La consommation d'alcool chez les Canadiens âgés de 55 ans et plus : étude des différences sur 10 ans et de l'association avec la perception de la santé

The aim of the thesis is to contribute to a better conceptual and empirical understanding of alcohol consumption among men and women aged 55 years and older from the general Canadian population. The two general objectives pursued are to gain a better understanding of the potential influence of the social/environmental context on drinking habits among older adults and to achieve a clearer discernment of the relation between alcohol consumption and health. The thesis comprises two empirical articles relating to each respective objective. More specifically, the first article verified whether contextual changes associated to alcohol and unique to the decade spanning the 1990s may have had an impact on alcohol consumption (period effect) by comparing two subsamples of older adults from two Canadian surveys: the 1994 CADS (Canada’s Alcohol and other Drugs Survey) and 2004 GENACIS (GENder, Alcohol, and Culture: an International Study). The article also assessed if the context had a significant effect on the differences observed when age, subjective perception of health and the sociodemographic composition of the samples were taken into consideration. Results first show that, in a social/environmental context that is more favourable to drinking in general, the rates of current drinkers, binge drinking, beer and wine drinkers are significantly higher in 2004. In addition, drinking profiles were not significantly different between 1994 and 2004 (volume, frequency, quantity, maximum quantity), pointing at the potential impact of normal physiological changes due to aging on drinking profiles. The second article aimed to build a drinking typology (including drinkers and non-drinkers) among older Canadian adults, to assess how the drinking typology was related to health status and to compare the role of alcohol with other determinants of health (demographic, psychosocial and health-related factors) in explaining health status. To do so, the subjective perception of health (subjective health) was used as a proxy for actual health status. Results from the 2004 GENACIS survey indicated that drinkers perceived themselves as being in better physical health than nondrinkers, regardless of the drinking pattern. Health status may explain drinking status and not the opposite. Results also showed that the demographic, psychosocial and health-related characteristics of older adults contributed significantly more to the variation in subjective health than the drinking status alone. Health benefits of drinking are explained by biological factors, but not exclusively by biological factors. In conclusion, alcohol research needs to emphasize the study of drinking among older adults, which can vary depending on the cohort and period under study. From a public health perspective, health-predicting models focusing on older adults need to be built on a better understanding of the impact of alcohol and other determinants of health on health status. Main contributions, practical implications, limitations of the thesis and recommendations for future research are presented in the discussion.

Keyphrases: Genre, Canada, Alcohol consumption, Older adults, Aging, Contextual/period changes, Sociodemographic composition, Determinants of health, Subjective health, Gender