Alcohol consumption, depression and self-rated health in older adults

Background and Purpose: Demographic changes have increased concerns about alcohol misuse and abuse among older adults. Although many studies have documented significant associations between alcohol consumption patterns, health and mental health outcome, there remain many concerns about types of measurement to best capture alcohol use and abuse as well as the need for community rather than clinically based samples. This study examines patterns of alcohol consumption among older adults to determine the prevalence of unhealthy drinking patterns and the relationship of these drinking patterns to health and mental health outcomes using a large community-based sample. Results can be useful in developing community-based preventative screening and assessment for alcohol–related problems.

Methods: This study used a cross-sectional analysis of a National Survey on Drug Use and Health (NSDUH, 2007) which is a representative sample of individuals living in the community. The study selected only those aged 65 and older for a sample of 2,025. Four measures of alcohol use (frequency, quantity, heavy and binge episodic drinking) were used. Other variables includes a DSM-IV compatible measure for major depressive episode and a physical health self rating. The time frame for all variables was the past year. Chi-square was used to test for equality of demographic characteristics across drinking pattern categories. Binary logistic regression was used to study associations between alcohol consumption measures and depression. OLS regression was used to assess the associations between alcohol consumption, depression and self-rated physical health. Logistic and OLS regression models controlled for gender, marital status and education level.

Results: 51% of the sample reported no alcohol consumption during the past year. 7.8% were classified as binge drinkers, having 5 or more drinks on the same occasion for the past 30 days. 1.8% were heavy drinkers having 5 or more drinks on the same occasion for 5 or more days for the past 30 days. The bi-variate logistic regression analysis assessing the relationship between depression and the four different alcohol consumption measures showed a positive significant relationship between alcohol quantity and depression {Odds ratio (OR)(95%CI): 1.458 (1.146, 1.854)} and a negative significant association with binge episodic drinking {OR (95% CI): .328 (.108, 1.000}. The OLS regression found relationships with subjective health with alcohol frequency and quantity (β = .081, p <.01 and β = .092, p< .01, respectively). Relationships between self-reported physical health and heavy alcohol use or binge episodic alcohol use were not significant.

Conclusions and Implications: This analysis supports past prevalence research in that more than half of the over age 65 population reports not using alcohol. Alcohol consumption was significantly related to depression, but self-reported health was also positively related to both alcohol frequency and quantity in a large community based sample. The negative relationship between binge drinking and depression requires further clarification. Limitations of this analysis include possible bias of self-reported measures, but the findings indicate that social work clinicians must address both the positive and negative aspects of alcohol use patterns that are typically not considered problematic.