Which Seniors Are Starting to Binge Drink More: Men or Women?
— Pre-pandemic data show how trends have changed over time for older population

MedPage 
by Kara Grant, Enterprise & Investigative Writer
December 8, 2021

In recent years, binge drinking among older folks increased for men but stayed flat for women, an analysis of National Survey on Drug Use and Health (NSDUH) data found.

From 2015 to 2019, binge drinking among people ages 65 and older significantly increased from 12.8% to 15.7% for men (P=0.02) while remaining stable for women, from 7.6% to 7.3% (P=0.97), reported Tala Al-Rousan, MD, MPH, of the University of California San Diego, and colleagues.

In adjusted models, attaining a college degree was linked to a lower risk of binge drinking among men (adjusted prevalence ratio [aPR] 0.69, 95% CI 0.56-0.85). For women, though, having a college degree was associated with a higher risk (aPR 1.68, 95% CI 1.13-2.50), the researchers said in their study in the Journal of the American Geriatrics Society.

Binge drinking, as defined by the National Institute on Alcohol Abuse and Alcoholism, is the consumption within 2 hours of five or more drinks for men, and four or more for women.

Al-Rousan and co-authors also found that men who reported being divorced or separated had an increased risk of binge drinking (aPR 1.25, 95% CI 1.05-1.50), whereas divorced or separated women showed no detectable changes in their binge drinking habits.

Compared with men with a family income of less than $20,000 a year, men who reported a yearly income of $50,000 to $74,999, or $75,000 or higher had a greater likelihood to binge drink (aPR 1.33, 95% CI 1.03-1.71; and aPR 1.33, 95% CI 1.01-1.74, respectively). Income was not linked to binge drinking behaviors among women.

Despite the number of gender-specific differences that the researchers discovered, the use of tobacco and cannabis products remained a common risk factor for binge drinking for both men and women:

• Tobacco use in men: aPR 1.87 (95% CI 1.61-2.17)
• Tobacco use in women: aPR 2.11 (95% CI 1.71-2.60)
• Cannabis use in men: aPR 2.05 (95% CI 1.63-2.58)
• Cannabis use in women: aPR 2.77 (95% CI 2.00-3.85)

Certain health conditions were associated with a lower risk for binge drinking:

• Diabetes in men (aPR 0.76, 95% CI 0.62-0.94)
• Diabetes in women (aPR 0.73, 95% CI 0.55-0.97)
• Kidney disease in men (aPR 0.54, 95% CI 0.34-0.86)

While hypertension was associated with a higher risk in men (aPR 1.25, 95% CI 1.05-1.49).

“Our study brings the most up-to-date findings on trends in binge drinking in older age, especially the unnoticed importance of understanding the unique demographic characteristics of binge drinking that differ in men and women given gender norms and expectations of societies that are consistently evolving,” Al-Rousan said in a statement.

“For example, we noted an increased frequency in education among binge drinking older women. Women with more education may have more opportunities to drink and may be less constricted by gender norms against women consuming alcohol,” she continued. “Moreover, our findings would encourage health providers who care for older men and women with chronic conditions who are at risk of binge drinking to offer tailored messages that are targeted at certain chronic conditions.”

For the study, the researchers analyzed answers from 18,794 NSDUH respondents age 65 and older from across the U.S. — 8,466 male respondents and 10,328 female respondents, 75-80% white, 8-10% Black, and 6-8% Hispanic.

The team also investigated whether the depressive episode or emergency department admission was associated with increased binge drinking, but no relationship between these factors was discovered, the researchers said.

They explained that this may be due, at least in part, to the fact that NSDUH data include only non-institutionalized individuals, omitting homeless or hospitalized populations from the overall sample. Another limitation, the researchers said, is that NSDUH is a self-report survey and thus subject to recall and social desirability bias, which may be especially true in the case of evaluating drug and alcohol use.