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The ‘Baby Boomer’ effect of increased alcohol-related harm

Older people represent an increasing proportion of alcohol-related hospital admissions, argues Dr Tony Rao

11 May 2016 – Last week (4 May 2016), Public Health England published its annual statistics for alcohol-related hospital admissions for England. Although we have usually associated the public health consequences of alcohol misuse with younger men, we have begun to see a very different picture emerge over the past decade.

Between 2001 and 2014, alcohol-related death rates in the England reduced significantly in men below the age of 60, with a corresponding significant increase in both older people men and women. For example, in men aged 70–74 and 80–84, there was an increase of more than 150%. The actual number of alcohol-related deaths in England between 1994 and 2014 increased by 65% or more in all age groups for both men and women. In the older age groups (aged 60 and over), the increase was considerably more over this 20-year timeframe. For older men, it was 117% and 82% for older women, with both of these groups showing a higher increase than the general population.

The recent data from Public Health England, as part of their Local Alcohol Profiles, paints a very similar picture. Overall, the number of alcohol-related admissions for the whole of England has increased by 32% between 2004/05 and 2014/15. For admissions that are wholly attributable to alcohol, this figure rises to 36%.

So where do older people figure in these datasets? The results might surprise you. During 2014/15, older men aged 65 and over formed 29% of alcohol-related admissions to hospitals in England. For older women, it was 26%. In other words, at least one-in-four alcohol-related admissions were for people aged 65 and over. Perhaps something else that might surprise you is that for people aged 65 and over, admissions were over 40% higher for mental and behavioural disorders associated with alcohol use compared with alcohol-related liver disease.

Last year, I looked at changes in drinking patterns in different age groups. What I found is revealing to say the least. For drinking frequency over the past week, the 16–24 age group showed a 23% reduction between 2005 and 2013 in both males and females. For those people aged 65 and over, there was only a 2% reduction for males and a 9% increase for females. For those drinking alcohol 5 days or more during the week, there was a reduction of 79% in males and 54% in females for the 16–24 age group. The corresponding reduction for the 65 and over age group was 8% in males and 5% in females. Lastly, for those 16–24 year-olds drinking above daily limits on the heaviest drinking day, there was a 35% reduction for males and a 32% reduction for females between 2005 and 2013. Over the same timeframe, there was an increase of 11% for males and 19% for women.

So what are to make of all this new data? Well, for one thing, a cause for concern for the public health and clinical implications of older people now being less likely to change their drinking behaviour than younger people is now beyond reasonable doubt. Older people also now form a sizeable proportion of alcohol-related deaths and hospital admissions.

The bottom line is that we need to pay close attention to drinking in people. There is still undoubtedly a 'Baby Boomer effect' of increased alcohol-related harm in older men and women. Although we are beginning to see pockets of activity around the country in addressing this trend, we have a still some way to go in providing integrated care at a clinical level for a problem that will continue to weigh heavily on the public health of this country.

Written by Dr Tony Rao, Consultant Old Age Psychiatrist, South London and Maudsley NHS Foundation Trust and Visiting Lecturer, Institute of Psychiatry, Psychology and Neurology.

All IAS Blogposts are published with the permission of the author. The views expressed are solely the author's own and do not necessarily represent the views of the Institute of Alcohol Studies.