ORLANDO – Elderly people tend to quit drinking alcohol as their health declines, but their medications play little role in this decision, according to a new study.
“We found no increased likelihood of drinking cessation among people taking alcohol-interactive medications, as opposed to those taking nonalcohol-interactive medications,” said Kristine E. Pringle, Ph.D., who presented that study in a poster at the annual meeting of the Gerontological Society of America.
“Our study really underscores the importance of physicians warning patients about alcohol-interactive drugs and the fact that they can produce serious, even fatal, reactions when mixed with alcohol,” she said in an interview.
The retrospective study included 8,883 subjects in Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) program who reported using alcohol in a 2000 survey. Survey data were then linked to prescription drug claims to examine which medications and health factors were associated with drinking cessation over the next 2 years.
Overall, 3.9% (347) of study subjects quit drinking during the study period. The most common reason was entry into a nursing home (odds ratio 4.5), followed by the addition of antipsychotic medications (OR 2.9) and antineoplastic agents (OR 2.67).
A decline in self-reported health increased the likelihood of quitting (OR 1.55), as did a fall in the previous year (OR 1.28).
But the addition of alcohol-interactive medications was not significantly more likely than the addition of nonalcohol-interactive medications to result in alcohol cessation (OR 1.8 vs. 1.78, respectively), said Dr. Pringle, a research specialist at First Health Services Corporation in Harrisburg, Pa.
“There were many medication classes where 100% of the drugs interacted with alcohol, such as some of the cardiovascular classes or the central nervous system agents. And people who initiated those classes between baseline and follow-up were no more likely to quit drinking,” she said.
“It's not clear if maybe the physician did warn them, but they disregarded the warning, or possibly they did not receive the warning. The prescription bottle itself would have the warning, but sometimes it's printed so small that they might have trouble reading it or they don't understand it. So, especially with older patients, verbal warnings are of paramount importance.”
Dr. Pringle said there were certain classes of drugs that were the least predictive of alcohol cessation, possibly because of the underlying conditions they were treating. These classes included anxiolytics and narcotic analgesics.
Several previous cross-sectional studies have linked poorer health in the elderly to former drinking, rather than current drinking, suggesting that the decision to quit was motivated by declining health. But this is the first longitudinal study to examine the associations with alcohol cessation, Dr. Pringle said.