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Alcohol and Older Adults in New Zealand

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Alcohol and Older Adults in New Zealand Alcohol and older adults in New Zealand A literature review Ian Hodges Caroline Maskill October 2014 ACKNOWLEDGEMENTS The Health Promotion Agency (HPA) would like to thank the Accident Compensation Corporation of New Zealand (ACC) for co-funding this research with HPA and for its shared vision of the need for this literature review. It is the first time that a comprehensive literature review about the impact of alcohol on older adults in New Zealand has been undertaken. HPA would also like to thank the authors - Ian Hodges and Caroline Maskill, HealthSearch Limited, for their dedicated work in undertaking this literature review report. The commissioning of this report was project managed by Rosie Pears, Principal Policy Advisor, HPA, and Lee Henley, Programme Manager, ACC. COPYRIGHT The copyright owner of this publication is the Health Promotion Agency. HPA permits the reproduction of material from this publication without prior notification, provided that fair representation is made of the material and HPA is acknowledged as the source. DISCLAIMER This research has been carried out by an independent party under contract to HPA. The views, observations and analysis expressed in this report are those of the authors and are not to be attributed to HPA. Provider: HealthSearch Limited ISBN: 978–1–927303–29-0 (Online) Citation: Hodges, I., & Maskill, C. (2014). Alcohol and older adults in New Zealand: A literature review. Wellington: Health Promotion Agency. This document is available at www.hpa.org.nz and www.alcohol.org.nz Any enquiries about this report should be directed to HPA at the following address: Health Promotion Agency Level 4, ASB House 101 The Terrace PO Box 2142 Wellington 6140 Email: [email protected] October 2014 Alcohol and older adults in New Zealand A literature review Ian Hodges and Caroline Maskill HealthSearch Limited ALCOHOL AND OLDER ADULTS IN NEW ZEALAND: A LITERATURE REVIEW CONTENTS Executive summary ........................................................................................................... 1 1 Introduction ................................................................................................................. 10 Research questions ....................................................................................................... 10 The literature search ...................................................................................................... 10 Environmental scan ....................................................................................................... 11 Preparing the report ....................................................................................................... 11 Structure of the report .................................................................................................... 12 2 Older adults in New Zealand ....................................................................................... 13 The diversity of older adults ........................................................................................... 13 Defining older adults ...................................................................................................... 14 Size of the older adult population – now and in future .................................................... 14 Gender .......................................................................................................................... 15 Ethnic group and birthplace ........................................................................................... 16 Work and income .......................................................................................................... 18 Home, family and friends ............................................................................................... 20 Wellbeing, health and disability ..................................................................................... 22 3 Drinking patterns of older adults ............................................................................... 25 Overview of New Zealand surveys ................................................................................ 25 Interpreting the survey results ....................................................................................... 26 Older adults who drink alcohol ....................................................................................... 27 Drinking status and ethnicity .......................................................................................... 29 Changes in drinking status ............................................................................................ 31 Drinking frequency......................................................................................................... 33 Amount of alcohol consumed ........................................................................................ 37 Types of drink ................................................................................................................ 45 Drinking location and events .......................................................................................... 46 Additional data from surveys of adults aged 50‒65........................................................ 47 4 Hazardous and harmful drinking among older adults .............................................. 48 Defining hazardous and harmful drinking ....................................................................... 48 Screening tools .............................................................................................................. 49 Prevalence of hazardous drinking .................................................................................. 53 Prevalence of harmful drinking ...................................................................................... 57 Hazardous/harmful drinking – surveys using full (10-item) AUDIT ................................. 59 Additional data from surveys of adults aged 50‒65........................................................ 62 i ALCOHOL AND OLDER ADULTS IN NEW ZEALAND: A LITERATURE REVIEW 5 Factors influencing the drinking of older adults ....................................................... 63 Why older adults drink ................................................................................................... 63 Reasons older adults reduce their alcohol consumption ................................................ 65 Reasons older adults increase their alcohol consumption.............................................. 68 Influences on early- and late-onset drinking problems ................................................... 72 6 Alcohol and the health of older adults ....................................................................... 78 Older adults have an increased sensitivity to alcohol ..................................................... 78 Health conditions associated with alcohol use ............................................................... 79 Research on specific health conditions .......................................................................... 82 Interaction of alcohol with existing health conditions ...................................................... 85 Interactions between alcohol and medications ............................................................... 86 7 Interventions to reduce hazardous and harmful drinking by older adults .............. 89 Population-wide interventions not covered here ............................................................ 89 Health promotion and health education ......................................................................... 90 Interventions delivered in health care settings ............................................................... 93 Professional education and training ............................................................................. 103 Specialist alcohol treatment services ........................................................................... 103 8 Knowledge gaps and future research ...................................................................... 114 Surveying the drinking patterns of older adults ............................................................ 115 Measuring hazardous and harmful drinking among older adults .................................. 115 Survey screening tools ................................................................................................ 115 Factors influencing the drinking of older adults ............................................................ 116 Alcohol and the health of older adults .......................................................................... 117 Screening and brief intervention .................................................................................. 118 Specialist alcohol treatment services ........................................................................... 118 Appendix tables ............................................................................................................... 119 References ...................................................................................................................... 146 Glossary........................................................................................................................... 160 ii ALCOHOL AND OLDER ADULTS IN NEW ZEALAND: A LITERATURE REVIEW LIST OF TABLES Table 2.1: New Zealand Health Survey health indicators, by age group, 2012/13 .............. 23 Table 3.1: Percentage of drinkers, Mosgiel survey, by
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