SOROCABA – One in ten Brazilians over 60 years of age abuses alcoholic beverages, indicates a study conducted by Federal University of São Paulo (Unifesp). According to the researchers’ projections, there are about 2 million elderly (6.7%) who consume several doses in a single occasion, a pattern of abusive consumption, known as binge drinking. About 1.16 million (3.8%) usually drink from 7 to 14 drinks per week, an amount that can put their health at risk. In total, one in four elderly people (23.7%) claims to be a consumer of alcoholic beverages, albeit occasionally.
To arrive at these consumption patterns, researchers from the São Paulo School of Medicine of the Federal University of São Paulo (Unifesp) analyzed data from a study with 5,432 Brazilians over 60 years of age. Data collected from 503 elderly people attended at Basic Health Units (UBSs) in São José dos Campos, in the interior of São Paulo, were also used. The work, which became a doctoral thesis by researcher Tassiane Cristine de Paula, is unprecedented in the country and points out that alcohol consumption among the elderly is already a public health problem.
Excessive drinking among the elderly is not exclusive to Brazilians. At 95 years old and close to completing 70 years of reign, the Queen Elizabeth II was advised by UK doctors to stop drinking daily. Sources close to the British royal family spoke about this recommendation to the magazine Vanity Fair.
The Brazilian study indicated that elderly men consume more alcoholic beverages than women, although they are more vulnerable to the effects of the drink. It also showed that frequency and quantity decrease with increasing age. Those who consume more risky are men between 60 and 70 years old, especially those with more education (over 9 years of schooling). After the age of 70, consumption drops, especially among women. Alcohol intake among the elderly is more common in the Southeast region of the country.
Carlos Alberto Dias, 68-year-old Charles, owner of a fishing tourism company in Sorocaba, countryside of São Paulo, drinks one to two glasses of wine “every other day”, as he says. It is a 20-year routine, initiated by the influence of a woman, of Spanish origin, who loves this drink. “Before I drank beer. Now, a bottle of wine lasts three days after opening, as we take care not to oxidize”, he said. A member of wine clubs, he admits that, at weekend meetings, the doses go up.
Charles believes that age should not prevent the cultivation of a “nice” habit that he does not consider harmful. “If the queen’s drinks are taken away (in reference to the British monarch), she dies”, he compared.
The entrepreneur guarantees that he goes to the doctor only for periodic exams. “I don’t have high blood pressure or hypertension and I stay away from pharmacies. I do physical activity regularly, I just can’t do two tennis matches in a row anymore. I have clients who are doctors and they advise against spirits, not wine”, he said.
His wife, Maria Josefa Lopez Dias, 65, accompanies him in the rounds of well-served glasses. “We’re actually a drinking couple together,” she said. The pair is on the threshold of high-risk consumption, as the study considers less than one drink a day for women and less than two drinks for men as low risk. Above a daily dose for women (or 7 a week) and two for men (14 a week) becomes high risk consumption. More than four doses for women and five for men, within two hours, characterizes abusive consumption.
Excess increases risk of chronic diseases and falls
According to Tassiane, it is essential to understand this problem to propose strategies to reduce alcohol consumption among the elderly, preventing it from becoming a more serious public health problem. “It’s a worrying fact, because, with the increase in life expectancy, the proportion of elderly people is higher in the general population.”
According to her, studies indicate that harmful alcohol consumption in adults and the elderly may be related not only to serious health problems, such as cardiovascular disease, hypertension, cancer and dementia, but also to a high risk of mortality and increased risk of accidents and injuries.
“In aging, the use of alcohol can aggravate chronic diseases and the use of medication. It also increases the risk of falls and accidents with fractures,” warns the scientist, who was advised by Professor Cleusa Ferri. Funded by the Foundation for Research Support of the State of São Paulo (Fapesp), the research was recently published in international scientific journals.
Intervention leads to reduced use
As part of the study, the researcher and her group interviewed 503 elderly people assisted by the Basic Health Units (UBS) of São José dos Campos. Of these, 242 were identified as consumers of alcoholic beverages and 80 were followed up, including in the home routine. This field work, which started in January 2020, had to be interrupted two months later, because of the pandemic.
Tassiane says that the approach was accompanied by a brief intervention carried out by the health agents she had trained. “It’s a quick action, of about 10 minutes, in which we explain the risks of drinking alcohol, because people always think they don’t have a problem with it. This work continued, during the pandemic, by telephone”, she says ”
After three months, we found that half had reduced consumption and 25% had stopped drinking. Of course there may be some effect of the pandemic, as many elderly people were not even able to buy drinks and stopped family parties, but the result encourages us to continue this work as soon as possible.” On the other hand, many elderly people reduced the social circle and some were even left alone, which reduces the chances that signs of inadequate consumption are noticed. The researcher’s expectation is to develop an intervention protocol for the elderly who drink for the public health system.
The merchant Décio Peres Martim, who coordinates with an aid group against alcoholism at the Bom Jesus church, in Sorocaba (SP), said that the number of elderly people seeking support has increased. “I’ve been working with these people for 24 years and before it was rare to have an elderly person in the group. Today we have several, but they are mainly elderly women”, she said.
He says that the most recent recovery case involved a 66-year-old woman who, due to abuse of vodka, lost the company of her husband and children. “She went to the supermarket to shop and came back with liters of vodka. As she was alone, there was no one to control her. When he came to us, it was already an extreme case. She said it either stopped or died. Luckily she stopped. A daughter and grandchildren have already moved back in with her,” he said.
According to the NGO Center for Information on Health and Alcohol (Cisa), data on alcohol consumption by the elderly are still scarce and underestimated in the country, but it is already known that 1% to 3% have physical and psychiatric morbidity related to its use. of alcoholic beverages.
Aging can decrease alcohol tolerance due to physiological changes with changes in liver metabolism and renal function, as well as body composition, with a greater tendency to dehydration.
Among the consequences of harmful use of alcohol in this population, deficits in cognitive and intellectual functioning, impairments in social behavior, increase in the number of comorbidities and aggravation of other health problems common to age stand out.
Alcohol consumption exposes the elderly to a greater risk of falls and other injuries, also promoting secondary effects due to the interaction with medications normally used by this population.