret results and critically reviewed the manuscript. S. Sherman helped conceptualize the study, interpret results, and critically reviewed the manuscript. K.

Role of the funding source

This research was funded by several grants through the National Institutes of Health: NYU CTSA grant 1KL2 TR001446 from the National Center for Advancing Translational Sciences (Han), K24AA15957 from the National Institute on Alcohol Abuse and Alcoholism (Moore), K01 DA-038800 from the National Institute on Drug Abuse (Palamar), and 1K24DA038345 from the National Institute on Drug Abuse (Sherman). The National Institutes of Health provided financial support for the project and the preparation

Acknowledgments

The authors would like to thank the Inter-university Consortium for Political and Social Research for providing access to these data (http://www.icpsr.umich.edu/icpsrweb/landing.jsp).

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