Patterns and determinants of alcohol consumption in people aged 75 years and older: results from the MRC trial of assessment and management of older people in the community

Background: very little work on alcohol consumption patterns in older people has been undertaken. As a result, knowledge about the prevalence and characteristics of regular drinkers and heavy drinkers in this age group remains limited. Objective: to determine the socio-economic and health characteristics associated with different levels of alcohol intake in older people. Design: detailed screening of patients in one arm of a cluster randomised trial. Setting: 53 UK general practices drawn from the Medical Research Council General Practice Research Framework. Subjects: all patients aged 75 and over on the GP lists (excluding those in nursing homes or other long stay care) were invited to participate in the study. Of the 15,358 people who received a detailed assessment in the 'universal' arm, 14,962 (97%) of these answered questions on alcohol consumption. Of these, 62% were female and the median age was 80.3 years. Methods: associations between reported alcohol intake and various socio-economic and health variables were investigated, first in univariate analyses and then controlling for other variables in logistic regression models. Results: 5% of men and 2.5% of women exceeded the Royal College of Physicians, Psychiatrists and General Practitioners' recommended drinking limits of 21 and 14 units a week respectively; 17% of subjects had never had a drink. Women and the very elderly were less likely to be drinkers. Those that drank were more likely to be people who still had a fairly active and sociable lifestyle, and with a better self-perceived health status compared with non-drinkers. Moderate drinkers were also less likely to be severely cognitively, impaired compared with non-drinkers: adjusted odds ratio 0.69 (95% Cl 0.57, 0.85); but more likely to report symptoms of anxiety: 1.31 (1.07, 1.61). Conclusions: our results suggest that moderate alcohol consumption is associated with relative financial security and good health with the exception of higher levels of anxiety amongst drinkers.