{ "version": "1.0.0", "segments": [ { "speaker": "Merrin", "startTime": "1.52", "endTime": "34.32", "body": "My husband and I had found we'd gotten into some habits that we would turn to alcohol quite frequently. We had an expression \"wine o'clock\". So is it wine o'clock yet? Either congratulating yourself for making it through the day, I will have a glass of wine, or commiserating with yourself, well, I'll just have a glass of wine. I like to get up early, and I was getting up the same early time, but just felt the effects that carried over into the next day." }, { "speaker": "Tracy Parish", "startTime": "38.16", "endTime": "54.295", "body": "Why are older Australians drinking more, not less? Welcome to Help! I'm Ageing, a podcast from the National Centre for Healthy Ageing that's tackling the big questions we face as we get older. I'm Tracy Parish, and today with co-host Dr Taya Collyer ..." }, { "speaker": "Taya Collyer", "startTime": "54.454998", "endTime": "55.015", "body": "That's me!" }, { "speaker": "Tracy Parish", "startTime": "55.094997", "endTime": "79.575", "body": "We'll hear from our visionary researchers and people with lived experience. We'll be discovering new ways of thinking, and we'll find out how data and science can help you to have a healthier future. With Australia's population rapidly ageing, the time has never been more pressing to shine the light on what's possible when we put research, health care, and lived experience together. How can we age well? Let's find out." }, { "speaker": "Tracy Parish", "startTime": "79.735", "endTime": "88.055", "body": "Joining us today is Dr Tina Lam, a senior research fellow at the Monash Addiction Research Centre and the National Centre for Healthy Ageing." }, { "speaker": "Taya Collyer", "startTime": "88.56", "endTime": "102.08", "body": "Tina is laser focused on what is going on for Australians aged 50 to 70, what's going on in their lives and going on with their drinking patterns. Tina's study is called the Beyond 50 Study. Tell us about it, Tina." }, { "speaker": "Tina Lam", "startTime": "102.245", "endTime": "122.54", "body": "Yeah. So we've got a couple of studies that we're running at the moment. One is called the Beyond 50 Study, which is a big cohort study, which just means we track people over time. We keep interviewing people year in, year out. And this study is interviewing people, over a 1000 people from the Frankston Mornington Peninsula, which is sort of in the Southern region of Victoria." }, { "speaker": "Tina Lam", "startTime": "122.7", "endTime": "145.375", "body": "And we're just asking lots and lots of questions about what is going on for these people. What is happening with their work lives? What is happening with their physical health? What their nutrition is like, what their mental health is like? We wanna know what is going to be predictive of, you know, better healthy outcomes in older age so that we can develop more interventions and support these healthier lifestyle factors." }, { "speaker": "Tina Lam", "startTime": "146.26", "endTime": "175.86499", "body": "And as a part of that, we are also developing this project called Alcohol Change. So we know that alcohol use is still very common amongst our older generation. About 30 percent of people in their fifties and sixties are drinking at risky levels still. And the Alcohol Change Project is really geared toward understanding some of the reasons for drinking, who's making changes to their drinking, and seeing if we can amplify some of those stories that people tell around their changes to drinking to see if it'll help others within the community." }, { "speaker": "Taya Collyer", "startTime": "176.52", "endTime": "187.08", "body": "And just a reminder that Tina and I are academic doctors. We have PhDs, but we are not medical doctors, and we are basing our discussion today on our research. So this isn't medical advice." }, { "speaker": "Tracy Parish", "startTime": "187.31999", "endTime": "191.88", "body": "Well, Tina, I guess the first big question is why do older Australians drink more?" }, { "speaker": "Tina Lam", "startTime": "192.895", "endTime": "215.03", "body": "So, I mean, it's such a difficult question, but also at the same time, everybody has different motivations for drinking. So some people might drink to help them relax. Some people might drink to help them socialise. Some people might find that drinking might help them cope with some negative feelings that they don't want to have around. Some