Depression and Heavy Drinking in Older Age: Does Gender Matter?

Background and Purpose: Heavy episodic drinking (a usual quantity of 4 or more drinks per drinking episode or 5 or more drinks per drinking episode in the past 12 months) among adults aged 60 or older is expected to increase in the near future and could lead to several negative health outcomes.  Preliminary evidence suggests that depressive symptoms increase risk of heavy episodic drinking in older adults, but there has been little investigation of whether this relationship differs between men and women, who have different levels of risk and susceptibility for both depressive symptoms and heavy episodic drinking.  It is also unknown whether the presence of social support differentially affects depressed men and women in their risk for heavy episodic drinking, although limited findings indicate that heavy drinking older men may have less social support. This study examined two questions: (1) Does gender moderate the relationship between depressive symptoms and heavy episodic drinking in older adults? (2) Is this relationship further moderated by the presence of social support?

Methods:  A cross-sectional secondary data analysis of the 2005-2008 waves of the National Health and Nutrition Epidemiologic Survey (NHANES) was conducted.  Weighted logistic regression models were used to examine the study questions in adult drinkers aged 60 or older (n=1,356).

Results:  Gender moderated the relationship between depressive symptoms and heavy episodic drinking.  Among women, those with more depressive symptoms had higher odds of heavy episodic drinking.  For men, the opposite was true: the odds of heavy episodic drinking decreased as depressive symptoms increased.  There was also a three-way interaction between gender, social support, and being bothered by depressive symptoms.  Particularly for women, the presence of social support buffered against the negative effects of being bothered by depressive symptoms on risk of heavy episodic drinking. 

Conclusion and Implications: Gender appears to significantly alter the effect of depressive symptoms on heavy episodic drinking in older age.  The presence of depressive symptoms, being bothered by depressive symptoms, and social support appear to be particularly important for women in determining risk of heavy episodic drinking in older age.  In addition, contrary to earlier findings, risk of heavy episodic drinking was lower for older men with increasing depressive symptoms, suggesting that more research is needed on gender differences in the relationships between mental health dysfunction and high risk behaviors like heavy drinking.  Social workers working with aging populations should assess drinking while treating depression, especially for women and those with fewer social resources.  More research on these mechanisms is needed to craft interventions addressing depressed older women’s unique risks for heavy episodic drinking.