Social factors can both predict and sustain alcohol misuse among older drinkers

Social factors have consistently been implicated as a cause of vulnerability to alcohol use and abuse. The reverse is also true, in that individuals who engage in excessive drinking may alter their social context. New research on drinking among older adults has found that older adults who have more money, engage in more social activities, and whose friends approve more of drinking are more likely to engage in excessive or high-risk drinking.

Results will be published in the April 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Ours is one of the first studies to focus longitudinally on high-risk drinking among older adults," said Rudolf H. Moos, senior research career scientist for the Department of Veterans Affairs Health Care System in Palo Alto, California, as well as corresponding author for the study, "and the first to have 10-year and 20-year follow-ups addressing this issue."

Moos and his colleagues examined 719 (399 men, 320 women) 55 to 65-year-old adults at baseline (between 1986-1988), and then again 10 and 20 years later. At each contact point, participants provided information regarding their drinking, as well as their social and financial resources.

"Our findings show that, one, certain social factors may enhance the chances of an individual engaging in high-risk drinking and, two, once high-risk drinking has developed, social choices may be made to facilitate continuing this behavior," said Moos.

More specifically, results showed that older adults who have more money, who engage in more social activities, and whose friends approve more of drinking are more likely to engage in what is considered high-risk drinking: more than three drinks per day or more than 14 drinks per week.

"These findings show that social contextual models of alcohol use apply to older drinkers," observed Charles J. Holahan, a professor in the department of psychology at The University of Texas at Austin. "The findings undercut the assumption of a solely dispositional view of drinking among older adults, whose alcohol use might easily be assumed to be outside the sway of social influences after a lifetime of drinking. They also provide a textured picture of two processes that link social context and alcohol misuse in a reciprocal way—social causation, whereby social context shapes alcohol use, and social selection, whereby alcohol use in turn shapes social context."

"Older adults who engage in high-risk alcohol consumption tend to select friends who are more likely to drink and to approve of drinking," said Moos. "They may also experience a decline in the quality of relationships with extended family members, that is, high-risk drinking may impair some family relationships. Compared to older women, older men may be more vulnerable or susceptible to some social influences on drinking. Specifically, having more money, and friends who approve more of drinking, seem to be more closely related to high-risk drinking among older men than among older women."

"The findings serve to undercut a solely person-blame approach to later life drinking," said Holahan. "They demonstrate that a spouse and friends can make a constructive difference in later life drinking. However, a spouse and friends can also unwittingly become caught up as facilitators in the process of later life drinking. The findings also encourage awareness that alcohol misuse does not go away with aging. Although alcohol consumption declined with aging, at the 20-year follow-up more than 20 percent of adults aged 75 to 85 still engaged in high-risk alcohol consumption."

"This information can be used to teach older adults, and family members and friends who care about and have some responsibility for them, about how to avoid or minimize 'triggers,' such as specific social activities or interactions with friends associated with heavy drinking," said Moos. "While this type of information might be useful for brief interventions for older adults in primary care or community settings, there is no inherent reason why family members and friends of older adults who engage in excessive drinking could not use it."