Binge Drinking is Frequent Among Older People and
Significant Public Health Problem
Among older moderate drinkers, those who binge drink
have a significantly greater death risk than regular moderate drinkers
March 5, 2014 - A study of the association between
binge drinking and mortality among moderate-drinking older adults has
found that those who engage in binge drinking have more than two times
higher odds of dying within 20 years in comparison to regular moderate
drinkers. It is believed to be the first study of binge drinking among
older people who are considered moderate drinkers based on average
consumption over time.
Numerous studies have highlighted the purported
association between moderate drinking and reduced mortality. However,
these analyses have focused overwhelmingly on average consumption, a
measure that masks diverse, underlying drinking patterns such as weekend
heavy episodic or binge drinking.
"Binge drinking is increasingly being recognized as
a significant public health concern," said Charles J. Holahan, a
professor of psychology at The University of Texas at Austin as well as
corresponding author for the study.
"In fact, the U.S. Centers for Disease Control
recently concluded that binge drinking is 'a bigger problem than
previously thought.' Ours is one of the first studies to focus
explicitly on an older population in examining binge drinking among, on
average, moderate drinkers."
"Some of the greater attention to binge drinking is
due to increases in binge drinking since the mid-1990s, but perhaps more
because of growing recognition of the importance of patterns: it's not
just how much you drink but how you drink," added Timothy Naimi, a
physician and alcohol researcher at Boston Medical Center at Boston
"All told, excessive alcohol use causes about
80,000 deaths annually in the US, and many of these deaths are among
youth and young and working-age adults."
For this study, researchers used data from a larger
project examining late-life patterns of alcohol consumption and drinking
problems. The baseline sample was comprised of 446 adults (334 men, 112
women) aged 55 to 65: 74 moderate drinkers who engaged in episodic heavy
drinking, and 372 regular moderate drinkers.
Study authors controlled for a broad set of
socio-demographic, behavioral, and health-status covariates. Death
across a 20-year follow-up period was confirmed primarily by death
The findings highlight the importance of focusing
on drinking patterns, as well as absolute amounts of ethanol consumed,
as predictors of health and mortality outcomes among older adults.
"We found that among older adults, those who engage
in heavy episodic drinking even when average consumption is moderate
show significantly increased total mortality risk compared to regular
moderate drinkers," said Holahan.
"These findings demonstrate that, among older
adults, drinking patterns need to be addressed along with overall
consumption in order to understand alcohol's health effects."
"This is a crucial point," added Naimi, "since
approximately a quarter of 'moderate' drinkers report binge drinking,
and most folks in the US don't typically drink in an 'average' way or on
a daily basis. Clinicians should understand that even among those with
apparently modest average consumption, a number of these folks may be
drinking in risky ways."
Both Holahan and Naimi said these findings may pose
special health concerns for these older adults, even though binge
drinking is damaging at any age.
"Binge drinking concentrates alcohol's toxicity and
is linked to mortality by damaging body organs and increasing accident
risk," said Holahan. "Binge drinking may be additionally risky for older
adults due to aging-related elevations in comorbidities as well as
Naimi agreed. "Binge drinking is dangerous and many
bad things have happened to drinkers or to others car accidents,
fights, injuries, domestic violence, sexual assaults on the basis of
binge drinking even if it is 'atypical' of how they drink and/or among
those who are not alcoholic," he said.
"While it is less common among those who are older
than among youth and younger adults, it may carry as much or more risk
on a per-person basis as older individuals have less physiologic
reserves, for example."
"The take-home message here for readers is that
binge drinking is a significant public health problem that is frequent
among middle-aged and older adults," said Holahan.
Results will be published in the May 2014
online-only issue of Alcoholism: Clinical & Experimental Research
and are currently available at Early View.
Alcoholism: Clinical & Experimental Research
(ACER) is the official journal of the Research Society on Alcoholism and
the International Society for Biomedical Research on Alcoholism.
Co-authors of the ACER paper, "Episodic Heavy Drinking and 20-Year Total
Mortality Among Late-Life Moderate Drinkers," were: Kathleen K. Schutte
and Penny L. Brennan of the Center for Health Care Evaluation at the VA
Palo Alto Health Care System; Carole K. Holahan of The University of
Texas at Austin; and Rudolf H. Moos of the Center for Health Care
Evaluation at the VA Palo Alto Health Care System, and Stanford
The study was funded by the National Institute on
Alcohol Abuse and Alcoholism, and the Department of Veterans Affairs
Health Services Research and Development Service. This release is
supported by the Addiction Technology Transfer Center Network at
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