people might just enjoy the taste of a drink." }, { "speaker": "Tina Lam", "startTime": "215.03", "endTime": "244.22", "body": "So it's different for every single person. And in terms of why older Australians are drinking, a lot of the time, it's the same reason why they started drinking when they were younger, but we also know that that experience can change over a lifetime and depending on what's happening in someone's life at that point in time. So we know, for example, that the retirement age can be a really transitional age where there's a lot happening. There's things happening with your work life. There's things happening with your social life, and all of those things can be stressful." }, { "speaker": "Tina Lam", "startTime": "244.22", "endTime": "271.41", "body": "So we know that in the literature, the research has found that people can change around this time. So some people will drink the same amount, some people drink less. But overall, we find that a lot of people drink a little bit more just immediately after that retirement age. And this is where we start to see a few more problems crop up. So even if we're drinking the same amount as what we used to, we might notice a few more things happening in our bodies that we previously didn't notice." }, { "speaker": "Tina Lam", "startTime": "271.41", "endTime": "276.915", "body": "Things like, the slight fuzzy headedness that Merrin referred to earlier. Mhmm." }, { "speaker": "Tracy Parish", "startTime": "276.915", "endTime": "292.56", "body": "Just before we unpack the science, the research, the data, the general messaging, I'm interested to hear from both of you about what the reaction's been already about saying older Australians drinking more, not less. Taya, what's been your experience?" }, { "speaker": "Taya Collyer", "startTime": "292.56", "endTime": "314.6", "body": "Yeah. I think the topic we know in the back of our mind that maybe this is an issue, but to think about it in a careful and extended way the way we're doing today. Like, in Australia, when we talk about drinking culture, what are we talking about? It's a bunch of guys at the footy club, at the cricket club. It's a young group of girls having a great night out, having a laugh." }, { "speaker": "Taya Collyer", "startTime": "315.32", "endTime": "336.745", "body": "But the data in Australia does suggest that that is not accurate. And the AIHW, Australian Institute for Health and Welfare, have reported that of the whole population in Australia, the group who are engaging in, like, the most risky drinking behavior are older people, which is a huge surprise, I think, to anyone who's not marinating in this research the way you are, Tina." }, { "speaker": "Tina Lam", "startTime": "337.21", "endTime": "352.40997", "body": "Absolutely. So that's exactly right. We know that, you know, basically, middle aged and older men are drinking the most within Australia. And of people in their 50s in Australia, about a third are drinking at risky levels for people." }, { "speaker": "Taya Collyer", "startTime": "352.65", "endTime": "352.88998", "body": "One third?" }, { "speaker": "Tina Lam", "startTime": "353.26498", "endTime": "379.51", "body": "Yeah. About one third, and then it's, very similar for people in their 60s and people in their 70s. About a quarter of them are drinking at risky national levels. And I know there's ... it can sound confusing what a risky level is, but here in Australia, it means having more than 10 standard drinks per week or more than four standard drinks in a single drinking session. And, basically, having more alcohol puts you at a higher risk of harm." }, { "speaker": "Tina Lam", "startTime": "379.865", "endTime": "388.505", "body": "That's what that risky drinking guideline refers to ... Drinking beyond those levels, the likelihood of harm greatly escalates after that drinking point." }, { "speaker": "Tracy Parish", "startTime": "388.505", "endTime": "411.335", "body": "Well, Tina, obviously, I fall into this category of being a little bit older than both of you today. And when I'm at a function, it really is noticeable how much adults drink, particularly much older adults. But the reaction often is, well, why should I you know, I don't really have a problem or it's not a big thing, or other people go, yeah. Yeah I really should address it." }, { "speaker": "Tracy Parish", "startTime": "411.335", "endTime": "414.935", "body": "But I think that it's quite blurred about what is too much drinking." }, { "speaker": "Tina