Do older adults drink alcohol whilst taking alcohol-interactive medication? Prevalence and ten-year mortality risk: findings from the UK Whitehall II cohort study

Abstract

Background Older people commonly take prescribed medications, some of which are contra-indicated with alcohol. Few population-based studies have assessed the relationship between taking these medicines, different levels of alcohol use, and potential harm. Aims To investigate the prevalence of taking alcohol-interactive (AI) medication and alcohol consumption among older adults and to compare the ten-year mortality risk among different categories of drinkers. Methods Data were obtained from 6220 participants (mean age 70, 71% male) within the UK Whitehall II cohort study of civil servants from phase 11 (2012–2013) who were followed up for mortality over ten years. Alcohol use was based on volume of consumption in self-reported drinks per week, and hazardous pattern of consumption was assessed with the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C). AI medications were coded from self-reported medication use. Deaths were obtained from the NHS central registry (2012–2022). Results 55% of participants took AI medication and of these, 73% also consumed alcohol, and 43% drank hazardously. These participants were more likely to be male, older, and belong to lower socioeconomic groups. Among those taking AI medication, there was a significantly higher mortality hazard for ex-drinkers (HR =1.43 CI 1.14, 1.80) and nondrinkers (HR= 2.09 CI 1.33, 3.27) compared to moderate drinkers but no significant difference for higher risk/hazardous drinkers after adjusting for confounding factors. Conclusion In these older adults, there was a high prevalence of taking alcohol-interactive medication and drinking alcohol. Whilst there was no increased mortality risk other non-fatal outcomes should be considered.