Summary: As many as one in ten older adults frequently binge drink, a new study reports. The risk of binge drinking in older adults is higher for males and for those who smoke or use cannabis.
More than a tenth of adults age 65 and older currently binge drink, putting them at risk for a range of health problems, according to a study by researchers at NYU School of Medicine and the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.
The study, published in the Journal of the American Geriatrics Society, also finds certain factors–including using cannabis and being male–are associated with an increase in binge drinking.
Binge drinking is a risky behavior, particularly for older adults due to aging-related physical changes (for instance, an increased risk of falling) and the likelihood of having chronic health issues. Despite the potential for harm, little research has focused on binge drinking among older adults.
“Binge drinking, even episodically or infrequently, may negatively affect other health conditions by exacerbating disease, interacting with prescribed medications, and complicating disease management,” said Benjamin Han, MD, MPH, the study’s lead author and an assistant professor in the Department of Medicine’s Division of Geriatric Medicine and Palliative Care, and the Department of Population Health at NYU Langone Health.
In this study, Han and his colleagues used the most recent national data to determine the current prevalence and factors that may increase the risk of binge drinking among adults. The researchers examined data from 10,927 U.S. adults age 65 and older who participated in the National Survey on Drug Use and Health between 2015 and 2017. They looked at the prevalence of current (past-month) binge alcohol use, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as five drinks or more on the same occasion for men and four drinks or more for women. They also compared demographic and health factors of past-month binge drinkers with people who drank within the past month, but below the binge drinking threshold.
The authors estimate that more than one in 10 (10.6 percent) older adults have binge drank in the past month–an increase compared to earlier studies. In the decade leading up to the data used in this study (2005-2014), binge drinking among adults 65 and older was between 7.7 and 9 percent.
Binge drinkers were more likely to be male, current tobacco and/or cannabis users, African American, and have less than a high school education. They were also more likely to visit the emergency room in the past year. Similar to previous studies, the study did not find associations between binge drinking and other mental health disorders.
“The association of binge drinking with cannabis use has important health implications. Using both may lead to higher impairment effects. This is particularly important as cannabis use is becoming more prevalent among older adults, and older adults may not be aware of the possible dangers of using cannabis with alcohol,” said CDUHR researcher Joseph Palamar, PhD, MPH, the study’s senior author and an associate professor in the Department of Population Health at NYU Langone Health.
The researchers also examined chronic disease profiles of older binge drinkers and noted that binge drinkers had a lower prevalence of two or more chronic diseases compared to non-binge drinkers. The most common chronic disease among binge drinkers was hypertension (41.4 percent), followed by cardiovascular disease (23.1 percent) and diabetes (17.7 percent).
“Binge drinkers were less likely to have most chronic diseases compared to alcohol users who did not binge drink. This may be because some people stop or decrease their drinking when they have an illness or alcohol-related disease,” said Han, who is also a CDUHR researcher. “Clinicians must be aware that some older adults with chronic disease still engage in binge drinking behaviors, which can worsen their health issues. This may explain why binge drinkers were more likely to report visits to the emergency room.”
The researchers note that while the study uses the NIAAA’s recommended threshold for binge drinking, the same organization also suggests lower drinking limits for adults over 65: no more than three drinks a day. Since the current analysis used the higher cutoff for binge drinking, the study may underestimate the prevalence of binge drinking among older adults.
“Our results underscore the importance of educating, screening, and intervening to prevent alcohol-related harms in older adults, who may not be aware of their heightened risk for injuries and how alcohol can exacerbate chronic diseases,” said Han.
In addition to Han and Palamar, study authors include Alison Moore of the University of California San Diego Rosie Ferris of NYU Langone.
Funding: This research was supported by grants from the National Institute on Drug Abuse (K23DA043651 and K01DA038800) and the National Institute on Alcohol Abuse and Alcoholism (K24AA015957).
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Binge Drinking Among Older Adults in the United States, 2015 to 2017
OBJECTIVES Binge drinking is a risk factor for a range of harms. This study estimates the national prevalence of binge drinking and adds to our understanding of correlates of binge drinking among older adults in the United States.
DESIGN Cross‐sectional analysis.
SETTING/PARTICIPANTS A total of 10 927 adults, aged 65 years or older, from the 2015 to 2017 administrations of the US National Survey on Drug Use and Health.
MEASUREMENTS We estimated the prevalence of past‐month binge alcohol use (five or more drinks on the same occasion for men and four or more drinks on the same occasion for women). Characteristics of past‐month binge drinkers, including demographics, substance use, serious mental illness, mental health treatment utilization, chronic disease, and emergency department (ED) use, were compared to participants who reported past‐month alcohol use without binge drinking. Comparisons were made using χ2 tests. We then used multivariable generalized linear models using Poisson and log link to examine the association between covariates and binge drinking among all past‐month alcohol users aged 65 years or older.
RESULTS Of 10 927 respondents, 10.6% (95% CI = 9.9%‐11.2%) were estimated to be current binge drinkers. Binge drinkers were more likely to be male, have a higher prevalence of current tobacco and/or cannabis use, and have a lower prevalence of two or more chronic diseases compared to nonbinge drinkers. In multivariable analysis, among past‐month alcohol users, the prevalence of binge drinking was higher among non‐Hispanic African Americans than whites (adjusted prevalence ratio [aPR] = 1.44; 95% CI = 1.16‐1.80), tobacco users (aPR = 1.52; 95% CI = 1.33‐1.74), cannabis users (aPR = 1.41; 95% CI = 1.11‐1.80), and those who visited the ED in the past year (aPR = 1.16; 95% CI = 1.00‐1.33).
CONCLUSION Over a tenth of older adults in the United States are estimated to be current binge drinkers. Results confirm the importance of screening for binge drinking behaviors among older adults to minimize harms.