Lam", "startTime": "414.935", "endTime": "449.24", "body": "Absolutely. So there can be a lot of confusion about what is a lower risk amount of drinking, what is, you know, a safe level of drinking. And, actually, the World Health Organization, and our National Health Medical Council, they basically say there's no safe level of alcohol use. Any amount of alcohol is gonna increase your risk of physical harms and mental harms related to alcohol. So in terms of what we understand as being a lower risk consumption level in Australia, as I said, no alcohol at all is the safest." }, { "speaker": "Tina Lam", "startTime": "449.4", "endTime": "458.52", "body": "But, staying within limits such as no more than 10 standard drinks per week and no more than four standard drinks in a single drinking session." }, { "speaker": "Taya Collyer", "startTime": "459.345", "endTime": "471.905", "body": "I feel like we, like, we all kinda know that. We all know it. It's on the poster when you go to see the GP. But in Australia, for whatever reason, as a nation, we've just got a bit of a problem. Right?" }, { "speaker": "Taya Collyer", "startTime": "471.985", "endTime": "505.385", "body": "I moved to the UK as part of my studies, and we were turning up at dinner parties, and this Australian couple were rolling into every dinner party in Edinburgh with a bottle of wine. And after a few parties, my husband's looking at me like, I tell you, I don't think you bring wine to a dinner party in this country. And we were like, what? Like, we were physically incapable of rolling into someone's house without alcohol, and we had a good look at ourselves. We, and it was in that moment that I realised, like, wow. I have been socialised to tote this drug around in my handbag." }, { "speaker": "Tracy Parish", "startTime": "505.69998", "endTime": "514.02", "body": "But it's everywhere, isn't it? It's all pervasive. I mean, you go to the MCG or the SCG. You go to a sporting event. There's alcohol there." }, { "speaker": "Tracy Parish", "startTime": "514.02", "endTime": "538.83997", "body": "There's the whole, \"I'll meet you for drinks before the game, during the game, halftime, and after the game\", at the cricket test series, across the summer, Australian summer, always is identified with that. And more and more in women's sport as well. So a lot of people would think that is the very ethos of Australia. It is about drinking, having a good time, you know, what's the harm in that?" }, { "speaker": "Tina Lam", "startTime": "538.92", "endTime": "562.74", "body": "Yeah. Absolutely. I think a lot of the good times that are to be had are because we're surrounded with family and friends, I and think we need to look into those situations and figure out what is it that actually brings us joy. Is it the joy of connecting with others, for example? Is it actually the alcohol as we see it in the ads, or is it actually, you know, all the other pals that we have in the ads that are being portrayed to us?" }, { "speaker": "Taya Collyer", "startTime": "562.9", "endTime": "581.455", "body": "Yeah. It might not be the alcohol. It might just be the things that we do that are making us feel good. I was just reflecting. I've never seen an alcohol ad where someone is sitting at home by themselves frowning. But is that the kind of drinking that older people are doing? Like, what what kind of drinking are are older Australians doing?" }, { "speaker": "Tina Lam", "startTime": "581.695", "endTime": "612.66504", "body": "So we know in Australia that most of the alcohol we consumed is purchased from off premise locations, so bottle stores. And we know that most of that alcohol is consumed in private locations such as your own home, such as a friend's home. So most of that alcohol is being consumed within the home. Whether or not it's with other people, it's a bit of a mix, and some of that has to do with some of the motivations that people have for drinking. So if it's at a friend's house, then, you know, maybe it's part of a social situation." }, { "speaker": "Tina Lam", "startTime": "612.66504", "endTime": "639.665", "body": "Someone, you know, is finding it alleviates their social anxiety. They find it easier to sort of interact with others. But some people might be drinking alone because it helps they find it helps them relieve their stress. They might be coming home from a busy day of work or something and be sitting on the couch watching some TV with their wine or cooking some dinner with their