Prevalence and Predictors of Increased and Hazardous Alcohol Consumption in a Cohort of Older South Australian Men during COVID-19 Restrictions

Main Article Content

Murray Nankivell
Natasha van Antwerpen
Deborah Turnbull
Tiffany Gill
Sean Martin
Melissa Opozda

Abstract

Background: Increasing levels of risky alcohol consumption in older men observed in many countries, combined with trends for increased alcohol-related misuse by men during COVID, indicate a need to examine
alcohol use by older men during the pandemic.


Aim: To examine the prevalence and predictors of increased and hazardous alcohol consumption in older South Australian men during COVID-19 restrictions.


Method: Data collected in the latest (eighth) wave of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) cohort study were interrogated. Participants were 746 community-dwelling older men (mean age 69 years) who completed a self-report survey on mental health, coping, COVID-related worries, and alcohol consumption during pandemic restrictions. Alcohol-related items asked about changes to overall consumption (analysed as increased vs. decreased/same) and number of standard drinks per occasion (analysed as <5 drinks [not hazardous consumption] vs. 5+ drinks [hazardous]). Two hierarchical binary logistic regressions were conducted to explore predictors of increased and hazardous alcohol intake.


Results: Eight percent of men reported increased alcohol intake and nine percent reported hazardous alcohol consumption during COVID-19 restrictions. Being in a younger age group (‘younger old’; OR=0.46, 95%CI=1.03, 2.28), having mild to severe depressive symptoms (OR=1.39, 95%CI=1.10, 5.05), and greater concern about becoming sick with COVID-19 (OR=1.52, 95%CI=1.03, 2.28) were predictive of increased alcohol consumption during restrictions. Younger age group (OR=0.46, 95%CI=0.34, 0.62) and greater concern about becoming sick with COVID-19 (OR=1.67, 95%CI=1.13, 2.51) were also predictive of hazardous alcohol consumption during this time.


Discussion: Men participating in longitudinal health study follow-ups may be less inclined to engage in unhelpful coping behaviours such as problematic alcohol use. Clinicians should regularly screen older men for risky alcohol consumption; a particular focus on screening ‘younger old’ men, those with more significant concerns around COVID-19, and those with depression symptoms may be warranted.

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How to Cite
Nankivell, M., van Antwerpen, N., Turnbull, D., Gill, T., Martin, S., & Opozda, M. (2023). Prevalence and Predictors of Increased and Hazardous Alcohol Consumption in a Cohort of Older South Australian Men during COVID-19 Restrictions . International Journal of Mens Social and Community Health, 5(SP2), e25-e39. https://doi.org/10.22374/ijmsch.v5iSP2.96
Section
Freemasons Centre for Male Health & Wellbeing Special Issue
Author Biographies

Murray Nankivell, School of Psychology, University of Adelaide, Adelaide, SA. Australia Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

School of Psychology, University of Adelaide, Adelaide, SA, Australia
Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

Natasha van Antwerpen, School of Psychology, University of Adelaide, Adelaide, SA, Australia

School of Psychology, University of Adelaide, Adelaide, SA, Australia

Deborah Turnbull, School of Psychology, University of Adelaide, Adelaide, SA, Australia Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

School of Psychology, University of Adelaide, Adelaide, SA, Australia
Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

Tiffany Gill, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia

Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia

Sean Martin, Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

Melissa Opozda, Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, SA, Australia

