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Protective health benefits of drinking alcohol may have been overestimated

But lower recommended alcohol levels for older people are unnecessary, study suggests

Ingrid Torjesen

Wednesday, 11 February 2015

Any health benefits from drinking alcohol in older people may be limited to women aged 65 and over and men aged 50-64 and even these may have been exaggerated, suggests research published in The BMJ today.

High alcohol consumption has been associated with more than 200 acute and chronic conditions, but some studies have suggested that moderate consumption, compared to total abstinence, may protect against cardiovascular disease and bring mortality benefits.

But the protective effects of light drinking may have been exaggerated by “selection biases” in studies, some critics have argued. For example, by including former (potentially heavy) drinkers in non-drinking groups or not taking full account of other unmeasured (confounding) factors.

Furthermore there has been concern about increasing alcohol consumption among older people and risk of alcohol related problems due to impaired metabolism of alcohol with age. As a result, the Royal College of Psychiatrists has recommend that alcohol consumption should be reduced for both sexes to a maximum of 11 units per week or 1.5 units a day for people aged 65 years or more.

For The BMJ study researchers explored the association between alcohol consumption and mortality in older age groups using interview data from Health Survey for England 1998-2008 linked to national mortality data. Samples of 18,368 and 34,523 adults were analysed by sex and age group (50-64 years and 65 years and over) and participants were interviewed about their average weekly alcohol consumption and use on the heaviest drinking day of the week. The results were adjusted for a range of personal, socioeconomic, and lifestyle factors.

Compared with never drinkers, protective associations were largely limited to men aged 50-64 years who reported consuming 15-20 units on average per week or 0.1-1.5 units on the heaviest day, and to women aged 65 and over who reported consuming 10 units or less on average per week. Little to no protection was found in other groups. The authors also stressed that protective associations “may be explained by selection biases”.

However, the researchers said that their results did not support the introduction of age specific recommended alcohol limits for persons aged 65 years and over.

In a linked editorial, Professor Mike Daube from Curtin University in Australia, welcomed the study as part of a growing body of evidence that alcohol intake is unlikely to offer any health benefits.  New evidence or health claims, “should be treated with great caution” and health professionals should discourage alcohol intake, even at low levels, for health benefits, he said.

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