Abstract
Background/Aims While heavy drinking and alcohol abuse pose clear health risks, even moderate alcohol consumption may be risky or frankly harmful in older adults with certain co-morbidities, medication use, symptoms, and functional limitations. However, national estimates of the prevalence of risky alcohol use by older adults are presently unavailable. Methods In 2005-2008 National Health and Nutrition Examination Survey respondents 65 years and older, reported alcohol consumption was considered alone and in the context of the individual's co-morbidities, medication use, and physical and psychological functional status to classify their consumption as Harmful (already experiencing alcohol-related health problems), Hazardous (at risk of alcohol-related health problems), or Healthwise, using the classification algorithm of the Alcohol-Related Problems Survey (ARPS), a screening tool for older adults. Weighted national prevalence estimates and adjusted prevalence odds ratios in subgroups defined by sex, age, and race/ ethnicity were calculated using survey statistical procedures. Results Among older adult drinkers, 85.5% (14,341,531 of 16,771,716; 95% Confidence Interval [CI]: 83.2%, 87.9%) consumed alcohol within recommended limits, but 37.4% (6,280,569 of 16,771,716; 95% CI: 34.9%, 40.0%) had Harmful consumption and more than half (53.3%; 8,946,997 of 16,771,716; 95% CI: 50.1%, 56.6%) had either Hazardous/Harmful consumption. Men had significantly greater odds of having Hazardous/ Harmful consumption than women (Odds Ratio [OR] = 2.14 [95% CI: 1.77, 2.6]). Blacks had significantly greater odds of having Hazardous/Harmful consumption than whites (OR = 1.49; 95% CI: 1.02, 2.17) despite having lower sex-specific rates of heavy drinking. The health status indicators most prevalent among Harmful drinkers were anti-hypertensive medication use, hypertension, quantity and frequency of alcohol consumption, and symptoms of depression/anxiety. Conclusions Most Americans 65 years and older drink less than the current recommended maxima for their age, yet in the context of their co-morbidities, medication use, functional status, and recent symptoms, the alcohol consumption of a substantial proportion compromises or places their health at risk. Issues of medication safety and effectiveness, chronic disease management, and prevention and wellness are critical issues for this population. Language: en
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