References

1. World Health Organisation. WHO coronavirus (COVID-19) dashboard. 2022. Available from: https://covid19.who.int/
2. OECD. Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response; 2021.
3. Ellison JM, Semlow AR, Jaeger EC, et al. COVID-19 and MENtal health: Addressing men’s mental health needs in the digital world. American Journal of Men’s Health. 2021;15:155798832110300. DOI: 10.1177/15579883211030021.
4. World Health Organisation. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 2022. Available from: www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide
5. Clay JM, Parker MO. Alcohol use and misuse during the COVID-19 pandemic: A potential public health crisis? The Lancet. 2020;5(5):E259. DOI: 10.1016/S2468-2667(20)30088-8.
6. Leonard KE, Rothbard JC. Alcohol and the marriage effect. Journal of Studies on Alcohol. 1999;13:139-46. DOI: 10.15288/jsas.1999.s13.139.
7. Mulia N, Zemore SE, Murphy R, et al. Economic loss and alcohol consumption and problems during the 2008 to 2009 U.S. recession. Alcohol: Clinical and Experimental Research. 2014;38(4):1026-34. DOI: 10.1111/acer.12301.
8. Hasin DS, Keyes KM, Hatzenbuehler ML, et al. Alcohol consumption and posttraumatic stress after exposure to terrorism: Effects of proximity, loss, and psychiatric history. American Journal of Public Health. 2007;97(12):2268-75. DOI: 10.2105/AJPH.2006.100057.
9. Cerdá M, Tracy M, Galea S. A prospective population based study of changes in alcohol use and binge drinking after a mass traumatic event. Drug and Alcohol Dependence. 2011;115(1-2):1-8. DOI: 10.1016/j.drugalcdep.2010.09.011.
10. Vijayasiri G, Richman JA, Rospenda KM. The Great Recession, somatic symptomatology and alcohol use and abuse. Addictive Behaviours. 2012;37(9):1019-24. DOI: 10.1016/j.addbeh.2012.04.007.
11. OECD. The effect of COVID-19 on alcohol consumption, and policy responses to prevent harmful alcohol consumption. 2021. Available from: www.oecd.org/coronavirus/policy-responses/the-effect-of-covid-19-on-alcohol-consumption-and-policy-responses-to-prevent-harmful-alcohol-consumption-53890024/
12. World Health Organisation Regional Office for the Eastern Mediterranean. Alcohol does not protect against COVID-19 and its access should be restricted during lock down. 2020. Available from: www.emro.who.int/mnh/news/alcohol-does-not-protect-against-covid-19-and-its-access-should-be-restricted-during-lock-down.html
13. Royal College of Psychiatrists. Addiction services not equipped to treat the 8 million people drinking at high risk during pandemic, warns Royal College. 2020. Available from: www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/09/14/addiction-services-not-equipped-to-treat-the-8-million-people-drinking-at-high-risk-during-pandemic-warns-royal-college
14. Castaldelli-Maia JM, Segura LE, Martins SS. The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic. Alcohol. 2021;96:37-42. DOI: 10.1016/j.alcohol.2021.06.004.
15. Biddle N, Edwards B, Gray M, et al. Alcohol consumption during the COVID-19 period: May 2020; 2020.
16. Roberts A, Rogers J, Mason R, et al. Alcohol and other substance use during the COVID-19 pandemic: A systematic review. Drug and Alcohol Dependence. 2021;229:109150. DOI: 10.1016/j.drugalcdep.2021.109150.
17. Acuff SF, Strickland JC, Tucker JA, et al. Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis. Psychology of Addictive Behaviours. 2022;36(1):1-19. DOI: 10.1037/adb0000796.
18. Kilian C, O’Donnell A, Potapova N, et al. Changes in alcohol use during the COVID-19 pandemic in Europe: A meta-analysis of observational studies. Drug and Alcohol Review. 2022;42(4):918-31. DOI: 10.1111/dar.13446.
19. National Institute on Alcohol Abuse and Alcoholism. Drinking levels defined. Available from: www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
20. Bosque-Prous M, Brugal MT, Lima KC, et al. Hazardous drinking in people aged 50 years or older: A cross-sectional picture of Europe, 2011-2013. . International Journal of Geriatric Psychiatry. 2017;32(8):817-28. DOI: 10.1002/gps.4528.
21. Chen CM, Yoon Y. Trends in alcohol-related morbidity among community hospital discharges, United States, 2000-2014. Bethesda, MD: National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism; 2017.
