Alcohol and Older People: A Systematic Review of Barriers, Facilitators and Context of Alcohol Use in Older People and Implications for Intervention Design
Research article
Abstract
Background
Alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed.
Methods
Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of alcohol use in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA.
Results
Alcohol use in older people is strongly linked to social engagement and there is skepticism about the health risks of alcohol. Alcohol use was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own alcohol use and strategies that emphasize the life experience of older people could be helpful.
Conclusions
To be effective, societal approaches need to take into account contexts of risks for alcohol use. The evidence supports a strong social role for consuming alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from using alcohol but retain the benefit of socializing.