wine. It really depends on the person and, you know, what what's in it for them when they drink." }, { "speaker": "Tracy Parish", "startTime": "640.305", "endTime": "655.39996", "body": "So I'm over 60, and I'm listening to this podcast right now. And I'm at home, and I'm thinking I'm going to open a wine because I don't like going out to bars. You know, I'm on my own. At what point does that become a problem? What does your research show?" }, { "speaker": "Tina Lam", "startTime": "655.63995", "endTime": "684.66", "body": "Yeah. So there's not necessarily hard and fast rules as to when something does become a problem, but we certainly have guidelines and criteria for for diagnosis around dependence. And we know that oftentimes the broader concept is when the drinking becomes an impediment to what you really wanna get on with in life. So maybe it's impacting on your social relationships. Maybe it's impacting on your work things, these things that you find important." }, { "speaker": "Tracy Parish", "startTime": "688.515", "endTime": "694.11505", "body": "Now we're just going to listen to Peter, who I think really explains how a journey with alcohol can become very complicated." }, { "speaker": "Peter", "startTime": "695.23505", "endTime": "719.785", "body": "There have been periods where I've I have used alcohol as a crutch. It physically was harmful. Mentally, I justified it. I future paced myself going forward about ten years. And I look back at where I was at that time, where the drinking had become a problem." }, { "speaker": "Peter", "startTime": "721.305", "endTime": "744.15", "body": "And I looked at myself, what was I creating that was worthwhile, that gave me some feeling that I had a purpose. It was an awakening. It really did. I was able to think about it and say, your future you is not very happy with you. What you gonna do about it?" }, { "speaker": "Tracy Parish", "startTime": "747.625", "endTime": "753.70496", "body": "So when we talk about older Australians drinking more, not less, why are they? And who are older Australians?" }, { "speaker": "Tina Lam", "startTime": "755.14496", "endTime": "777.835", "body": "So the literature will generally define older people as being aged 65, but more and more these days, we're defining older ages starting a little bit earlier. So maybe anyone sort of age 50 are gonna be thinking about ageing and what we do even at those slightly earlier ages. It's gonna have a huge impact on how we live later on in life." }, { "speaker": "Tracy Parish", "startTime": "778.635", "endTime": "784.475", "body": "But Tina, a lot of people over 65 don't see themselves as old. You know, they think 65 is the new 40." }, { "speaker": "Tina Lam", "startTime": "784.475", "endTime": "784.71497", "body": "Yeah." }, { "speaker": "Tracy Parish", "startTime": "784.71497", "endTime": "786.475", "body": "So it's in Australia in particular." }, { "speaker": "Taya Collyer", "startTime": "786.86005", "endTime": "789.34", "body": "So News Flash. They're not reading the literature." }, { "speaker": "Tina Lam", "startTime": "789.34", "endTime": "859.065", "body": "We are living longer and better for sure, and I think this is one of the great reasons why we wanna talk about some of the ways in which we can live not only longer, but healthier lives. We wanna be living in a way that really feels great to us, in a way that we can keep doing the things that we wanna do and remain, you know, illness free for as long as possible. When we really look at big groups of people, we can sort of start to see clusters of reasons for drinking, and we try to sort of summarise some of those clusters on a nerdy chart that goes along two dimensions. Basically, we're looking at some of the internal reasons for drinking. So say what it sort of what how we feel an internal motivation for that drinking or maybe like an external motivation for that drinking such as the friends that we have around us. And then we also think about the emotions that it brings out in us. So we might have some more positive emotions, such as, you know, feeling more sociable, or we might have some relief from negative emotions. So maybe we were feeling really stressed." }, { "speaker": "Tracy Parish", "startTime": "859.22504", "endTime": "859.465", "body": "Mhmm." }, { "speaker": "Tina Lam", "startTime": "859.545", "endTime": "862.025", "body": "And drinking helps to bring us some of that relief." }, { "speaker": "Tracy Parish", "startTime": "862.265", "endTime": "870.265", "body": "And