Drinking in Ontario
The Centre for Addiction and Mental Health's 2001 CAMH Monitor eReport: "Addiction & Mental Health Indicators Among Ontario Adults" provides interesting figures on drinking and other substance use throughout Ontario in 2001, and changes since 1977.
The statistics in the report may point to some trends that need to be carefully considered and monitored closely. More older Ontarians are drinking daily, and more are drinking at higher levels, both percentage wise and in absolute numbers. Older adults (people 65+) are the fastest growing age group in Canada, and that age group will expand significantly over the next 20 to 30 years as "Baby Boomers" (those born between 1945 and 1964) grow into old age.
CAMH derives its estimates from the 2001 CAMH Monitor. This is a telephone survey of 2,627 adults. These CAMH surveys represent the longest ongoing study of adult alcohol and other drug use in Canada.
You can find the full report (152 pages) at: www.camh.net/pdf/CM2001_EpiReport_final.pdf
Highlights of the Ontario Report
The graph below shows the change in the percentage of Ontario seniors who consume alcohol (1977 to 2001). Adapted from Table 3.1.2, page 16 of the report. While the percentage of middle aged people who consume alcohol has been decreasing during the past 24 years, the percentage of older Ontarians (aged 65+) who drink has gradually been increasing.*
Are yesterday's younger people carrying their earlier life drinking patterns into later life? Is drinking being promoted among older adults as a healthy activity by health providers or the media?
*The percentage of drinkers has decreased for successive waves of those in their 40s and remained fairly stable for successive waves of people in their 50s.
Percentage of Middle aged and Older Ontarians Drinking Alcohol During Past 12 Months, 1977-2001
Page 19: Daily drinking tends to increase significantly with age. It ranges from a low of 1.6% among 18 to 29 year-olds, to a high of 10.9% for those 65 and older.
The figure at page 80 of the report, shows that older adults who drink daily are also much more likely than other age groups to be experiencing some form of psychological distress.
Key Message #1: The percentage of people drinking daily tends to increase significantly with age.
Key Message #2: Daily drinking ranges from a low of 1.6% among 18 to 29 year-olds, to a high of 10.9% for those 65 and older.
Key Message #3: Daily drinking has been decreasing over the past 25 years among many other age groups, but not as much among older adults.
Page 24 provides a graph with the percentage of men and percentage of women aged 50+ who consume alcohol daily. While the percentage of middle aged and older adults drinking daily has decreased since 1977, it is much higher than for Ontarians generally.
So for example, while about 11% of men and only 1% of women aged 18-29 were drinking daily in 1977, this decreased to 2% of men and 1% of women in the same age group by 2001. In other words, there has been a five- fold decrease for the young men over the past twenty-five years.
While about 21% of men and 5% of women aged 30-49 were drinking daily in 1977, this also decreased dramatically to only 5% of men and 2% of women in the same age group in 2001. In other words, for the men in this age group, the percentage of daily drinkers was only one quarter of what it had been approximately 25 years earlier.
Among people aged 50 and over the percentage decrease has been much less. For the men aged 50 and over, it went from about 17% in 1977 to 14% in 2001. For the women aged 50 and over, it decreased from about 7% to 4% from 1977 to 2001.
The Percentage of Older Ontarians Drinking Daily During the Past 12 Months, 1977-2001. Adapted from Table 3.2.3, page 22.
Average Number of Drinks that Ontario Seniors Consumed Weekly
Key Message # 4: Average number of drinks consumed by older adults per week (3.73) in 2001 was only slightly less than that for 18-29 year olds (3.85), in spite of the less physical tolerance for alcohol of many older adults.
Key Message # 5: While younger adults are drinking less on average in a week period compared to 10 years ago, older adults are not.
The average figures for numbers of drinks consumed by drinkers aged 65 and over per week have gone up and down since 1992. The average was 3.73 drinks in 2001 (Page 26). This average is just slightly lower than for 18-29 year olds.
As can be seen from the graph, younger people appear to be drinking much less on average compared to 10 years ago (from an average of just under six drinks weekly in 1992 to about 4 drinks weekly in 2001) . Older people are not.
It is also important to realize that there are significant differences between men and women across all age groups in terms of who is likely to be drinking on a daily basis. Men tend to drink more, more frequently and more regularly. Any trends in later life we tend to see, are actually more pronounced (stronger) among older men, if you take gender into account.
Key Message # 6: Drinking 15+ drinks a week is considered a level that can likely compromise people's health and wellbeing. About 1 in 38 seniors (2.6%) consumes 15+ drinks a week. This is a higher percentage than 40-49 year olds or 50-64 year olds.
Key Message # 7: Widows and widowers may be more likely than married couples to drink at unhealthy levels.