22. Kanny D, Naimi TS, Liu Y, et al. Annual total binge drinks consumed by U.S. adults, 2015. American Journal of Preventive Medicine. 2018;54(4):486-96. DOI: 10.1016/j.amepre.2017.12.021.
23. Nordløkken A, Pape H, Wentzel-Larsen T, et al. Changes in alcohol consumption after a natural disaster: A study of Norwegian survivors after the 2004 Southeast Asia tsunami. BMC Public Health. 2013;13:58. DOI: doi.org/10.1186/1471-2458-13-58.
24. Jacob L, Smith L, Armstrong NC, et al. Alcohol use and mental health during COVID-19 lockdown: A cross-sectional study in a sample of UK adults. Drug and Alcohol Dependence. 2021;219:108488. DOI: 10.1016/j.drugalcdep.2020.108488.
25. Ritter A, Wilkinson C, Vuong T, et al. Distilling our changing relationship with alcohol during COVID-19. Sydney: UNSW Social Policy Research Centre; 2020.
26. Winstock A, Zhuparris A, Gilchrist G, et al. GDS COVID-19 special edition: Key findings report, Global Drug Survey; 2020.
27. Australian Bureau of Statistics. Household impacts of COVID-19 survey, May 2021. 2021. Available from: www.abs.gov.au/statistics/people/people-and-communities/household-impacts-covid-19-survey/may-2021
28. Davies EL, Puljevic C, Gilchrist G, et al. Impacts of changes in alcohol consumption patterns during the first 2020 COVID-19 restrictions for people with and without mental health and neurodevelopmental conditions: A cross sectional study in 13 countries. International Journal of Drug Policy. 2022;101:103563. DOI: 10.1016/j.drugpo.2021.103563.
29. Wardell JD, Kempe T, Rapinda KK, et al. Drinking to cope during the COVID-19 pandemic: The role of external and internal factors in coping motive pathways to alcohol use, solitary drinking, and alcohol problems. Alcoholism: Clinical and Experimental Research. 2020;44(10):2073-83. DOI: 10.1111/acer.14425.
30. Callinan S, Mojica-Perez Y, Wright CJC, et al. Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic. Drug and Alcohol Review. 2021;40(2):183-91. DOI: 10.1111/dar.13200.
31. Zajac IT, Rice S, Proeve M, et al. Suicide risk, psychological distress and treatment preferences in men presenting with prototypical, externalising and mixed depressive symptomology. Journal of Mental Health. 2022;31(3):309-16. DOI: 10.1080/09638237.2020.1755026.
32. Nolen-Hoeksema S. Gender differences in risk factors and consequences for alcohol use and problems. Clinical Psychology Review. 2004;24(8):981-1010. DOI: 10.1016/j.cpr.2004.08.003.
33. Neill E, Meyer D, Toh WL, et al. Alcohol use in Australia during the early days of the COVID-19 pandemic: Initial results from the COLLATE project. Psychiatry and Clinical Neurosciences. 2020;74(10):542-9. DOI: 10.1111/pcn.13099.
34. Trias-Llimós S, Bosque-Prous M, Obradors-Rial N, et al. Alcohol and educational inequalities: Hazardous drinking prevalence and all-cause mortality by hazardous drinking group in people aged 50 and older in Europe. . Substance Abuse. 2022;43(1):152-60. DOI: 10.1080/08897077.2020.1773597.
35. Iparraguirre J. Socioeconomic determinants of risk of harmful alcohol drinking among people aged 50 or over in England. BMJ Open. 2015;5:e007684. DOI: 10.1136/bmjopen-2015-007684.
36. Roche AM, Kostadinov V. Baby boomers and booze: we should be worried about how older Australians are drinking. Medical Journal of Australia. 2019;210(1):38-9. DOI: 10.5694/mja2.12025.
37. Grant BF, Chou SP, Saha TD, et al. Prevalence of 12-month alcohol use, high-risk drinking, and DSM-IV alcohol use disorder in the United States, 2001-2002 to 2012-2013: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry. 2017;74(9):911-23. DOI: 10.1001/jamapsychiatry.2017.2161.
38. Hallgren MÅ, Högberg P, Andréasson S. Alcohol consumption and harm among elderly Europeans: falling between the cracks. European Journal of Public Health. 2010;20(6):616-7. DOI: 10.1093/eurpub/ckq111.
39. Jiang H, Griffiths S, Callinan S, et al. Prevalence and sociodemographic factors of risky drinking in Australian older adults. Drug and Alcohol Review. 2020;39(6):684-93. DOI: 10.1111/dar.13122.
40. Wang Q, Zhang Y, Wu C. Alcohol consumption and associated factors among middle-aged and older adults: results from China Health and Retirement Longitudinal Study. BMC Public Health. 2022;22:322. DOI: 10.1186/s12889-022-12718-8.
41. Royal College of Psychiatrists. Alcohol and older people. 2015 [cited 2022 5 August]. Available from: www.rcpsych.ac.uk/mental-health/problems-disorders/alcohol-and-older-people
