Alcohol use in retirement: A silent epidemic?

Posted by Roxanne Armstrong-Moore, Fuse PhD student, University of Sunderland

I was on a course recently and someone mentioned that her parents, since retiring were all about the “three Gs – Gardening, Grandchildren and the Grape”. Laughter ensued from other colleagues, then a sadness dawned on me – she explained that the drinking had gone beyond a social drink with friends and was ingrained in their lives, the glass of wine was getting earlier and earlier and functioning was getting less. It made me think, why is this acceptable once someone has left work? Of course, individuals have worked hard all their lives and they deserve some respite – but should this come at a cost of lessened functioning, higher chance of diseases, premature death and breakdowns in the relationships that have been nurtured over a lifetime?

My PhD aims to develop a strategy for those in, or about to enter retirement, to avoid what seems to be a downward spiral into ill health.

In what is a relatively scarce area of literature, myself and my supervisory team have begun this task by conducting a systematic review of current literature. This is to investigate what we currently know about current interventions and how they can help older individuals to reduce negative effects of alcohol. Six papers were included, all of which were in the United States. Individuals in this age group appear to respond well to interventions, with all interventions showing improvements (a reduction in drinking or, in one case study, improvements in quality of life) in at least one area of alcohol consumption or frequency of consumption. These findings were presented at the European Health Psychology Conference in Aberdeen (2016).

This scarce amount of literature available on interventions shows that older people are currently being neglected in our field. Healthcare professionals may feel it is not their duty to step in and “ruin the fun” but - with predictions that by 2050, 22% of the world population will be aged 60 and over, and that a significant amount of these older individuals will have a “pattern or level of drinking which places them at harm” (Wadd & Galvani, 2014, p. 656)1 - something needs to be done.

But what can be done? Don’t they deserve to have a drink? Are we spoiling their fun? Would they even want an intervention and how would this work? This is where the hard work begins…

Older people are more susceptible to the detrimental effects of alcohol, as tolerance to alcohol lowers with age. Drinking more than five standard drinks per week has been found to quadruple the risk of developing psychiatric problems including depression and memory loss (Stevenson, 2005)2. Cognitive impairment as a result of alcohol use can lead to an increased likelihood of falls, and because older people often have weaker bones, this can lead to hip fractures - one of the highest causes of death in the older population (Mukamal et al., 2004; Merrick et al., 2008)3.4.

While much research has focused on students and younger adults, little has explored the drinking of older individuals. The evidence in this field is growing, however it is still not adequate to inform an intervention in the area.

So, why retirement? Evidence suggests that those who have recently entered retirement are statistically and significantly more likely to drink almost every day compared to those who are still in work, or those who have been retired for a longer time. At the moment, there is limited support and guidance offered by employers, government and the third sector to those who are retiring in the future. The “Easing the Transition” report from the Drink Wise - Age Well project (Holley-Moore & Beach, 2016)5 suggests that for some individuals, this can be a negative time marred with a loss of purpose, periods of ill health or financial difficulties.

So this is where my PhD comes in, at the moment very little qualitative data exists in this area. We are hoping to interview individuals – not only those who have retired recently and those who are due to retire, but also their employers. This data will then be analysed to establish core themes using a framework approach and fitted to an intervention map to really find a tool that could be used to help people going through this (at times) difficult transition.

From data collection, we will use the findings to begin to develop an intervention that can be implemented in the workplace, or after leaving work. This will be the first protocol of its type that uses the information gathered from those who are going through this transition and will hopefully ease the transition between working and retirement and reduce the growing burden on public health.


