Changes in alcohol intake and their relationship with health status over a 24-year follow-up period in community-dwelling older adults

Abstract

Objectives: To determine whether alcohol use changes over time in older adults and whether alcohol intake is associated with common chronic diseases.

Design: Twenty-four-year longitudinal study.

Setting: Southern California community.

Participants: One thousand seventy-six members of the Rancho Bernardo cohort aged 50 to 89 at baseline.

Measurements: Participants completed two to six research visits at approximately 4-year intervals between 1984 and 2009. At each visit, participants completed standard questionnaires on alcohol use, chronic diseases, and behaviors. Mixed-effects linear models were used to examine changes in average weekly alcohol intake over time and in relationship to health status.

Results: Prevalence and frequency of alcohol use was high throughout the study, with more than 60% of participants reporting weekly alcohol intake. The average amount consumed declined with advancing age, regardless of the presence of any of the eight most common chronic diseases. Prevalence of drinking in excess of age- and sex-specific low-risk guidelines was high across all visits and did not vary according to disease burden. At the final visit, 29% of participants drank in excess of low-risk drinking guidelines, including 28% of those with hypertension and 31% with diabetes mellitus.

Conclusion: Prevalence and frequency of alcohol intake remained stable over a 24 year follow-up in this cohort of educated, white, middle-class, older adults, although average amount consumed decreased with advancing age. Despite this decrease, a high proportion of older adults, including those with common chronic health conditions, drank in excess of current guidelines. Clinicians should provide more education on the importance of older adults moderating alcohol intake.

Keywords: aging; alcohol trajectory; diabetes mellitus; drinking; hypertension.