those positive reactions to drinking, that surely that's in the moment. Like, it's you're having a great time. You're out and about. Is it the next morning?" }, { "speaker": "Tina Lam", "startTime": "870.53", "endTime": "895.795", "body": "So even though drinking might make us feel quite good in the moment, that doesn't mean that, you know, it's great for our bodies and in the longer term as well. So in the short term, even, like, you know, an hour after we start drinking, we might start to get the feeling that we have to go to the loo, for example. It's a diuretic. You know, it's gonna start to dehydrate us. And, you know, it might just be sort of annoying at night." }, { "speaker": "Tina Lam", "startTime": "895.795", "endTime": "905.57", "body": "You know, you might be waking up multiple times during the night to go to the bathroom. But, you know, we're gonna start to see some other impacts of that dehydration in our body." }, { "speaker": "Taya Collyer", "startTime": "905.73", "endTime": "909.32996", "body": "I have a question. Is alcohol a depressant?" }, { "speaker": "Tina Lam", "startTime": "910.44995", "endTime": "915.00995", "body": "Yeah okay. So in the alcohol and other drug field, we have different categories for different drugs." }, { "speaker": "Taya Collyer", "startTime": "915.075", "endTime": "915.47504", "body": "Right." }, { "speaker": "Tina Lam", "startTime": "915.47504", "endTime": "942.66", "body": "So we'll have stimulant drugs such as amphetamines, and we'll also have depressant drugs which will start to slow our body down. So it might not feel that way subjectively, but it'll start to slow things down in terms of our heart rate, especially if we have, you know, larger quantities of that. So we think about other drugs that are in the depressant category. We can think of opioids such as some of the pharmaceutical opioids we commonly take such as codeine, oxycodone,but also heroin." }, { "speaker": "Taya Collyer", "startTime": "944.065", "endTime": "945.66504", "body": "Drum roll. Where's alcohol?" }, { "speaker": "Tina Lam", "startTime": "945.66504", "endTime": "948.145", "body": "Drum roll. Alcohol absolutely is a depressant. Yes." }, { "speaker": "Taya Collyer", "startTime": "948.145", "endTime": "950.945", "body": "That might be surprising to people. It's surprising to me. And I .." }, { "speaker": "Tina Lam", "startTime": "951.025", "endTime": "951.66504", "body": "Absolutely, yes." }, { "speaker": "Taya Collyer", "startTime": "951.905", "endTime": "954.705", "body": "I'm a researcher as who's reasonably well studied in this." }, { "speaker": "Taya Collyer", "startTime": "954.705", "endTime": "960.17", "body": "So what are the implications of that for our bodies and for our lives if alcohol is a depressant?" }, { "speaker": "Tina Lam", "startTime": "960.57", "endTime": "975.025", "body": "I guess if we wanna start from the very pointy end, it is absolutely possible to overdose on alcohol. So that's gonna be stopping our heart rate. It's gonna be stopping our breathing. Woah. It can be lethal at very, very high doses for sure." }, { "speaker": "Tina Lam", "startTime": "975.98505", "endTime": "984.065", "body": "In terms of what you referred to earlier about, like, oh, that's not necessarily our immediate feeling that it's it's a depressing. Maybe you're feeling a bit if I'm breathing hard yeah." }, { "speaker": "Tina Lam", "startTime": "984.065", "endTime": "994.58", "body": "Exactly. I might feel a little bit more perked up in the initial stages. But if you think about it in terms of what it does in higher quantities, then, yeah, definitely, it has those classic sort of depressant symptoms." }, { "speaker": "Taya Collyer", "startTime": "994.66", "endTime": "1008.515", "body": "So let's talk about cancer. Because cancer, I think, is something that was absolutely not on the agenda in the nineties, but that is a recent push, right, from the medical research sector. What's going on with alcohol and cancer?" }, { "speaker": "Tina Lam", "startTime": "1008.515", "endTime": "1043.8049", "body": "Yeah. So it's a link that we've been thinking about within the research sector for quite a while. Like, we can go and dig up World Health Organization reports from the 1980s and they were starting to talk about the link between alcohol and cancer back then. Right. Even back then, they were saying, yeah. Look. You know, we're really quite certain that this is causal. Alcohol is a carcinogen. And now we know, you know, there are nine