THE BLOG

Is Alcohol Now the Scourge of Older People and Younger Women?

04/05/2016 15:47

On 5 May 2016, Public Health England publishes its annual statistics for alcohol related hospital admissions for England. Traditionally the scourge of younger and middle-aged men, we have seen a very different picture from alcohol related deaths, the data for which was published earlier this year.

Between 2001 and 2014, alcohol related death rates in England reduced significantly in men below the age of 60, with a corresponding significant increase in both older people men and women. For example, in men aged 70-74 and 80-84, there was an increase of more than 150%. It was perhaps a surprise to find that alcohol related death rates over the same time frame increased significantly in women, but this time in both the 25-39 and the 65 and over age groups.

The actual number of alcohol related deaths in England between 1994 and 2014 increased by 65% or more in all age groups for both men and women. Although this was more significant for older men compared with younger men (117% vs 65%), there was very little difference between older (82%) and younger (78%) women.

In January this year, I provided a warning of the shape of things to come in the form of last year's data on alcohol related admissions in England. The figures may seem unbelievable. The first of these is that a higher number of older people were admitted to hospital in England during 2014-2015 for mental and behavioural disorders related to alcohol use (11,373) than for alcohol-related liver disease (9,890). We also know that the number of 60- to 74-year-olds treated as in-patients for mental and behavioural disorders such as alcohol dependence and alcohol withdrawal has almost doubled over the past decade, from 5,074 in 2005-06 to 9,492 in 2014-15. Among those aged 75 and older, the figure has risen from 1,265 to 1,881 over the same period. Both increases far outstrip the growth in the elderly population.

I honestly believe that alcohol-related memory problems are hugely under-reported and mistaken for Alzheimer's disease. Ten years ago I would have been treating no more than three people at any one time for alcohol-related brain damage. Now there are at least 10 patients with that in my clinical service. Most of these patients were originally thought to have either depression or Alzheimer's until disclosure of their history of heavy drinking led to me to change the diagnosis to one of alcohol-related brain damage. The average age of these patients has also reduced. In the last 1990s, it was people in their mid-70s. It is now those in their mid-60s.

But what about women in their mid to late 20s and 30s? Surely not a group we would expect to be ravaged by drink? In 2013, a study in 3 English cities found a trend of increasing alcohol related deaths in women in their early 30s. The same can be seen in the data presented above, with alcohol related deaths in women aged 30-34 representing a group with a 133% rise on alcohol related deaths between 2001 and 2014. It's perhaps not difficult to put the pieces of the jigsaw together. An increasing late night drinking culture and cheap alcohol (e.g. wine) has been fuelled by skilful marketing and promotion by the alcohol industry in a group of the population who are increasingly financially independent but a night or more on the town is beginning to take its toll. We have known for some years that the gender gap for heavy drinking is narrowing in the UK, but the current figures bring a stark warning as to the extent of this narrowing, which now means that the dangers of heavy drinking in younger women is now a shot across the boughs.

The bottom line is that we need to pay close attention both to drinking in men and women aged 65 and over and in younger women in their late 20s and 30s. Although there is still a 'Baby Boomer effect' of increased alcohol related harm in older men and women, there appear also we are now also facing a serious problem in younger women who drink heavily and whose drinking is putting their lives at risk.

It has been known for some time that women are closing the gap on men when it comes to alcohol related harm, but the difference between changes in death rates from alcohol in younger women born between 1974 and 1989 compared with younger men in the same birth cohort is shocking.

I would hazard the guess that the next set of alcohol related admissions for the England will only re-inforce what we now know about alcohol related deaths. The tables have turned and we didn't see it coming, but at least now we have been warned.

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