Alcohol and Older People: A Systematic Review of Barriers, Facilitators and Context of Drinking in Older People and Implications for Intervention Design

PLoS One. 2018 Jan 25;13(1):e0191189. doi: 10.1371/journal.pone.0191189. eCollection 2018.


Background: Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed.

Methods: Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA.

Results: Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful.

Conclusions: To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / prevention & control
  • Alcohol Drinking / psychology
  • Crisis Intervention
  • Female
  • Health Promotion
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Social Environment

Grant support

This paper presents independent research funded by the NIHR School for Public Health Research Ageing Well Programme (Grant number RG67185 to Professor Carol Brayne) and the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England (Grant number RG74482 to Professor Carol Brayne). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. SPHR is a partnership between the Universities of Sheffield, Bristol, Cambridge, Exeter, University College London; The London School for Hygiene and Tropical Medicine; the LiLaC collaboration between the Universities of Liverpool and Lancaster; and Fuse, The Centre for Translational Research in Public Health, a collaboration between Newcastle, Durham, Northumbria, Sunderland and Teesside Universities. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.