plus cancers that are caused by alcohol, and those include some of our most common cancers. So, for example, up to 10 percent of breast cancers that are attributable to alcohol consumption." }, { "speaker": "Tina Lam", "startTime": "1044.69", "endTime": "1066.415", "body": "Breast cancer is the most common cancer amongst Australian women, especially older Australian women. Mhmm. Prostate cancer is the most common male cancer in Australia, especially amongst older men. And with prostate cancer, for example, you don't really need that much. Consuming just one standard drink every 10 days can increase your risk of prostate cancer compared to not drinking at all." }, { "speaker": "Tina Lam", "startTime": "1066.4951", "endTime": "1076.6799", "body": "And drinking something like five drinks a day can increase your risk of prostate cancer by 18 percent. So this a big issue that we want to raise awareness around." }, { "speaker": "Tracy Parish", "startTime": "1076.76", "endTime": "1086.9199", "body": "Let's have a listen to Ross who had a stroke about two years ago, and it was a trigger to reevaluate his alcohol consumption, but particularly about the effect he thought it might have on his grandchildren." }, { "speaker": "Ross", "startTime": "1088.605", "endTime": "1110.47", "body": "It was actually 18 months ago I did the Pier to Pub swim and I came home, was sitting on that couch, my daughter said, you know, you look strange dad. And one eye was going that way, the other eye was going that way. It was double vision. So it took me down to the emergency, they put me straight in, I'd had a stroke. But as a consequence of that, then you start to rethink your attitude to all sorts of things." }, { "speaker": "Ross", "startTime": "1110.4701", "endTime": "1128.245", "body": "The grandchildren are important. How they perceive the world is very important to us. We're very close to them. I don't want to see them having the same visual culture that we had because growing up in the 70s with so much alcohol around, I'm very aware that I don't want them to see us drinking all the time." }, { "speaker": "Tina Lam", "startTime": "1129.2799", "endTime": "1141.0399", "body": "Friends and family are incredibly important to people. And if we're talking more about what alcohol means to us within our relationships, then that can be really important for making behavior changes." }, { "speaker": "Taya Collyer", "startTime": "1141.355", "endTime": "1156.1599", "body": "So not just like a statistical number. Like, well, if you keep going with your one VB every ten days, you're gonna increase your risk of this particular disease by this particular amount. Like, that it's actually more important to be thinking about the relationships that mean a lot to you and how alcohol is involved." }, { "speaker": "Tina Lam", "startTime": "1156.1599", "endTime": "1168.105", "body": "Exactly. Thinking about what is important to you. So for some people, might be remaining sharp at work, for example, maintaining their brain health. Uh-huh. For other people, it might be, you know, their physical health." }, { "speaker": "Tina Lam", "startTime": "1168.105", "endTime": "1181.5299", "body": "Maybe their the doctor has told them they're at risk of diabetes. For example, alcohol is quite high in calories. If you drink one pint of beer, that's 200 calories. That's the equivalent of three eggs. So you can imagine a night out and you're having" }, { "speaker": "Taya Collyer", "startTime": "1181.5299", "endTime": "1184.49", "body": "I'd love a night out with eggs! I'd love a night out with three eggs!" }, { "speaker": "Tina Lam", "startTime": "1184.49", "endTime": "1191.45", "body": "Just line them up in little shot glasses. Yes. Just just have a nibble every now and again. It's gonna sustain you. Yeah." }, { "speaker": "Tina Lam", "startTime": "1191.45", "endTime": "1192.49", "body": "It's gonna be way better." }, { "speaker": "Taya Collyer", "startTime": "1192.49", "endTime": "1214.22", "body": "Now we don't have calorie information on the backs of our alcoholic drinks in Australia because this this is something that I know because I'm a nerd who did a who did a degree. Right? But alcohol is processed by the liver into fat, f- a- t, every single time. There's no other option for your body but to try but to convert it to fat, and yet we don't have it on the back. And, you know, everyone's watching their calories." }, { "speaker": "Taya Collyer", "startTime": "1214.22", "endTime": "1220.86", "body": "We