Links between adolescent binge drinking and midlife alcohol use behaviors by age, sex, and race/ethnicity
Research article
Summary
A University of Michigan study reveals that adults ages 35 to 60 are consuming alcohol at unprecedented rates. The study shows a striking link between high school binge alcohol consumption and high-risk midlife alcohol consumption.
Women, in particular, seem to be experiencing a pronounced surge in high-risk alcohol use, according to the research published in the scientific journal Alcohol: Clinical and Experimental Research.
About 20% to 30% of midlife adults reported binge alcohol use – with four or more alcoholic drinks for women, five for men – and 1 in 10 engaged in high-intensity alcohol use, having 8-10 alcoholic drinks in a row.
Given the increased health risks linked with aging, the study signals a concerning pattern and highlights a critical need for public health interventions.
We found that people who reported binge [alcohol use] in high school engaged in higher levels of alcohol use on a range of indicators decades later during midlife, compared to people who did not binge drink [alcohol] in high school,” said author Megan Patrick of the Institute for Social Research, according to University of Michigan reporting.
For example, among those who didn’t binge at age 18, only 20% reported binge [alcohol use] in midlife compared with 40% among those who did binge at age 18.”
Megan Patrick, Institute for Social Research, University of Michigan and lead author of the study
Alcohol use is one of the biggest contributors to disease and death for all adults in the United States, and alcohol use conveys even more risk for adults in midlife, according to the researchers.
Decreases in muscle mass and metabolism that are a part of the aging process may inhibit the body’s ability to process alcohol. People at this age more commonly have health conditions that are made worse by alcohol use and especially by higher and high-risk levels of alcohol consumption, such as diabetes, high blood pressure, cardiovascular disease and osteoporosis.
While men drank more alcohol than women on all measures, the association between binge [alcohol use] in high school and high-intensity [alcohol use] in midlife was stronger for women,” Ms Patrick said according to University of Michigan reporting.
Women who reported binge [alcohol use] at age 18 were three times more likely to report high-intensity [alcohol use] in midlife; men were twice as likely to report high-intensity [alcohol consumption] if they engaged in binge alcohol use at age 18.
We noted that alcohol use among women in midlife has risen steadily in recent years, while alcohol use among men has not.”
Megan Patrick, Institute for Social Research, University of Michigan and lead author of the study
The study also found that age and race/ethnicity are linked with alcohol use behaviors. Although alcohol use declined with age, among 60-year-olds, 1 in 5 still reported binge alcohol use in the past month. And the link between high school binge alcohol use and maximum alcoholic drinks was stronger at age 60 than at age 35.
White participants reported higher typical and maximum alcoholic drinks than other racial or ethnic groups. Previous studies have found that nonwhite alcohol consumers may experience greater adverse outcomes from alcohol use, despite their lower rates of alcohol use frequency, quantity and alcohol use disorder compared to white alcohol users.
Researchers analyzed data from more than 5,000 surveys of adults age 35, 40, 45, 50, 55 and 60. These participants had been part of a national longitudinal study, the Monitoring the Future Panel study, since the 12th grade. The aim was to explore if there were long-term links between binge alcohol use in adolescence and alcohol use in midlife.
Respondents in midlife were asked about their alcohol consumption habits in the past 30 days. Specifically, they reported the typical number and the maximum number of alcoholic drinks they consumed on the days they consumed alcohol.
The research was funded by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse.
Adolescent alcohol use is a predictor of health and well-being in midlife. This provides strong evidence for thinking about prevention and intervention in adolescence for long-term impacts,” Ms Patrick said.
Megan Patrick, Institute for Social Research, University of Michigan and lead author of the study
Abstract
Background
Alcohol use is increasing among adults in midlife (i.e., ages 35–60), but few studies examine specific alcohol use behaviors in this age group.
The researchers examined measures of typical alcoholic drinks, maximum alcoholic drinks, binge alcohol use, and high-intensity alcohol use by age, sex, and race/ethnicity among midlife adults, as well as the prospective link between age 18 binge alcohol use and midlife alcohol consumption behaviors.
Methods
Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35–60 in 2022 (followed since they were in 12th grade in 1980–2005) were used to estimate past 30-day midlife alcohol consumption behaviors (i.e., typical alcoholic drinks, maximum alcoholic drinks, binge, and high-intensity alcohol use) by age group, sex, and race/ethnicity.
Associations between age 18 binge alcohol use status and midlife alcohol consumption outcomes were examined, as well as moderation by sociodemographic characteristics.
Results
Across ages 35–60, the mean typical number of alcoholic drinks on alcohol consumption days within the past month ranged from 1.4 to 1.8; the mean maximum alcoholic drinks ranged from 2.3 to 3.2.
Past-month binge and high-intensity alcohol use prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively.
Estimates of alcohol use behaviors were generally higher among respondents aged 35–40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge alcohol use (vs. not).
Adolescent binge alcohol use was a stronger predictor of high-intensity alcohol use among females than males and of typical and maximum alcoholic drinks among older (age 60) than younger (age 35) respondents.
Conclusion
Binge and high-intensity alcohol use were reported by a meaningful percentage of the US midlife adults.
Binge alcohol use in adolescence was a predictor of subsequent alcohol-related risks. These long-term connections were especially strong among females. Age 18 binge alcohol use was a stronger predictor of high-intensity alcohol use at age 60 than earlier in midlife, underscoring that adolescent binge alcohol use is a key indicator of risk across the lifespan.
