Background: Alcohol consumption is a leading modifiable risk factor for a range of diseases and social harms globally. Older adults are vulnerable to alcohol-related harms due to physiological changes, multimorbidity, and medication use; however, many older adults continue to drink at high-risk levels. This study examined the prevalence and gender-specific correlates of hazardous and heavy episodic drinking (HED) among Swedish and Finnish community-dwelling older adults.
Methods: Cross-sectional data from the 2021/2022 Gerontological Regional Database (GERDA) survey included 11,747 participants aged 65, 70, 75, 80, 85 and 90 years. Missing data were multiple imputed by chained equations. Hazardous drinking was defined as an AUDIT-C score of four or more, and HED was defined as consuming six or more drinks on a single occasion at least monthly. Sociodemographic, psychosocial, functional status, and health-related factors were analyzed using multinomial and logistic regression models, stratified by gender and accounting for regional differences.
Results: Overall, 30.2% (95% CI, 29.0–31.4) of men and 9.8% (95% CI, 9.1–10.6) of women were classified as hazardous drinkers. HED prevalence was 13.0% (95% CI, 12.1–13.9) in men and 2.9% (95% CI, 2.5–3.3) in women. Hazardous drinking and HED in women were associated with higher socioeconomic status and psychosocial stressors, such as depression and bereavement, while functional and health-related factors were significant predictors of problematic alcohol use in men. Across both genders, religious participation was a protective factor, while self-reported cardiovascular disease was associated with increased risk of hazardous drinking.
Conclusions: Hazardous and HED are prevalent among older adults in Sweden and Finland with some regional differences, and notable gender differences in associated risk factors. There is a need for interventions that focus on strengthening resilience to psychosocial stressors and provide older adults with clear, consistent health communication about alcohol's harmful effects on cardiovascular and overall health.
John Wiley & Sons, 2025. Vol. 49, no 8, p. 1744-1758