High-Risk Drinking in the Elderly.

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Alcohol consumption and associated negative impacts are a significant problem affecting public health. Worldwide, alcohol-related diseases are responsible for 2.5 million deaths per year [1]. Korea also faces a number of alcohol-related health and social problems. Although the primary causes may be cultural, wherein offering a drink is seen as hospitable and heavy drinking is seen as a symbol of masculinity, beliefs regarding the health benefits of alcohol may also contribute to the increase in alcohol-related problems. The belief that moderate alcohol consumption is beneficial for health became popular after the 1990s. A meta-analysis showed that light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes [2]. In Korea, a similar belief already existed since much earlier [3]. Doctors often encounter patients who believe that alcohol is good for blood circulation.

In recent years, however, several studies have shown that even small amounts of alcohol intake can cause health problems. In a cohort study of 23 million adults with a median of 5.4 years of follow-up in Korea, light drinking including even one alcoholic drink a day was associated with increased risks of esophageal, gastric, and colorectal cancer [4]. In a meta-analysis of 222 observational studies, light drinking (≤1 drink/d) increased the risk of cancer of the oral cavity and pharynx, esophagus, and female breast [5]. In another meta-analysis of 60 cohort studies, very light (≤0.5 drink/d) or light (≤1 drink/d) drinking was associated with the incidence of breast cancer in women and colorectal cancer in men, while there was no association with the risk of other common cancers [6]. Studies of the effects of light drinking on health have mainly focused on cancer, and there is still some controversy to reach clear conclusions. In recent years, however, guidelines suggest avoiding even light drinking based on these findings [7].

Standards for problem drinking in the elderly over 65 years are equivalent to half of the general adult standards. This is because the body’s ability to break down alcohol decreases with age. However, there has been little focus on the effects of alcohol on the elderly. In the present issue, Kim et al. [8] investigated the relationship between high-risk alcohol consumption and metabolic syndrome in elderly Korean men using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire from the 2010–2012 Korean National Health and Nutrition Examination Surveys (KNHANES). In this study, 17% of respondents were high-risk drinkers (AUDIT score ≥15). High-risk drinkers had a higher odds ratio (1.40; 95% confidence interval, 1.03–1.89) for metabolic syndrome compared with low-risk drinkers. Although previous studies have found that high-risk drinking is related to metabolic syndrome in the elderly, this study is meaningful as the first to report this association with Korean national population-based data.

The high-risk drinking rate of Korean elderly aged over 65 years was 8.7% in men (≥7 drinks at a time and >2 times/wk) and 0.3% in women (≥5 drinks at a time and >2 times/wk) in the 2016 KNHANES [9]. In another 2014 survey, the high-risk drinking (≥8 drinks/wk) rate was 33.4% in Korean men aged over 65 years [10]. This is lower than in younger adults, but it is still a high number considering that elderly people are relatively vulnerable to alcohol. In this regard, more research is needed on the effects of drinking on the health of the elderly. Additionally, these studies will have many implications considering the increase in the elderly population as aging rapidly progresses in Korea.