Online intervention helps older Australians rethink alcohol use

A University of NSW (UNSW) study has found that an online self-help program designed specifically for older adults can significantly reduce risky alcohol use.

“High-risk alcohol use in older adults is increasing, but there are few effective treatments tailored to this life stage, despite clear links with serious health conditions like dementia,” lead researcher and program lead in Lifespan and Brain Health Research at the University of Sydney’s Matilda Centre for Research in Mental Health and Substance Use Dr Louise Mewton said.

“We found that an online self-help program that we designed specifically for older adults is effective in reducing alcohol use in adults aged over 60 years.”

The Rethink My Drink trial showed that adults aged 60-75 who used the program cut their alcohol intake by an average of five standard drinks per month more than the control group, with overall reductions exceeding 36 drinks per month among participants.

Data shows that while many older Australians have given up drinking, those who do drink are more likely to drink daily and at risky levels. In 2022-23, 11.7 per cent of people aged 70 and over drank daily, the highest of any age group, and around one in three people in their 50s and 60s exceeded national alcohol risk guidelines.

Risky drinking in later life is linked to falls, adverse medication interactions, liver disease, cognitive decline and dementia. Alcohol use disorders also more than triple a person’s dementia risk, according to a 2024 Lancet Commission, which identifies alcohol reduction as a key modifiable risk factor for brain health.

The program was co-designed with older adults and delivered entirely online, making it accessible for people in rural and remote areas and scalable across aged care settings. The four-module program mirrors the skills and strategies typically delivered in therapy, but without requiring clinician time, a major advantage in a stretched workforce.

Dr Mewton also emphasised the broader potential of the intervention.

“Rethink My Drink is ready for large-scale dissemination among older adults in the community and has the potential for substantial beneficial effects on alcohol-related burden of disease in older adults,” she said.

The randomised controlled trial included 888 participants across Australia. Key outcomes included:

• Five-drink greater reduction per month compared with control
• 36 drink average reduction within the intervention group over 12 months
• Fewer high-risk drinking days at follow-up
• Cognitive improvements were observed but not significantly greater than the control group.

“Those in the treatment group improved their cognitive function significantly, however this was not improved relative to a control condition. We may need larger trials to test this more robustly,” Dr Mewton noted.

Under the Australian Alcohol Guidelines, adults should consume no more than 10 standard drinks per week and no more than four in a single day to keep health risks below one in 100.

Yet many older Australians exceed these limits due to long-established habits, social isolation, chronic pain or using alcohol as a sleep aid.

CHeBA co-director Professor Perminder Sachdev said the trial highlights the potential benefits of digital health approaches.

“This study shows that scalable digital programs can help address one of the most important modifiable risk factors for dementia at a population level,” he said.