got our low carb beers and whatnot. Like, why do you think that people aren't more aware of the energy density of alcohol?" }, { "speaker": "Tina Lam", "startTime": "1221.6051", "endTime": "1234.5651", "body": "Yeah. So, I mean, you've already answered some of the the some of the questions there, Taya, with the fact that we don't have nutrition information on the back of the labels. Right. And we, in public health, have been pushing for that for quite some time. It does take a while." }, { "speaker": "Tina Lam", "startTime": "1234.5651", "endTime": "1251.405", "body": "So, you know, we spent 20 years trying to get a label on the back of alcohol saying, alcohol causes harm for your baby. Twenty years. How long do you think it's gonna take us to get, you know, the nutrition information on the back of the label? How long do you think it's gonna take for us to get the cancer information on the back of the label?" }, { "speaker": "Taya Collyer", "startTime": "1251.885", "endTime": "1255.805", "body": "One beer equals three eggs. I think that's a sell. I think that's ..." }, { "speaker": "Tina Lam", "startTime": "1256.525", "endTime": "1258.365", "body": "Absolutely. It it doesn't take much." }, { "speaker": "Taya Collyer", "startTime": "1258.365", "endTime": "1278.25", "body": "Well, we know and we hear all the time that older people are concerned about their memories. And as a medical statistician, I analyse data all the time collected from people living with dementia and their families. And alcohol does have a really a really big impact on the brain. Tina, can you can you fill our listeners in on that a bit?" }, { "speaker": "Tina Lam", "startTime": "1278.5651", "endTime": "1306.37", "body": "Yes. Absolutely. And I'm gonna rewind shortly to, like, have engaging in that social support stuff with meaningful activities to say that, you know, you can socialise and have all of that support without alcohol. So in terms of what alcohol does to our cognitive health, we know that alcohol is incredibly important in the area of brain health. So we know that even small quantities, some like a few drinks a week is gonna have an impact on our working memory." }, { "speaker": "Taya Collyer", "startTime": "1306.745", "endTime": "1308.505", "body": "We will notice that? What's our working memory?" }, { "speaker": "Tina Lam", "startTime": "1308.505", "endTime": "1313.625", "body": "It's like the immediate memory that we try to access when we're when we're doing stuff right now." }, { "speaker": "Taya Collyer", "startTime": "1313.865", "endTime": "1315.065", "body": "Oh where my keys?" }, { "speaker": "Tina Lam", "startTime": "1315.305", "endTime": "1363.2799", "body": "Yeah. Yeah. Basically. Yeah. It's like that explicit running thought that you have right now, and it can probably be differentiated from, say, your long term memory of stuff that you're not thinking about right now. But if you were asked to recall your grandmother's maiden name or something like that, you could really think about it and and access that. So, yeah, it has a big impact on working memory, and we know that it has an impact on a variety of different brain conditions, including dementia. So we know, for example, that alcohol is one of the strongest modifiable behaviour risk factors for dementia, which is just another way of saying when we think about the things that we can change as adults to reduce our risk of dementia, alcohol is basically the biggest thing that we can change at this point in time to reduce our risk of dementia." }, { "speaker": "Tracy Parish", "startTime": "1363.2799", "endTime": "1369.945", "body": "And do you have to have a relative that's had dementia, or is it the direct impact of alcohol that can cause dementia?" }, { "speaker": "Tina Lam", "startTime": "1370.025", "endTime": "1383.1699", "body": "Yeah. So a bit of both. There is a genetic component, but there is most certainly a direct effect of alcohol on the risk of dementia. There is a subcategory of dementia, which is fairly common in Australia called alcohol-related dementia." }, { "speaker": "Taya Collyer", "startTime": "1383.17", "endTime": "1412.23", "body": "Mhmm. See, I feel like that will be so surprising to our listeners. And even as someone who is a dementia researcher, that's not something that we talk about often enough. And I feel like the the theme running under all of our discussion today is, like, why are we not able to have these conversations about the harms of alcohol? Like, who is out