References:

1. Wadd, S., & Galvani, S. (2014). Working with Older People with Alcohol Problems: Insight from Specialist Substance Misuse Professionals and their Service Users. Social Work Education, 33(5), 656–669. http://doi.org/10.1080/02615479.2014.919076
2. Stevenson, J. S. (2005). Alcohol use, misuse, abuse, and dependence in later adulthood. Annual Review of Nursing Research, 23, 245–80. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16350768
3. Mukamal, K. J., Cushman, M., Mittleman, M. A., Tracy, R. P., & Siscovick, D. S. (2004). Alcohol consumption and inflammatory markers in older adults: the Cardiovascular Health Study. Atherosclerosis, 173(1), 79–87. http://doi.org/10.1016/j.atherosclerosis.2003.10.011
4. Merrick, E. L., Horgan, C. M., Hodgkin, D., Garnick, D. W., Houghton, S. F., Panas, L., … Blow, F. C. (2008). Unhealthy Drinking Patterns in Older Adults: Prevalence and Associated Characteristics. Journal of the American Geriatrics Society, 56(2), 214–223. http://doi.org/10.1111/j.1532-5415.2007.01539.x
5. Holley-Moore, G., & Beach, B. (n.d.). Drink Wise, Age Well: Alcohol Use and the Over 50s in the UK. Retrieved from www.drinkwiseagewell.org.uk

Photo attribution:

• 'Anonymous Drinker' by David Goehring via Flickr.com © 2013: https://www.flickr.com/photos/carbonnyc/8686574743
• 'Conundrum’ by Robert S. Donovan via Flickr.com © 2010: https://www.flickr.com/photos/10687935@N04/4854800303

"What should I wear?!" - My first conference as a PhD student

Guest post by Roxanne Armstrong, PhD student at Sunderland University

First of all, let me introduce myself. My name is Roxanne and I am currently doing a PhD at the University of Sunderland and I am part of the Fuse partnership. On the 18 – 20 November I attended my first ever conference, the UKCRC public health conference that took place in Edinburgh. I am going to use this blog to guide you through my experience, not to include the academic research that was presented. Hopefully providing an insight into what the “First Conference” feels like for a PhD student.

I am writing this blog, because despite being surrounded by a really supportive supervisory team, there are some things you just wouldn’t ask. A few examples; “do you think a four inch wedge is too formal for the day events? How about with jeans? Do I wear a dress for the conference dinner? Are flat shoes okay?”. This list goes on… This “fashion anxiety” led me to take a suitcase that could clothe a small town, four pairs of shoes and an array of eye shadow shades that a stylist from London fashion week would be proud of.

I started my journey on the train. A busy, smelly, full train. I had reserved a seat, sure, but due to me being (possibly overly) kind, I let someone take it. I glanced around and saw some other Fuse members that I recognised; I braved going over and introducing myself and ended up having a really nice, chatty trip to Edinburgh. Hurdle one – accomplished!

Professor John Frank, Director of  SCPHRP, got into the Scottish spirit at the conference dinner

Second hurdle, accommodation. Would I have a bed? Would I be sharing with a stranger that was prone to sleepwalking? How about free toiletries? I had no idea what to expect and have heard some fairly scathing reviews about conference accommodation. When I walked into my room I practically had to call someone to pick my jaw up off the floor. My accommodation was bigger than my own house! Bed? Check. Free toiletries? Check. Oh and two double beds, two plasma TVs and a kitchen area. I felt like Kate Middleton; surely this means I have made it in the world….

The third hurdle I faced was being in a sociable environment with people I’d only ever seen in a professional light. This was the most rewarding aspect for me; making connections, talking about normal things with lovely, like minded people. We shared mealtime and a couple of drinks and I finished the first evening with people I now class as friends.

Making connections with lovely like minded people

The conference itself was another challenge; I was full of nerves thinking about all of the other academics that would be there and how I’d act around them, but in truth it was so easy going. I was engaging with lots of approachable individuals with a lot of knowledge to share and exchange. I left the conference sessions feeling excited for my own future and how I was so grateful that I have such a diverse and welcoming community around me for at least the next three years and hopefully many more after that.

If I had to give some advice to someone who had never been to a conference before it would be the following: be open minded – every conference is different and you will find yourself being a social chameleon, adapting to whoever you meet, this is a great skill to develop. Secondly, enjoy it! I enjoyed every minute and really made the most of it. Finally, take as many free pens as your pocket will allow… That’s what they’re there for!

Oh, and I couldn’t end this blog without telling you – I opted for three inch wedge boots, jeans and a neutral shade of eye shadow. You’re welcome.

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