Psychotropic drug use and alcohol consumption among older adults in Germany: results of the German Health Interview and Examination Survey for Adults 2008-2011

Abstract

Objectives: The use and combined use of psychotropic drugs and alcohol among older adults is a growing public health concern and should be constantly monitored. Relevant studies are scarce in Germany. Using data of the most recent national health survey, we analyse prevalence and correlates of psychotropic drug and alcohol use among this population.

Methods: Study participants were people aged 60-79 years (N=2508) of the German Health Interview and Examination Survey for Adults 2008-2011. Medicines used during the last 7 days were documented. Psychotropic drugs were defined as medicines acting on the nervous system (ATC code N00) excluding anaesthetics (N01), analgesics/antipyretics (N02B), but including opiate codeines used as antitussives (R05D). Alcohol consumption in the preceding 12 months was measured by frequency (drinking any alcohol-containing beverages at least once a week/a day) and quantity (alcohol consumed in grams/day; cut-offs: 10/20 g/day for women/men defining moderate and risky drinking). SPSS complex sample module was used for analysis.

Results: 21.4% of study participants use psychotropic medications, 66.9% consume alcohol moderately and 17.0% riskily, 51.0% drink alcohol at least once a week and 18.4% daily, 2.8% use psychotropic drugs combined with daily alcohol drinking. Among psychotropic drug users, 62.7% consume alcohol moderately, 14.2% riskily. The most frequently used psychotropic medications are antidepressants (7.9%) and antidementia (4.2%). Factors associated with a higher rate of psychotropic drug use are female sex, worse health status, certified disability and polypharmacy. Risky alcohol consumption is positively associated with male sex, smoking, upper social class, better health status, having no disability and not living alone.

Conclusions: Despite the high risk of synergetic effects of psychotropic drugs and alcohol, a substantial part of older psychotropic drug users consume alcohol riskily and daily. Health professionals should talk about the additional health risks of alcohol consumption when prescribing psychotropic drugs to older adults.

Keywords: Germany; alcohol; national health survey; older adults; psychotropic drugs.

Figure 1

Prevalence of psychotropic drug use and alcohol consumption among adults aged 60–79 years. German Health Interview and Examination Survey for Adults (DEGS1) 2008–2011. A1, psychotropic drug use only, no alcohol use (n=387, 17.5%, 95% CI 15.5% to 19.6%). A2, combined use of psychotropic drugs and alcohol (but not risky drinking) (n=17, 0.7%, 95% CI 0.4% to 1.2%). A3, daily alcohol use, but not risky drinking, no psychotropic drug use (n=99, 3.9%, 95% CI 2.9% to 5.1%). A4, psychotropic drug use combined with risky drinking (but not daily) (n=22, 1.0%, 95% CI 0.6% to 1.7%). A5, psychotropic drug use combined with daily risky drinking (n=59, 2.1%, 95% CI 1.5% to 2.9%). A6, daily risky alcohol drinking, but no psychotropic drug use (n=293, 11.9%, 95% CI 10.3% to 13.7%). A7, risky drinking only, no daily alcohol use and no psychotropic drug use (n=82, 2.6%, 95% CI 1.9% to 3.5%). One hundred and forty-two persons with missing values for psychotropic drug use, risky drinking or daily alcohol drinking were excluded; 1407 non-users of psychotropic drugs who neither drink daily nor riskily are not shown in the figure. All percentages were weighted according to the German national population of 31 December 2010; Daily alcohol drinking, drinking of alcohol-containing beverages at least once a day; Risky drinking, average daily alcohol consumption of ≥20 g for men and ≥10 g for women.