Intended for healthcare professionals


Alcohol complicates multimorbidity in older adults

BMJ 2019; 365 doi: (Published 27 June 2019) Cite this as: BMJ 2019;365:l4304
  1. Duncan Stewart, senior lecturer in addictive behaviours and public health,
  2. Jim McCambridge, professor of addictive behaviours and public health
  1. Department of Health Sciences, University of York, York, UK
  1. Correspondence to: D Stewart duncan.stewart{at}

Attention to alcohol should be integral to routine care

Lower birth rates and higher life expectancy are transforming global population age profiles, such that the prevalence of long term health conditions in the general population is rising steeply, with more people living with multimorbidity as they age.1 Most people aged 65 or over have multiple conditions,1 and the proportion with multimorbidity can be expected to increase further. Trends in alcohol consumption show higher levels of unhealthy drinking among older birth cohorts in high income countries, and older people in the UK drink more than those in other European countries, Australasia, and North America.2 The challenges of clinical management of older adults with multimorbidity are made more difficult by alcohol consumption, even at low doses.

Health risks

Drinking alcohol increases risks to health in a largely dose-response manner.3 It is a particular concern among older people because metabolic efficiency is diminished with age. As a toxic and addictive drug, alcohol can make existing health problems worse by posing direct …

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