Guidelines from the National Institute on Alcohol Abuse and Alcoholism recommend no more than 4 alcoholic drinks in a day or 14 drinks per week for men under age 65 and no more than 3 drinks in a day or 7 drinks per week for women and persons over age 65. This community-based cohort study examined the association between drinking and alcohol problems* among 719 adult drinkers aged 55 to 65 years at baseline and followed for 20 years.

• Among participants who continued to drink over the follow-up period, the percentage exceeding recommended guidelines decreased from 65% of men and 49% of women to 49% of men and 27% of women.
• At baseline, 34% of men and 21% of women who drank ≥2 drinks per day or ≥7 drinks per week had drinking problems, while 41% of men and 27% of women who drank ≥3 drinks per day or ≥14 drinks per week had drinking problems.
• Twenty years later, 22% of men and 8% of women who drank ≥2 drinks per day or ≥7 drinks per week had drinking problems, while 30% of men and 15% of women who drank ≥3 drinks per day or ≥14 drinks per week had drinking problems.

*Meeting 2 or more DSM-IV criteria for alcohol abuse.

Commentary by Michael Boyle, MA
A substantial number of older adults have life problems related to alcohol consumption. Many of these individuals may respond well to brief interventions provided by their primary care physicians if such problems are identified. The authors of this study recommend using a more conservative screening cutoff of ≥2 drinks per day or ≥7 drinks per week to better identify excessive drinking in older adults that may be associated with drinking problems, particularly among men. As the population ages, the ability to identify alcohol-related problems through more effective screening will become increasingly important, as will the availability of treatments that are desirable and work well for older adults.