New research shows that one in 10 of them over 65 engages in college-style drinking behavior
Binge drinking is often portrayed as a college thing. But this risky form of imbibing actually declined among U.S. university students from 2005 to 2014. It is now most prevalent among people from 25 to 34 and is increasing among people over 50. And new research finds that 10.6% of seniors 65 and older are binge drinkers — though the actual total is almost surely higher.
“Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States,” according to the Centers for Disease Control and Prevention. It is linked to everything from car crashes and burns to homicide and suicide, along with stroke, heart disease, and cancer. Especially among the elderly, it also increases the risk of falls.
The new study, published in the Journal of the American Geriatrics Society, involves self-reported data on the drinking patterns of 10,927 U.S. adults 65 and older. Researchers used a common definition of the minimum threshold for binge drinking: four drinks for a woman or five for a man in a single two-hour window in the past month.
While the new figure for seniors is higher than previous estimates of 7.7% to 9%, it’s not entirely clear if binge drinking among the 65-plus set is on the rise, or if the increase is a result of differing data and methods, explains study leader Benjamin Han, an assistant professor in the department of medicine at NYU Langone Health.
Other research, however, points to an increase.
A separate 2017 study by Han and colleagues found that binge drinking rose 19.2% between 2006 and 2014 among people 50 and over. And a 2017 study led by Bridget Grant at the National Institute on Alcohol Abuse and Alcoholism, using different survey data, determined that high-risk drinking rose 65.2% among people 65 and over from 2001 to 2013. High-risk drinking was defined as weekly consumption (rather than in the past 30 days) of four drinks for women, or five for men, in a given day (instead of in a two-hour period).
“What’s more, binge-drinking seniors are more likely to double-dip: 5.5% of them used cannabis in the past month, compared to 1.1% of non-drinkers and 2.3% of people who drink but don’t binge.”
“There is strong evidence that the rate of binge drinking is increasing among older adults,” says Frederic Blow, director of the Addiction Center at the University of Michigan. Blow, who was not involved in the new study, said it validates similar research he and others have conducted, showing that binge drinking later in life is common.
It’s not clear why so many seniors are bingeing. In the past, people have tended to drink less after middle age, researchers say. But baby boomers — who are now 55 to 75 — are “continuing to use alcohol at a higher rate than previous older generations,” according to a 2016 study in the journal Alcohol Research.
The new analysis shows that 58.3% of the binge drinkers are men, and that binge drinkers are more likely to have less than a high school education and family incomes below $20,000 a year. African Americans, the analysis shows, are more likely to binge than other ethnic groups.
What’s more, binge-drinking seniors are more likely to double-dip: 5.5% of them used cannabis in the past month, compared to 1.1% of non-drinkers and 2.3% of people who drink but don’t binge. Combining the two substances can cause greater impairment and lead to higher consumption of both, and a greater risk of mental health disorders, the researchers say.
The problem is often underestimated
The new study, and others like it, rely on self-reporting, which is not always accurate — particularly with sensitive questions.
“People who drink tend to underreport, but people who drink a lot tend to underreport more, both because they may be more conscious that they drink too much, but also they may forget,” says Timothy Naimi, professor of medicine at Boston University School of Medicine and a physician at Boston Medical Center. Further, Naimi explains, some people who drink a lot aren’t enrolled in the surveys, in part because they may not have stable housing or otherwise be accessible to researchers. Therefore, surveys typically capture less than half of actual alcohol consumption, based on alcohol sales data, he says.
While 10.6% is a “robust and concerning amount” of senior bingeing, the true prevalence is “probably considerably higher,” Naimi says. And though Han’s study looked only at the minimum threshold, “typically people who binge drink do it three or four times a month,” Naimi says.
Binge drinkers may not drink all the time, he adds, but when they binge, men typically consume seven or eight drinks, and women down more than five or six on average. “For most folks, it’s drinking to the point of being drunk,” Naimi says.
A strange twist
Among the binge-drinking seniors, 41.4% have high blood pressure, 23.1% have cardiovascular disease, and 17.7% have diabetes, Han’s team finds. Each of these conditions is exacerbated by drinking and especially by heavy drinking or binge drinking, the researchers say. The binge drinkers also report more visits to the emergency room compared to drinking seniors who do not binge drink, Han says.
Curiously, however, binge drinkers are less likely to have chronic diseases than other seniors who drink but don’t binge, the study finds. Anomalies like this are seen in other studies of alcohol consumption, and Han explains what scientists think is going on: “As adults get sicker, either from having more chronic diseases or being hospitalized, they tend to decrease their alcohol use,” he says. “Many think of it as: You have to be healthy enough to drink, especially to drink in excess.”
That in no way suggests binge drinking is good for people.
Binge drinking amplifies liver injury in chronic drinkers, researchers found in a 2013 review of multiple studies, reported in the journal Alcoholism: Clinical & Experimental Research. Because the liver produces and stores nutrients and other substances vital to other organs, liver disease caused by alcohol consumption can have a domino effect on the function of the heart, kidneys, and blood vessels, the researchers say.
And no surprise, frequent binge drinking, more than two days a week, ups the odds of insomnia symptoms by 84%, another study found.
Unaware of the risks
Binge drinkers may not even realize they’re binge drinkers, Han says.
“When I see patients, many are not aware that there are recommendations for drinking limits,” he explains. “I also find that among older adults, many do not realize that there are recommendations to decrease alcohol use, especially when taking certain prescription medications or if they have specific chronic diseases. We have a lot to do to educate people to reduce alcohol-related harms.”
“Unfortunately, our knowledge about the impact of drinking on older adults is still emerging,” says Blow, the University of Michigan researcher. What’s clear, he says, is that “alcohol use increases potential for bad outcomes as we age, and just maintaining drinking levels from earlier ages can result in serious consequences.”