BMC Public Health BMC series https://doi.org/10.1186/s12889-018-5199-x Published: 1 March 2018
By 2050, around 22% of the world population will be aged 60 and over, with a significant proportion of these older individuals having a “pattern or level of drinking which places them at harm” p.656 [3]. In comparison to younger people, older adults are more susceptible to the detrimental effects of alcohol, as their tolerance to alcohol lowers with age. In addition, older people are also more likely to take prescription medications which, when taken with alcohol, can reduce effectiveness of medication, exacerbate side effects or even lead to the development of new illnesses [4].
Drinking more than five standard drinks per week and a history of an alcohol problem in men over the age of 50 has been found to quadruple the risk of developing psychiatric problems including depression and memory loss [5, 6]. Cognitive impairment can lead to an increased likelihood of falls [7] and because older people often have weaker bones, this can lead to hip fractures, which is one of the highest causes of death in the older population [8]
Type of interventions
Interventions used in trials included varying techniques and some used more than one intervention group, and these are listed below:
- Motivational Enhancement [19]
- Brief Motivational Intervention [23]
- Brief Advice [19]
- SHARE (Senior Health and Alcohol Risk Education) [17]
- Brief Intervention (BI) – used BI protocol including a workbook containing feedback on individuals’ behaviours and other educational resources. Two appointments, one month apart consisting of the intervention and then a reinforcement session [22]
- Personalised reports on risks and problems [18, 20]
- Educational tools [18, 21, 22]
- Diaries [20]
- Telephone Counselling [17, 20]
Conclusion
This study has shown that while there is a growing evidence base for interventions for alcohol use in older individuals, there is still a need to conduct more research in the field to understand more about alcohol use in later life, and specifically understand which interventions work and for whom. Currently, interventions are aimed at general populations rather than focusing on older people. Older people are affected disproportionately by lifestyle changes such as bereavement, social isolation and loneliness and worklessness which may affect alcohol consumption [9]. More work is needed to establish the relationship between these factors and patterns of drinking in older people and also to look at varying levels of alcohol consumption across the life course, playing closer attention to stages of old age and factors such as retirement.