Alcohol Use in Older Women

Abstract & Commentary

By Mary Elina Ferris, MD, Clinical Associate Professor, University of Southern California. Dr. Ferris reports no financial relationship to this field of study.

Synopsis: Although most older women have stable patterns of alcohol use over time, they still need to be periodically questioned about alcohol use since some will increase their intake substantially after age 50, and may develop new risks for alcohol-related problems.

Source: Bobo JK, et al. Alcohol use trajectories in two cohorts of U.S. women aged 50 to 65 at baseline. J Am Geriatr Soc 2010;58:2375-2380.

To investigate the natural history of alcohol intake in women after age 50, two randomly sampled, nationally representative large cohorts of older women initially between the ages of 50 and 65 were followed with biannual questionnaires for concurrent 8-10 year periods. The alcohol use questions covered the preceding 3 months and collected data on days of use and daily amount. These data were used to create group-based models of four drinking trajectories: infrequent or non-drinkers (62% of the largest cohort of 3233 women), increasing drinkers (5%), consistent drinkers (26%), and decreasing drinkers (7%). The percentages from the second cohort of 1017 women were very similar.

The majority of older women studied maintained a stable drinking pattern as they aged: consistent, infrequent, or non-drinkers were 87.7% of the largest cohort and 82.6% of the other cohort. Within the consistent drinkers, there was a trend over time to slightly decrease the amount of drinks per day, from 1.78 to 1.59 drinks in the first group and from 1.62 to 0.99 drinks per day in the second group.

The surprising finding was that 4.9% of the larger cohort and 8.8% of the smaller cohort reported notable increases in the number of drinks per day over the 8-10 years of the study.

Commentary

This report demonstrates that the vast majority of older women have stable alcohol intake as they age, and may even decrease their intake with time. A similar study of women enrolled at ages 45-64 also found that 81% of baseline drinkers and 88% of non-drinkers reported no change in drinking status over 6 years of follow-up.1

The American Geriatrics Society actually has posted clinical guidelines for low-risk alcohol use in older adults on their web site, and recommends no more than 7 drinks/week with a maximum of 2 drinks on any one occasion. However, these amounts have been questioned since safety may be specific to what medications or chronic diseases are present, and there is scant research support for older adults having different guidelines from younger ages if health status is equivalent.2

The group that merits our attention are the small numbers that may actually increase their alcohol intake over time and put themselves at risk for alcohol-related complications. The authors promise to publish subsequent reports of which risk factors were associated with increasing and decreasing alcohol use to help us target these groups in the future.

References

1. Eigenbrodt ML, et al. Alcohol consumption with age: A cross-sectional and longitudinal study of the Atherosclerosis Risk in Communities (ARIC) study, 1987-1995. Am J Epidemiol 2001;153:1102-1111.

2. Lang I, et al. What level of alcohol consumption is hazardous for older people? Functioning and mortality in U.S. and English national cohorts. J Am Geriatr Soc 2007;55:49-57.