42. Grant JF, Martin SA, Taylor AW, et al. Cohort profile: The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. International Journal of Epidemiology. 2014;43(4):1040-53. DOI: 10.1093/ije/dyt064.
43. National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC; 2020.
44. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1(3):385-401. DOI: 10.1177/014662167700100306.
45. Beck AT, Ward CT, Mendelson M, et al. An inventory for measuring depression. Archives of General Psychiatry. 1961;4:561-71. DOI: 10.1001/archpsyc.1961.01710120031004.
46. Shafer AB. Meta-analysis of the factor structures of four depression questionnaires: Beck, CES-D, Hamilton, and Zung. Journal of Clinical Psychology. 2006;62(1):123-46. DOI: 10.1002/jclp.20213.
47. Smarr KL, Keefer AL. Measures of depression and depressive symptoms: Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthritis Care Research. 2011;63:S454-S66. DOI: 10.1002/acr.20556.
48. Spitzer RL, Kroenke K, Williams JBW, et al. A brief measure for assessing generalised anxiety disorder. Archives of Internal Medicine. 2006;166(10):1092. DOI: 10.1001/archinte.166.10.1092.
49. Sinclair VG, Wallston KA. The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment. 2004;11(1):94-101. DOI: 10.1177/1073191103258144.
50. Rahman MA, Hoque N, Alif S, et al. Factors associated with psychological distress, fear, and coping strategies during the COVID-10 pandemic in Australia. Globalisation and Health. 2020;16:95. DOI: 10.1186/s12992-020-00624-w.
51. Kocalevent R, Zenger M, Hinz A, et al. Resilient coping in the general population: Standardisation of the Brief Resilient Coping Scale (BRCS). Health and Quality of Life Outcomes. 2017;15:251. DOI: 10.1186/s12955-017-0822-6.
52. Team RC. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2021.
53. van Buuren S, Groothuis-Oudshoorn K. mice: Multivariate Imputation by Chained Equations in R. Statistical Software. 2011;45(3):1-67. DOI: 10.18637/jss.v045.i03.
54. Drinkaware. Drinkaware warns lockdown level drinking could have lasting impact. 2020. Available from: www.drinkaware.co.uk/news/drinkaware-warns-lockdown-level-drinking-could-have-lasting-impact
55. Fernandez A, Kullgren J, Malani P, et al. Alcohol use among older adults: National Poll on Healthy Ageing. 2021. Available from: http://dx.doi.org/10.7302/1328
56. Australian Bureau of Statistics. Alcohol consumption, 2020-2021. 2022 [cited 2022 6 August]. Available from: www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/latest-release
57. Butterworth P, Schurer S, Trinh TA, et al. Effect of lockdown on mental health in Australia: Evidence from a natural experiment analysing a longitudinal probability sample survey. The Lancet Public Health. 2022;7(5):e427-e36. DOI: 10.1016/S2468-2667(22)00082-2.
58. Grimes DA, Schulz KF. Cohort studies: Marching towards outcomes. Lancet. 2002;359(9303):341-5. DOI: 10.1016/S0140-6736(02)07500-1.
59. Delfabbro P, Winefield H, Winefield A, et al. Factors associated with attrition in a 10-year longitudinal study of young people: Implications for studies of employment in school leavers. Australian Psychologist. 2017;52:41-51. DOI: 10.1111/ap.12207.
60. Keyes KM, Jager J, Platt J, et al. When does attrition lead to biased estimates of alcohol consumption? Bias analysis for loss to follow-up in 30 longitudinal cohorts. International Journal of Methods in Psychiatric Research. 2020;29(4):1-9. DOI: 10.1002/mpr.1842.
61. McCoy TP, Ip EH, Blocker JN, et al. Attrition bias in a U.S. internet survey of alcohol use among college freshmen. Journal of Studies on Alcohol and Drugs. 2009;70(4):606-14. DOI: 10.15288/jsad.2009.70.606.
62. Osler M, Kriegbaum M, Christensen U, et al. Rapid report on methodology: Does loss to follow-up in a cohort study bias associations between early life factors and lifestyle-related health outcomes? Annals of Epidemiology. 2008;18(5):422-4. DOI: 10.1016/j.annepidem.2007.12.008.
63. Thygesen LC, Johansen C, Keiding N, et al. Effects of sample attrition in a longitudinal study of the association between alcohol intake and all-cause mortality. Addiction. 2008;103(7):1149-59. DOI: 10.1111/j.1360-0443.2008.02241.x.
