Updated Understanding of the Experiences and Perceptions of Alcohol Use in Later Life

Abstract

The purpose of this study was to update our understandings of older adults’ experiences and perceptions of alcohol use. Taking a community-based research approach, three Knowledge Café workshops hosted 66 older adults and service providers in Vancouver, BC. Thematic analysis identified three overarching categories: (a) reasons older adults use alcohol, including out of habit, social expectations, or to self-medicate; (b) personal experiences of alcohol use, including reduced consumption over time as a result of the cost of alcohol, the physical effects, and increased knowledge about the effects of alcohol; and (c) older adults’ perceptions of alcohol use outcomes, including positive outcomes from drinking in moderation and negative outcomes that can worsen one’s health, lead to tolerance, and harm others. Developing and promoting healthy drinking behaviours in later life is needed as the general population continues to age.

Clusters of older adults with and without experience of alcohol-related harms based on affective motivations for drinking

“…Regarding coping and enhancement-motivated drinking, our results both corresponded to, and diverged from, those reported in previous studies. Similar to our study, across various populations, drinking alcohol to cope has been found to be associated with diverse measures of problematic drinking, including the DPI scale ( Ertl et al, 2018 ; Gilson et al, 2013 ; Gilson et al, 2017 ; Grant et al, 2007 ; Kuntsche et al, 2005 ; Moos, Brennan, et al, 2010 ; Moos, Schutte, et al, 2010 ; Nehlin & Öster, 2019 ; Öster et al, 2017 ; Schijven et al, 2019 ), some type of psychological affliction ( Beseler et al, 2008 ; Carpenter & Hasin, 1998 ; Ertl et al, 2018 ; Lau-Barraco et al, 2016 ; Miller et al, 2014 ; Simons et al, 2005 ), or painful medical condition ( Moos, Brennan, et al, 2010 ). We found two discrepancies between our results and those reported in Gilson et al (2017) , where items such as drinking to gain self-confidence and to cope with physical pain increased the odds of being a problem drinker.…”

“…Although with some variations in the number of dimensions (and their subtypes), drinking motivations common to all models have been differentiated as: internally generated coping motivation – involving negative reinforcement through avoidance or reduction of negative affect; externally triggered social motivation – social relatedness­; and internally generated enhancement motivation – which involves positive reinforcement through facilitating or intensifying positive emotions ­( Cooper et al, 1992 ; Cox & Klinger, 1988 ). Carpenter and Hasin (1998) also indicated the importance of considering the intensity of self-reported drinking motivation on drinking behaviour, and in the context of alcohol-related problems. For instance, having a stronger coping motive (drinking to relieve anxiety, perhaps) has been found to be a risk factor associated with clinically diagnosed alcohol use disorders ( Beseler et al, 2008 ; Carpenter & Hasin, 1999 ).…”

“…As is often underscored, alcohol-linked deterioration of physical and mental health, especially in older people, is a highly relevant individual and societal threat ( Anderson & Scafato, 2010 ; Behrendt et al, 2021 ; Bye & Moan, 2020 ; Emiliussen et al, 2017 ; Hallgren et al, 2010 ; Sorock et al, 2006 ). To enhance our understanding of drinking behaviour among older adults, alcohol consumption must also be understood in terms of the personal context (e.g., psychological health) or situation in which drinking occurs ( Carpenter & Hasin, 1998 ). Whether a person is likely to experience alcohol-related issues, either medical or non-medical, seems to be contingent not only on how often or how much alcohol people consume, but even more prominently on why people drink (e.g., in reaction to negative life events or to cope with negative emotions) ( Brennan & Moos, 1997 ; Gilson et al, 2013 ).…”

“…People give a multitude of reasons for drinking (e.g., socialising) and the way they drink (e.g., moderately, sporadically) (Canham et al, 2021;Emiliussen et al, 2017;Haarni & Hautamäki, 2010;Immonen et al, 2011;Kuntsche et al, 2014;Kuntsche et al, 2005). In most cultures where alcohol is available, users seem strongly motivated to consume alcohol for its hedonic effect, derived, essentially, from the intoxicating nature of the substance (Heather et al, 2001;Peele & Brodsky, 2000), and this powerful motivation may be perceived either as harmless or harmful for different persons and for different reasons (Edgar et al, 2016;Haarni & Hautamäki, 2010;Ward et al, 2011).…”