Marital Quality and Alcohol Use among Couples in Mid- and Later-Life

By Jennifer Roebuck Bulanda

Alcohol use has increased among older adults, and this increase has been particularly pronounced for older women. Social relationships influence drinking decisions, and married spouses affect one another’s patterns of alcohol use over time. We set out to add to this existing knowledge by exploring how both positive and negative aspects of marital relationships affect alcohol use during mid- and later life. Unhappy relationships might lead to an increased risk of heavy drinking if individuals are using alcohol as a way of coping with relationship problems. On the other hand, happy relationships may be associated with increased drinking if couples are using alcohol together during social interactions.

The National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking for men as more than 4 drinks on any given day or more than 14 drinks per week. For women, more than 3 drinks on any given day or 7 in a week constitutes heavy drinking. Heavy alcohol use may be particularly consequential for older adults’ well-being, as aging inhibits the body’s ability to process alcohol and alcohol can interact with prescription medication and exacerbate pre-existing conditions such as diabetes and memory problems. Previous research links heavy drinking with a higher risk of a variety of health conditions and a greater risk of death. 

We used longitudinal data from 1,389 couples in the 2014, 2016, and 2018 waves of the Health and Retirement Study to examine alcohol use over time. All spouses were over age 50 and provided information on their drinking behavior and their positive and negative assessment of marital quality. We accounted for a variety of sociodemographic, economic, social support, and health characteristics in our analyses. We analyzed the data using Actor-Partner Interdependence Models (APIM), which allowed us to assess the influence of respondents’ marital quality on their own alcohol use and their partner’s alcohol use. 

Although we expected that both positive and negative dimensions of marital quality might be linked to spouses’ alcohol use during mid- and later life, results show this is only the case for positive marital quality. Neither husbands’ nor wives’ evaluations of negative marital quality were associated with their own or their spouses’ heavy alcohol use. It therefore appears that couples over age 50 may not use heavy drinking as a way of coping with an unhappy marital relationship. 

Instead, we find that wives’ higher ratings of positive marital quality are linked to an increased risk of heavy drinking over time both for themselves and for their husbands. Wives’ higher ratings of positive marital quality are also associated with an increase in the number of drinks that they themselves typically consume when drinking. It is only the wife’s perception of marital quality – not the husband’s – that is associated partners’ heavy alcohol use. This finding may reflect gender differences in who maintains a couple’s social ties. Because wives are more likely than husbands to sustain and organize couples’ social connections, wives who feel positively about their marriages may be more likely to initiate and to participate in social gatherings with their husbands, increasing the opportunity for heavy alcohol consumption for both of the partners.
Our results call for increased alcohol literacy and also suggest that interventions for heavy alcohol use should take into account couple-level patterns of drinking behavior. Many couples may perceive “heavy drinking” in other terms, such as becoming drunk, or marked by specific behaviors, such as passing out. Couples may also not recognize that heavy drinking recommendations vary for men and women. The NIAAA’s weekly threshold for heavy drinking for men is twice the amount for women, and women may not be aware that keeping pace with their husband’s alcohol consumption puts them in a high-risk category. To learn more, assessments such as the Screening, Brief Intervention, and Referral to Treatment (SBIRT) tool can be utilized by healthcare providers as a quick screening method to assess alcohol use during regular, preventative-care visits. Community organizations such as senior centers can use an adapted version of this tool (the SBIRT-plus model). Given our findings, interventions that bring together both spouses to change drinking behavior over time (such as Alcohol-focused Behavior Couple Therapy) offer a promising approach to modifying the couple’s relationship with alcohol.

Article Details
Marital Quality and Alcohol Use among Couples in Mid- and Later-Life
Jennifer Roebuck Bulanda, Angela L. Curl, and Amy Restorick Roberts
First published online December 9, 2022
DOI: 10.1177/07334648221143305
Journal of Applied Gerontology

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