In research, the percentage of people reporting 15 or more drinks on a weekly basis can be considered as an indicator of how much of the population is drinking at a level that may potentially compromise their health and well-being. Across all age groups, the odds of men drinking at this rate are almost 10 times greater than women (6.3% vs .1%).
The 15+ drinks / week figure is an average used for all
age groups. It does not take into account any differences in people's health, or
whether they take any medications that might adversely interact with alcohol.
Across all age groups, people who were never married and people who were previously married are significantly more likely to drink 15 or more drinks weekly (6.3% and 3.4%, respectively) than those who are currently married (2.3%). That would seem to suggest that becoming widowed might be linked to higher drinking, particularly for some older men.
Page 29 shows that 2.6% of the seniors are drinking 15+ drinks a week. It is much higher than 40-49 year olds or 50-64 year olds. (The authors of the report caution that the estimates for all age groups here are statistically unstable).
The 5+ Indicator
Key Message # 8: One in twenty older adults who drinks consumes five or more drinks on a single occasion on a weekly basis.
Key Message # 9: Having 5+ drinks in one sitting leads to a higher blood alcohol content for an older person and likely has a greater negative health effect (e.g., more likely leading to falls, other unsafe behaviours such as falling asleep while smoking and drinking) compared to a younger adult.
Key Message # 10: The 5+ rate of drinking for older adults has been increasing from 1977 to 2001, but moreso for older men than older women.
Another indication of unhealthy drinking is if people are drinking five or more drinks on a single occasion on a weekly basis during the 12 months before the survey is used as an indicator of regular heavy intake of alcohol.
Realistically for most older adults, drinking at that rate is more than heavy intake, it is hazardous drinking, because of age-related changes. Older adults end up with a higher blood alcohol concentration (BAC) than younger people after consuming an equal amount of alcohol. The higher BAC results from an age-related decrease in the amount of body water in which to dilute the alcohol (NIAAA, 1998).
The Ontario report notes that the rates of consuming 5+ drinks a day on a weekly tend to decline significantly with age, which is accurate. People aged 18 to 29 report the highest rate of consuming five or more drinks weekly (18.4%), compared to the older age groups.
People aged 65 and older reported the lowest rate (5.5%). (See table below, which is adapted from CAMH figure at page 33 of the report). That's much lower than 18-29 year olds and other age groups, but the negative health effects of drinking at this level are likely to be greater for older adults.
Another stereotype bites the
dust: People may incorrectly assume that drinking is higher among
people who have less education. In actuality, consuming 5+ drinks weekly is less common among people who are less
educated. This level of drinking is more common among people with a high school
education, than among people who did not complete high school.
Page 37 also shows that the 5+ rate has been increasing from 1977 to 2001 for older adults, but more for the men than women.
Measuring the Extent of Alcohol Related Problems Among Older Adults
Key Message # 11 : The survey tools that are being used to measure alcohol problems may not reflect the types of problems that many older adults experience, and as a result may under-represent the problems in older adults.
The Ontario survey uses AUDIT to measure harmful drinking- unfortunately it is not very a reliable tool for measuring problem drinking among older adults.
As a result, it is not surprising that the survey could find almost no "problem drinkers" in the older population using this criteria (1%), in spite of the fact that other indicators throughout the survey seem to suggest otherwise.
The use of inappropriate measurements or indicators is a significant problem that impedes our understanding the extent and nature of alcohol problems among older adults. It fails to identify or minimizes existing problems. It can seriously misrepresent the problem, and accordingly misinform the direction of public policy and resource allocation.
Summary and Conclusion
It is very easy to overlook the drinking trends among older adults. The trends seem benign and older adults are often treated as an invisible group of people. Compared to younger adults, they appear to be moderate drinkers and have a greater portion on non-drinkers. It is easy to overlook the fact that
- the percentage of people drinking daily is higher among older adults (65+) than any other age group,
- while the percentage of daily drinkers has been decreasing significantly in other age groups in Ontario over the past 24 years, the decrease in percentage is far less among older adults,
- the average number of drinks consumed weekly is higher among people 65 and over than it is 18-29 years olds,
- among the older drinkers, over one in twenty is drinking at a level that would likely be problematic for adults of any age,
- having 5+ drinks in one sitting leads to a higher blood alcohol content for an older person and likely has a greater negative health effect (e.g., more likely leading to falls, other unsafe behaviours such as falling asleep while smoking) compared to a younger adult.
The existence of alcohol problems among older adults is easily underestimated. The survey instruments used to measure alcohol use problems are not well suited to older adults' life situations.
Centre for Addiction and Mental Health. (2002) Addiction & Mental Health Indicators Among Ontario Adults, 2001.whttp://www.camh.net/pdf/CM2001_EpiReport_final.pdf
National Institute on Alcohol Abuse and Alcoholism, Alcohol Alert,No. 40, April 1998. See: www.niaaa.nih.gov/publications/aa40-text.htm
Page last updated Monday January 17, 2005
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