Wine Information Council
december 2010
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Alcohol consumption and harm among elderly Europeans: falling between the cracks

The ageing of Europe means that the absolute number of older Europeans with alcohol use disorders will rise and the consequences of these changes must be considered early. However, little is currently known about the health, social and economic impacts of alcohol consumption by this cohort. We do know that the elderly are more sensitive to alcohol’s negative health effects compared to younger adults and are more prone to fall injuries.1 Research also suggests that alcohol use disorders among the elderly are frequently misdiagnosed or overlooked.2 Significant shifts in global and European Union trade policies have resulted in lower average alcohol prices and greater alcohol availability as the EU has expanded, resulting in higher average consumption levels across most age groups.3

As part of its’ Council of the European Union presidency in 2009, the Swedish National Institute of Public Health (SNIPH) commissioned a report to examine alcohol consumption trends and alcohol-related harms among the elderly (aged ≥60 years) from 10 EU Member States (Czech Republic, Finland, Germany, Italy, Latvia, Poland, the UK, Slovenia, Spain and Sweden).4 For the first time, the survey revealed important trends in alcohol consumption and harm among the elderly, with implications for European public health policy. It was found that elderly Europeans drink in less hazardous ways compared to younger adults. Hazardous alcohol consumption and binge drinking are less common among the elderly compared to younger adults. However, alcohol-related deaths have increased markedly over the last 10 years. For example, in Finland, alcohol attributable deaths more than doubled over 10 years (1997–2007) among adults aged ≥60 years, and the rate of male deaths was more than double the rate of female deaths. Alcohol-related deaths also increased in Sweden, the UK, Slovenia, Latvia, Poland and the Czech Republic.

Elderly men drink more alcohol than elderly women and in ways that result in higher rates of hospitalization and death. In some countries, such as the UK, the frequency of alcohol consumption among elderly men approaches that of all adults (≥16 years). Elderly women, on the other hand, consistently report drinking less alcohol (less frequently and in smaller amounts) than both elderly men and all adults, respectively. Binge drinkingBinge drinking (consuming rapidly four or more alcoholic drinks over a short period of time) has bee..., which is consistently associated with the greatest level of harm, is also much higher among elderly European men. Importantly, it was found that the elderly are not a homogenous group: alcohol consumption and alcohol-related mortality differ between age groups. Adults aged 60–70 years typically reported more alcohol consumption and greater harms compared to those aged >75 years. The amount of alcohol consumed and the number of alcohol-related deaths decrease significantly among elderly over 79 years of age.

The survey also indicates that most EU Member States do not currently have alcohol consumption guidelines developed specifically for the elderly. Finland, Sweden and the UK have consumption guidelines applicable to all adults, but Italy was the only country to report a specific guideline for the elderly (no more than one alcoholic beverage, or about 12g of pure alcohol per day). Training to enable health care professionals to identify and assist elderly Europeans whose condition indicates hazardous alcohol use either do not exist or appear to be inadequate. Only four countries (Finland, the UK, Italy and Poland) provided information about staff training in screening and brief intervention on harmful or hazardous alcohol use.

Of importance, the SNIPH report highlights concerning gaps in the available data on alcohol consumption and harm, making it difficult to compare trends over time between countries, and in some cases, within individual member states. While a small number of EU member states should be commended for recent efforts to improve their data collection methods, the overall picture is not promising—data omissions are ubiquitous and measurement tools vary from one country to the next. Sound epidemiological data is a staring point for understanding the consequences of alcohol use, and is the basis of important prevention work. Improved data collection must be given priority both at the national level by individual EU members, and also by the WHO which does not presently collect or report trends in alcohol-related harms by adults aged ≥65 years in Europe.

As a final point, it is worth considering what role alcohol could play in the lives of elderly Europeans in the future. Alcohol in Europe is now more affordable and readily available than ever before. Elderly Europeans are living longer, working longer and have access to more disposable income than before—changes which have influenced current drinking patterns. Lifestyle and health changes associated with ageing present elderly people with opportunities and challenges. For many, retirement and ageing is a period of great freedom, presenting opportunities to travel and spend more time with loved ones. However, for others, the opposite may be true—retirement can result in social isolation and loneliness, feelings which can worsen in the context of health problems. It is also known that depression is one of the main health issues facing elderly people and, for some, alcohol plays a role in alleviating depression and anxiety. In moderate quantities, and in the absence of health problems, this may not be problematic, but there is evidence suggesting that many elderly people develop hazardous drinking habits later in life in response to their changing social and health status, which again reinforces the importance of staff training to screen and detect risky drinking habits. Future research should address these issues and consider the circumstances under which elderly people use alcohol to alleviate psychological and physical distress. The psychosocial benefits of moderate drinking should not be forgotten, but nor should the health risks associated with hazardous consumption, particularly among the elderly who are already a vulnerable group. Alcohol consumption by the elderly is a subject which has until recently fallen between the gaps of ageing research on the one hand, and alcohol and drug research and policy on the other. Acknowledging this fact is a step towards generating the information needed to better understand patterns of alcohol use among the elderly and their consequences.

Additional Info

  • Authors

    Hallgren M.A.; Hogberg P.; Andreasson S.

  • Issue

    Eur.J.Public Health / pages 616-617 / volume 20

  • Published Date

    december 2010

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