64. Zhao J, Stockwell T, Macdonald S. Non-response in alcohol and drug population surveys. Drug and Alcohol Review. 2009;28(6):648-57. DOI: 10.1111/j.1465-3362.2009.00077.x.
65. National Rural Health Alliance. Alcohol use in rural Australia; 2014.
66. Australian Institute of Health and Welfare. Alcohol and other drug use in regional and remote Australia: Consumption, harms, and access to treatment 2016-17. Canberra: AIHW; 2019.
67. Alsharawy A, Spoon R, Smith A, et al. Gender differences in fear and risk perception during the COVID-19 pandemic. Frontiers in Psychology. 2021;12:689467. DOI: 10.3389/fpsyg.2021.689467.
68. Lowies B, Kutin J, Russell R, et al. The psychological wellbeing and financial decision-making of older Australians in times of uncertainty. Adelaide, Australia: University of South Australia; 2022.
69. Reidy DE, Berke DS, Gentile B, et al. Man enough? Masculine discrepancy stress and intimate partner violence. Personality and Individual Differences. 2014;68:160-4. DOI: 10.1016/j.paid.2014.04.021.
70. Cooper ML, Russell M, Skinner JB, et al. Stress and alcohol use: Moderating effects of gender, coping, and alcohol expectancies. Journal of Abnormal Psychology. 1992;101(1):139-52. DOI: 10.1037/0021-843x.101.1.139.
71. Caputo A. Social desirability bias in self-reported well-being measures: Evidence from an online survey. Universitas Psychologica. 2017;16(2):1-13. DOI: 10.11144/Javeriana.upsy16-2.sdsw.
72. Davis CG, Thake J, Vilhena N. Social desirability biases in self-reported alcohol consumption and harms. Addictive Behaviours. 2010;35(4):302-11. DOI: 10.1016/j.addbeh.2009.11.001.
73. Australian Bureau of Statistics. Cultural diversity of Australia. 2022. Available from: www.abs.gov.au/articles/cultural-diversity-australia
74. Roche A, Kostadinov V, Fischer J, et al. Addressing inequities in alcohol consumption and related harms. Health Promotion International. 2015;30:ii20-35. DOI: 10.1093/heapro/dav030.
75. Cerdá M, Vlahov D, Tracy M, et al. Alcohol use trajectories among adults in an urban area after a disaster: Evidence from a population-based cohort study. Addiction. 2008;103(8):1296-307. DOI: 10.1111/j.1360-0443.2008.02247.x.
76. Wu P, Liu X, Fang Y, et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol and Alcoholism. 2008;43(706-712). DOI: 10.1093/alcalc/agn073.
77. Substance Abuse and Mental Health Services Administration. Treating substance use disorder in older adults: Treatment improvement protocol (TIP) 26; 2020.
78. Wadd S, Galvani S. Working with older people with alcohol problems: Insight from specialist substance misuse professionals and their service users. Social Work and Education. 2014;33(5):656-69. DOI: 10.1080/02615479.2014.919076.
79. Lancaster K, Seear K, Ritter A. Reducing stigma and discrimination for people experiencing problematic alcohol and other drug use: A report for the Queensland Mental Health Commission. Sydney, Australia: Drug Policy Modelling Program; 2017.
80. Royal College of Psychiatrists. Substance misuse in older people: An information guide. London, UK: Royal College of Psychiatrists; 2015.
81. Royal College of Psychiatrists. Our invisible addicts, 2nd edition. London, UK: Royal College of Psychiatrists; 2018.
82. Bareham BK, Kaner E, Hanratty B. Managing older people’s perceptions of alcohol-related risk: A qualitative exploration in Northern English primary care. British Journal of General Practice. 2020;70(701):e916-e26. DOI: 10.3399/bjgp20X713405.
83. Kelly S, Olanrewaju O, Cowan A, et al. Interventions to prevent and reduce excessive alcohol consumption in older people: A systematic review and meta-analysis. Age and Ageing. 2018;47:175-84. DOI: 10.1093/ageing/afx132.
84. Bareham BK, Stewart J, Kaner E, et al. Factors affecting primary care practitioners’ alcohol-related discussions with older adults: A qualitative study. British Journal of General Practice. 2021;71(711):e762-e71. DOI: 10.3399/BJGP.2020.1118.
85. Australian Institute of Health and Welfare. Alcohol and other drug treatment services in Australia annual report (cat. no. HSE 250). Canberra: AIHW; 2022.
86. Seddon J, Trevena P, Wadd S, et al. Addressing the needs of older adults receiving alcohol treatment during the COVID-19 pandemic: A qualitative study. Ageing and Mental Health. 2022;5:919-24. DOI: 10.1080/13607863.2021.1910794.

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