Hidden harm: Up to 40% of older Kiwis drink hazardously

"Our findings strongly suggest that risky drinking is not a ‘youth culture’ issue as it’s often made out to be; risky drinking is a ‘New Zealand culture’ issue,” Dr Andy Towers says.

Dr Andy Towers from the School of Health Sciences.

There is a common misconception that hazardous or risky drinking is something only young people do, but new research shows that between 35 to 40 per cent of New Zealanders aged 50 years or older may also drink hazardously.

A research team from Massey University’s School of Health Sciences and the University of Auckland’s Centre for Addiction Research, funded by the Health Promotion Agency (HPA), explored the prevalence of hazardous drinking using data from more than 4,000 New Zealanders aged 50 years or older from the Massey University Health, Work and Retirement Longitudinal Study.

Research co-leader Dr Andy Towers, from Massey University, says the research focused on older adults, as they are more at risk of harm from alcohol than younger drinkers. “As we age our body can’t process alcohol as well, making it more toxic to us. Also, the older we get the more likely we are to develop health conditions and use medication that alcohol can interfere with. In this respect, the longer we live, the less alcohol we should drink.”

The team found that 83 per cent of older New Zealanders in this sample were current drinkers, and between 35 to 40 per cent were considered ‘hazardous drinkers’. This means that their level of drinking – either on its own or in combination with health conditions and medication use – increased their risk of immediate harm (e.g., blackout, hospitalisation) or long-term harm (e.g., worsening health, death). Approximately half of older males (46 to 50 per cent) were hazardous drinkers, compared to around a quarter of older females (25 to 31 per cent).

Dr Towers says this is a staggering finding from a large New Zealand study. “We know that the New Zealand population is ageing, but to find that so many of this growing population are at risk from their drinking is concerning. The majority of New Zealanders wouldn’t consider their parents or grandparents to be risky drinkers, yet we’ve found that half of older men drank hazardously. This poses significant questions about how we identify and manage older drinkers in our health system,” he says.

Professor Janie Sheridan and Dr David Newcombe, research co-leaders from the University of Auckland, noted the importance these findings for informing alcohol screening practice. “This research highlights the need to screen all older patients for alcohol use, regardless of their presenting problem,” Professor Sheridan says. “We found that many older New Zealanders are drinking hazardously, and many of those who are most at-risk see their GPs at least three times a year. This makes primary health care a perfect setting for identifying and helping older at-risk drinkers.”

The report specifically compared the rate of hazardous drinking found with a standard alcohol screening tool that looks only at alcohol use patterns (the AUDIT-C) with the rate from a US-developed screen that combines alcohol use and other health-related risk factors for older drinkers (the CARET). While the screens agreed on the classification of many older drinkers, the team found a small number of drinkers whose health conditions and medication use would place them at risk of harm, but whom the usual alcohol screens would miss.

Dr Newcombe says one of the positive outcomes of this research was the ability to translate research outcomes into advice for primary health care professionals. “We can let GPs and nurses know that there are people presenting who normally wouldn’t be screened for alcohol, but really should be. They tend to be older adults who drink frequently, but not in great quantity at any one time, who also have health conditions such as heart disease or depression, and who may report driving after drinking.”

The report offers primary health care professionals a helpful flow chart identifying the key characteristics of a range of older adult drinking groups, from those least at-risk of harm through to those most at-risk, but unlikely to appear so on traditional alcohol screening tools.

Dr Towers says that in addition to providing insights for health professionals to enhance screening practice, these results also reveal a lot about the New Zealand drinking culture. “The laws that allow young adults to drink so much today were put in place by their parents and grandparents who our research shows are drinking just as hazardously. Our findings strongly suggest that risky drinking is not a ‘youth culture’ issue as it’s often made out to be; risky drinking is a ‘New Zealand culture’ issue.”

Prevalence of hazardous drinking in older New Zealanders was written by Dr Andy Towers (School of Health Sciences, Massey University), Professor Janie Sheridan and Dr David Newcombe (Centre for Addiction Research, University of Auckland), and Dr Ágnes Szabó (School of Health Sciences, Massey University).

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