At-risk drinking risky for older men

Elderly men who engage in “at-risk” drinking have higher mortality rates than those who abstain or drink safer amounts of alcohol, a report indicates.

The authors define at-risk drinking as excessive drinking or the “use of alcohol in amounts deemed risky in the presence of relevant comorbidities.” An example of excessive alcohol use alone would be 3 drinks per day on 4 or more occasions per week. At risk drinking would also encompass 2-3 drinks per day with anxiety disorder or gout, or while taking medication for pain or insomnia, for example.

Dr. Alison A. Moore, of the University of California, Los Angeles, and colleagues examined the effect of alcohol use and co-morbid illness on 20-year mortality in 4,691 adults who were at least 60 years of age.

At the outset, 1,658 (39 percent) were drinkers, and 425 (10 percent) were at-risk drinkers—336 men and 89 women. Most at-risk drinkers (69 percent) were identified as such because of their use of alcohol with relevant comorbidities.

“The most common medical and psychiatric conditions responsible for identifying at-risk-drinking men were gout (22 percent) and ulcer disease (16 percent),” the authors report in the Journal of the American Geriatrics Society.

“Ulcer disease (20 percent) and anxiety disorder (defined as having a nervous breakdown or taking medications for nerves) (17 percent) were the most common conditions identifying at-risk-drinking women,” they note.

“Pain medication was the most common medication used to identify at-risk drinkers in men and women (13 percent of men, 22 percent of women).”

A total of 2,673 subjects died over the 20-year follow-up period. At-risk drinking was associated with higher mortality rates than not-at-risk drinking among men. There was no association between abstinence and greater mortality in men.

Neither at-risk drinking nor abstinence was related to a greater mortality rate in women.

“These findings suggest that a lower threshold of alcohol use should be recommended for older adults with specific morbidities to reduce mortality risks,” the team concludes.

SOURCE: Journal of the American Geriatrics Society May 2006.

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