Excessive Drinking - Ages 65+

Excessive Drinking - Ages 65+ in United States

United States

Excessive drinking is a problem that affects people of all ages and is responsible for approximately 95,000 deaths and 2.8 million years of potential life lost each year in the United States. Adults ages 65 and older have a higher alcohol-attributed death rate than adults ages 25-44. Between 2015 and 2019, nearly 48,000 people ages 65 and older died from excessive alcohol use on average each year. 

Excessive alcohol consumption is associated with many negative health outcomes, including:

• Unintentional injuries, such as alcohol poisoning, motor vehicle accidents and falls.
• Cardiovascular conditions, including hypertension, heart disease and stroke.
• Cancers of the breast, colon, esophagus, liver, mouth and throat.
• Mental health consequences, including dementia and mood disorders such as anxiety and depression.

Alcohol tolerance tends to decrease with age, often leading to increased alcohol sensitivity among older adults. Alcohol also causes harmful interactions with many prescription drugs, which are commonly used among older populations. More than 87% of people ages 65 and older have used at least one prescription drug within the last 30 days, and nearly 40% have used five or more prescription drugs. One study found that 20% of community-dwelling adults ages 57-84 reported drinking at least one drink a week while taking medication with a documented alcohol interaction.

The prevalence of excessive drinking is higher among:

• Older men compared with older women.
• American Indian/Alaska Native older adults compared with Asian older adults. White, Hispanic and Black older adults also have a high prevalence.
• Older adults with an annual household income of $75,000 or more compared with those with incomes less than $25,000. Those with incomes of $25,000-$49,999 also have a low prevalence.
• Older adults living in metropolitan areas compared with those in non-metropolitan areas.

Alcohol misuse among older adults is often underreported, under-detected and misdiagnosed. The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse. Behavioral counseling may reduce alcohol misuse for persons engaged in risky or hazardous drinking. The Community Services Preventive Task Force provides several evidence-based community-level strategies to reduce the harms of excessive alcohol consumption. These include using electronic screening, increasing taxes on alcohol purchases and limiting the days and hours alcohol can be sold. There are also treatment options for older adults who misuse alcohol, including support groups, rehabilitation facilities and therapy. The Centers for Disease Control and Prevention has a free online alcohol screening tool to anonymously check an individual's drinking, identify barriers to and motivators for drinking less, and make a personalized change plan.

Healthy People 2030 has a goal to reduce the proportion of people ages 21 and older who engaged in binge drinking in the past month.

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Esser, Marissa B., Adam Sherk, Yong Liu, Timothy S. Naimi, Timothy Stockwell, Mandy Stahre, Dafna Kanny, Michael Landen, Richard Saitz, and Robert D. Brewer. “Deaths and Years of Potential Life Lost From Excessive Alcohol Use — United States, 2011–2015.” MMWR. Morbidity and Mortality Weekly Report 69, no. 39 (October 2, 2020): 1428–33. https://doi.org/10.15585/mmwr.mm6939a6.

“Health, United States, 2018.” Hyattsville, MD: National Center for Health Statistics, 2019. https://www.cdc.gov/nchs/data/hus/hus18.pdf.

Qato, Dima Mazen, Beenish S. Manzoor, and Todd A. Lee. “Drug–Alcohol Interactions in Older U.S. Adults.” Journal of the American Geriatrics Society 63, no. 11 (2015): 2324–31. https://doi.org/10.1111/jgs.13787.

Worcester, Sharon. “Study Shines Light on ‘Invisible Epidemic’ of Alcohol Use.” Caring for the Ages 17, no. 7 (July 1, 2016): 6. https://doi.org/10.1016/j.carage.2016.06.007.