Patterns of Concurrent Alcohol and Medication Use Among Community-Dwelling Older Adults

Objectives:

Prior research suggests that the concurrent use of alcohol and prescription and/or over-the-counter medications can lead to a number of significant health problems. This is of particular salience for older adults, who take more medication than any other age group (Pringle, Ahern, Heller, Gold, & Brown, 2005). Despite older adults' increased risk of alcohol-medication interaction, limited research has focused on the rates and correlates of simultaneous alcohol and medication use in older adults outside of acute care settings. The purpose of this study was to examine trajectories of concurrent alcohol and medication use over time among community-dwelling older adults. In addition, this analysis examined whether patterns of concomitant alcohol and medication use varied by age, gender and race.

Methods:

Data from the Cardiovascular Health Study (CHS), a population-based longitudinal study of older adults, were analyzed for this study. Participants completed a series of face-to-face and telephone interviews along with clinical examinations over a 10-year period between 1989 and 1999. This analysis only utilizes data from wave 1 through 6. The CHS cohort consists of 5,888 men and women ages 65 and older. The mean age of respondents is 72 and roughly 15% of the sample is African American. Among other topics on well-being, respondents answered detailed questions on their alcohol consumption and prescription medication use. Concurrent use was calculated using weekly alcohol consumption and the total number of alcohol-interactive medications currently being taken.

Results:

Analysis revealed that over 54% of the sample concurrently used alcohol with alcohol-interactive medications at some point over the course of the study, with 16% reporting concomitant use in 4 or more of the 6 study waves. Baseline concomitant use of alcohol with alcohol-interactive medications was significantly correlated to future concurrent use. Trajectories of concomitant alcohol and medication use vary between the subgroups: findings suggest that younger individuals, men and Whites were significantly more likely than older individuals, women, and African Americans to have a longitudinal course of concurrent use. Additionally, individuals who were problem drinkers and reported taking a greater number of alcohol-interactive medications at baseline were significantly more likely to report concurrent use over the course of the study period.

Implications:

This study expands upon the existing literature regarding the patterns and correlates of concurrent alcohol and medication use in community-dwelling older adults in an effort to develop knowledge that can aid in the creation of comprehensive programs and policies that effectively meet the needs of this population. The results demonstrate that men and Whites are at increased risk for prolonged concurrent alcohol and medication use. These findings indicate a significant need for health care professionals to educate older adults about the dangers of concurrent alcohol-medication use. Additionally, it appears that there is a need for health campaigns that focus on the promotion of safer use of alcohol and medications by older adults.