Alcohol and aging: A longitudinal study of alcohol habits and health effects due to alcohol consumption in old adulthood

Alcohol use is a leading risk factor for injuries, mortality and the burden of disease. Alcohol consumption among older adults varies considerably, depending on factors such as age, social class, education, ethnicity, time period and geographical setting. Furthermore, the health effects associated with alcohol consumption in old age are an under researched area. The overall aim of this thesis was to investigate trends in alcohol consumption among older adults (60 years or older) from the same geographical setting across 25 years, and any health effects due to alcohol consumption. Participants aged 60–99 when attending the Norwegian population-based Tromsø Study were followed for up to 25 years. The overall abstinence rate decreased considerably between 1994 and 2016, from 31 % to 11 %. The probability of reporting frequent drinking increased more among women compared to men (6-8-fold increase compared to 3-4-fold increase). The overall prevalence of at-risk drinking was equal in women and men in 2016; 44 % and 46 %, respectively. At-risk drinking was associated with very good health, living with a spouse or partner, and having adequate social support in women, while it was associated with the use of sleeping pills in men. We found that women, but not men, who consumed ≥ 100 g / week had better self-rated health than those who consumed < 100 g / week (OR 1.85, 95 % CI 1.46-2.34). Our findings indicate that women’s drinking patterns are approaching those of men. So far there is no definite evidence of increased mortality in the heaviest drinkers, as their balanced risk factors appear to be beneficial. Nevertheless, we conclude that our findings imply that a change in governmental strategies and alcohol policy to influence alcohol consumption among older adults should be considered

The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: The Tromsø Study 1994-2020

Background Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. Methods This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows followup of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60–99 (53% women). Primary outcome measures: Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. Predictor: Average weekly alcohol consumption (non-drinker, Results We found that women who consumed ≥100g/week had better SRH than those who consumed Conclusions There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specifc risk factors in combination with the highest level of alcohol consumption led to adverse efects on self-rated health. In men it was the use of sleeping pills or tranquilisers and≥20 years of smoking, in women it was physical illness and older age

Sex differences in at-risk drinking and associated factors–a cross-sectional study of 8,616 community-dwelling adults 60 years and older: the Tromsø study, 2015-16

Background: Alcohol consumption among older adults is on the rise, which may be an increasing public health concern. The proportion of older adults who drink above defined low-risk drinking limits, associated characteristics and the sex distribution of at-risk drinking vary across countries. The aims of this study were to (i) estimate the prevalence of at-risk drinking among older adults in Norway, (ii) investigate factors associated with at-risk drinking, and (iii) examine sex differences in alcohol consumption in the context of sociodemographic and selected health characteristics. Method: A cross-sectional study based on Tromsø 7 (2015–16), an ongoing population-based cohort survey. Data were retrieved from participants aged 60 and older (60-99 years) who answered questions about alcohol consumption (n = 8,616). Sex-stratifed logistic regressions were used to assess the association between three at-risk drinking outcome variables, and sociodemographic and selected health characteristics. The outcome variables were operationalized using the Alcohol Use Disorders Identifcation Test (AUDIT), and Alcohol Consumption Questions (AUDIT-C), i.e. – cut of for at risk drinking, drinking any 6+ in the past year, and any alcohol problems. Results: The overall prevalence of at-risk drinking among those aged 60-99 years was equal in women and men; 44% and 46%, respectively. At-risk drinking was strongly associated with a higher level of education, with OR 2.65 (CI 2.28- 3.10) in women and OR 1.73 (CI 1.48-2.04) in men. Conclusions: Almost half of older adults in Norway exceeded sex- and older adult-specifc at-risk drinking thresholds. Our findings suggest some diferences in factors associated with at-risk drinking between women and men. Explicitly, at-risk drinking was associated with very good health, living with a spouse or partner, and having adequate social support in women, while it was associated with the use of sleeping pills in men. Our findings suggest that women exceed at-risk drinking thresholds with better health, while men exceed at-risk drinking thresholds regardless of good or poor health

The changing alcohol drinking patterns among older adults show that women are closing the gender gap in more frequent drinking: the Tromsø study, 1994–2016

Background As the population of older adults continues to grow, changes in alcohol consumption are important to monitor because an increase may have public health consequences. Rates of alcohol use vary with geographical location. The aim of this study was to examine trends in alcohol consumption among older adults in a geographically defined area in Norway, especially changing sex differences in drinking patterns over a 22-year period. Methods Repeated cross-sectional survey (in 1994–95, 2007–08, and 2015–16) of a general population of older adults. Eligible for this study were 20,939 participants (aged 60–99 years). The data were analysed using generalized estimating equations, stratified by age and sex. Alcohol consumption and drinking patterns were assessed, using an adaptation of the AUDIT-C. Results Between 1994 and 2016, there has been a significant increase in the proportion of current drinkers among older adults. Furthermore, the probability of frequent drinking (alcohol consumption at least twice weekly) increased significantly between 1994 and 2016, particularly among older women; OR 8.02 (CI 5.97–10.79) and OR 5.87 (CI 4.00–8.63) in the age groups 60–69 and 70+ respectively for women, and OR 4.13 (CI 3.42–4.99) and OR 3.10 (CI 2.41–3.99), in the age groups 60–69 and 70+ respectively for men. The majority of older adults drank small amounts of alcohol on typical drinking days, but there was an increasing probability of drinking three drinks or more on each occasion over the study period, except among women aged 70+ years. Conclusions Among older adults in Norway, alcohol consumption in terms of frequency and quantity on typical drinking days has increased considerably from 1996 to 2016. This change is in the opposite direction of what has been reported among younger adults. The gap between women and men in frequent drinking has been markedly narrowed, which indicate that women’s drinking patterns are approaching those of men. This may involve a need to change alcohol policy in Norway to more targeted interventions aimed at older people