Newswise — People who first experience problems with alcohol after the age of 60 may have better mental health functioning than those whose drinking problems start sooner, and the benefits of alcohol treatment are not conditional on when hazardous drinking began, a new study suggests. The findings emerged from the first known study to examine the alcohol use, mental health functioning, and treatment outcomes of older adults whose problematic drinking started at varying life stages. In the UK, more than one in five older adults drink alcohol at levels that risk harmful consequences; multiple countries report rising rates of problem drinking among people in mid- and late- life. Among older people drinking alcohol at harmful levels, one in three started problem-drinking after age 40. This may be linked to a loss of purpose, bereavement, or attempts to cope with physical or psychological challenges, as opposed to the genetic predisposition that is relatively common among younger problem drinkers. The age of onset of problem drinking has been regarded as an important indicator of drinking patterns and longer-term prognosis, but data on treatment outcomes is scarce. For the study in Alcohol: Clinical & Experimental Research, researchers in the UK examined how people with very late-onset problem drinking (age 60+) differ in their alcohol use, mental health, and treatment outcomes from those whose hazardous drinking started earlier.
Researchers worked with 780 people who drank hazardously; all were aged 50 or over, and 56% were men. Fifteen percent were early-onset problem drinkers (starting <25 years), 26% were mid-onset (starting 25–39 years), 48% were late-onset (40–59 years), 11% very late-onset (≥60 years). Participants completed assessments on alcohol use, mental health (anxiety, depression, and mental health well-being), and cognitive functioning. The researchers used statistical analysis to explore differences between the groups, adjusting for the effects of age (distinct from the age of onset of problem drinking).
On average, the very late-onset participants scored better on a medical measure of hazardous alcohol intake than those whose problem drinking began earlier in life. They also had lower levels of depression and better mental health well-being, suggesting that later age of onset is associated with better functioning for some aspects of mental health. Age on onset was independent of any change in drinking following treatment or the likelihood of completing treatment, indicating that adults could benefit from treatment regardless of their age when drinking became problematic. Other factors were somewhat predictive of treatment outcomes, however. Older adults were more likely to complete treatment than younger adults, older women reduced their drinking more than older men, and those with higher alcohol use when treatment began were more likely to discontinue treatment. Additional associations—such as lower anxiety and higher cognitive functioning in the very late-onset group—dissipated after the researchers adjusted for age. Although previous studies have suggested certain links between onset age and outcomes (e.g., that earlier onset is linked to higher alcohol use), the new findings imply that such results may have been, in part, a reflection of age, as opposed to age of onset.
Better understanding of the characteristics and outcomes of people who begin to experience problems with alcohol later in life can potentially inform more effective prevention and treatment strategies. Many people who need help with alcohol use have developed problem drinking after age 60. The results suggest that the age of onset of problem drinking does not predict alcohol use severity and treatment outcomes and that older adults can benefit from alcohol treatment irrespective of the age their alcohol problem began.
The characteristics and treatment outcomes of people with very late onset of problem drinking. J. Seddon, S. Wadd. (pp xxx)
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