Prevalence of concomitant use of alcohol and sedative-hypnotic drugs in middle and older aged persons: a systematic review.
OBJECTIVE
To systematically review the prevalence of concomitant alcohol and sedative-hypnotic use among middle-aged and older persons.


METHODS
A bibliographic search of English-language literature was performed using MEDLINE, EMBASE, and PsycINFO (January 1990-August 2012). The reference lists of all included articles were screened for additional relevant articles not identified by any of the bibliographic searches.


METHODS
Population-based studies in which the mean age of participants was 40 years or older were included. For a study to be included in the review, alcohol use had to be reported in terms of the quantity or frequency consumed. Data from included articles were extracted using a standardized data extraction tool.


RESULTS
Five population-based studies conducted in North America, 10 in Europe, and 1 in Australia were included in the review. Up to 88% of men and 79% of women who used sedative-hypnotics also consumed alcohol. Up to 28% of those who consumed alcohol were concomitant users of sedative-hypnotics. Alcohol was consumed at higher levels among middle-aged than older persons. Risky drinking (eg, binge drinking, heavy drinking) was more prevalent among middle-aged than older persons. In contrast, sedative-hypnotic use was more prevalent among older persons.


CONCLUSIONS
Our review identified a higher prevalence of alcohol consumption among middle-aged than older persons. However, middle-aged persons may experience harm from alcohol/sedative-hypnotic drug interactions due to risky drinking behavior. Despite lower levels of alcohol consumption, older persons may be more susceptible to addictive central nervous system effects than younger persons because of physiologic changes in psychotropic drug and alcohol metabolism. Clinicians should consider patients' alcohol consumption patterns before prescribing sedative-hypnotic drugs.
Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia. jenni.ilomaki@unisa.edu.au
Jenni
J
Ilomäki
Tapio
T
Paljärvi
Maarit Jaana
MJ
Korhonen
Hannes
H
Enlund
Christopher P
CP
Alderman
Jussi
J
Kauhanen
J Simon
JS
Bell
D000375:Aging; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D063425:Binge Drinking / Q000453:epidemiology; D004198:Disease Susceptibility; D005060:Europe / Q000453:epidemiology; D018565:Food-Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D009656:North America / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology
D006993:Hypnotics and Sedatives