Trends in alcohol use by educational level in individuals aged 65 and over in Spain

Abstract

Background/Objectives: Alcohol is the most frequently consumed drug in people aged ≥ 65 years, many of whom exceed the daily limits of alcohol consumption recommended by public health guidelines. Further more, 25% of alcohol attributable deaths occur in people aged ≥ 65 years. While the overall trend of alcohol use has been declining in recent years, some point out that this does not happen in people aged ≥ 65 years. Our objective was to describe the evolution of alcohol consumption in people aged ≥ 65 years in Spain by sex and educational level during 2001-2020. Methods: Data comes from the consecutive editions of the Spanish National Health Survey (ENSE) and the European Health Survey (EES) in Spain. We selected people aged ≥ 65 years. Average daily alcohol intake in grams of pure alcohol was estimated from the quantity frequency of self-reported intake of different alcoholic beverages, assigning a differentiated alcohol content to each of them. Subsequently, the prevalence of intake of < 10/20 grams (moderate drinking) and ≥ 10/20 grams (regular excessive drinking) for women and men, respectively, were obtained. Educational level was categorized into ≤ primary, secondary, and higher education. Changes in alcohol use between 2001-2011 and 2014-2020 were assessed. Results: Prevalence of moderate drinking showed an increasing trend in men throughout the period, while in women it remained stable. By contrast, the prevalence of regular excessive drinking showed a general downward trend in both men and women, regardless of their educational level. The prevalence of regular excessive drinking decreased between the two analysed periods, being this decrease more noticeable in men, while no major sex differences were observed for moderate drinking prevalence. The differences according to educational level in prevalence of alcohol use decreased during the study period. Conclusions/Recommendations: Among people aged ≥ 65 the prevalence of regular excessive alcohol use decreased during 2001-2020, while the prevalence of moderate drinking increased. Educational inequalities in alcohol consumption decreased in the most recent years.