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Am Fam Physician. 2006;74(11):1951

Studies have shown that alcohol consumption in middle-aged women carries risks and benefits. Notable risks include an association between higher alcohol use and cancer and an increased risk of fractures; benefits include a decrease in the 10-year mortality rate and improvement in psychological well-being. However, these benefits apply only to moderate drinking; they are attenuated in heavier drinkers. The risks and benefits of moderate alcohol consumption in women 70 years and older are not known. Despite the lack of current studies specific to older women and alcohol consumption, this age group often is advised to drink fewer than one to two drinks a day, an amount that defines moderate drinking. To address the need for more data, Byles and colleagues reported on the relationship between alcohol consumption, mental and physical status, and mortality in women 70 years and older.

The Australian Longitudinal Study on Women’s Health, a 20-year survey, used a series of three surveys of women in three age groups—young (18 to 23 years), middle-aged (45 to 50 years), and older (70 years and older)—who were randomly chosen to complete a health survey. The authors focused on the group of women 70 to 81 years of age who responded to one of the surveys. Each questionnaire asked about health status and the frequency and quantity of alcoholic drinks. A “low-intake 2” group, defined as one to two drinks per day in a three- to six-day period, closely matched the recommended maximal weekly intake of alcohol for women and so was made the reference group. Socioeconomic data also were gathered.

Baseline alcohol use was determined on the basis of 11,878 responses to the first survey. Thirty-five percent of the participants said they were nondrinkers, 29 percent said they rarely drank, and 3 percent were in the high-intake group. The rest were in the four low-intake categories. Drinking patterns remained stable during the six-year study. The risk of death was significantly higher in women who did not drink and in those who rarely drank than in the reference group, but no other differences among them were significant. Women who were nondrinkers and those who rarely drank had lower scores in general health perception and physical functioning, and the women who did not drink also had lower scores in mental health and social functioning.

During the study, those who were non-drinkers or rarely drank had higher mortality rates and a lower quality of life compared with moderate drinkers. The women in the low-intake groups did not differ significantly in their health. It appears that the health benefits of consuming one to two drinks daily may be the same for women older than 70 years as they are for middle-aged women.

The authors conclude that even though there are no studies that recommend alcohol use, this one indicates that it may be safe and beneficial for women with moderate alcohol intake to continue drinking at that level.

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Copyright © 2006 by the American Academy of Family Physicians.

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