there? Who is \"team alcohol\" that might be perhaps preventing our older Australians from having a crystal clear understanding of these risks." }, { "speaker": "Tina Lam", "startTime": "1412.39", "endTime": "1453.5651", "body": "So we do know that in the general population, it's not often talked about the harms of alcohol aren't often talked about, but one group of clinicians who do talk about it a lot are those dementia specialists. So when we do talk to those specialists, they say, oh, we always have to talk about alcohol in terms of the first consultation we have with the patient and their families, and we always talk about are they drinking at the moment. If they are, they've got to reduce or, you know, abstain preferably to reduce the increasing severity of their, of the, dementia and also to reduce the current symptom severity of the dementia." }, { "speaker": "Taya Collyer", "startTime": "1453.5651", "endTime": "1463.325", "body": "And we don't have any curative treatments for dementia. We don't have a cure. And so what you're saying is that when a person is diagnosed, like, step one is to drink less?" }, { "speaker": "Tina Lam", "startTime": "1463.4851", "endTime": "1467.7251", "body": "Yes. Absolutely. That's gonna be a conversation you have with your dementia specialist in the clinic." }, { "speaker": "Taya Collyer", "startTime": "1467.78", "endTime": "1482.8201", "body": "Wow. Yes. So you mentioned that you're looking at hospitalisations, Tina. And I think, like, people out there might be thinking, how does one become hospitalised? And I think this is another aspect about drinking that we don't often talk about." }, { "speaker": "Taya Collyer", "startTime": "1482.8201", "endTime": "1487.605", "body": "So what are you looking when you say you're looking at hospitalisations, what are you looking at?" }, { "speaker": "Tina Lam", "startTime": "1487.6849", "endTime": "1512.7201", "body": "Yeah. In short, it's a real mixed bag. So we might have some short term harms that get you into the emergency department. So for example, you might have you might be you might have been drinking that night, and then, you know, you were trying to get to the bathroom in the middle of the night, and then, you know, you weren't as steady on your feet as you usually would be, and you fell over. And then that fall might be classed as an alcohol related injury" }, { "speaker": "Taya Collyer", "startTime": "1512.9601", "endTime": "1513.12", "body": "Mhmm." }, { "speaker": "Tina Lam", "startTime": "1513.28", "endTime": "1528.09", "body": "When you turn up to the emergency department. And then once you're in the emergency department, you know, maybe the the injury requires you to be hospitalised. So then you turn up in our hospitalisation dataset. So they're two different datasets, the emergency department and the hospitalisation dataset. Right." }, { "speaker": "Taya Collyer", "startTime": "1528.09", "endTime": "1532.7299", "body": "So older people are coming into the emergency department because of their drinking behavior." }, { "speaker": "Tina Lam", "startTime": "1532.73", "endTime": "1543.715", "body": "Absolutely. Absolutely. And that's what we're seeing in terms of our statistics, like this big jump of older people turning up in our emergency department and hospitalisation datasets." }, { "speaker": "Taya Collyer", "startTime": "1544.1951", "endTime": "1562.0599", "body": "Wow. This is so ... I'm putting this together just over our conversation. So we have an ageing population. We have more older people than ever, and our older people are drinking more than ever, and they are particularly vulnerable to the harms of drinking. So it sounds like as a country, we need to get our heads around this problem." }, { "speaker": "Tina Lam", "startTime": "1562.38", "endTime": "1568.06", "body": "Absolutely. We need to understand more, but that being said, we already understand a lot, and I think we need to sort of put ..." }, { "speaker": "Taya Collyer", "startTime": "1568.38", "endTime": "1569.3401", "body": "Yeah. Roll up our sleeves." }, { "speaker": "Tina Lam", "startTime": "1569.3401", "endTime": "1572.06", "body": "Put on your boots Yeah. Get on with it. Yeah." }, { "speaker": "Tracy Parish", "startTime": "1572.135", "endTime": "1587.0898", "body": "What about the conversations you have with your GP? Everyone talks about if you can't talk to your family or friends, because sometimes people can't. Or family and friends have tried to talk to you about your problem. How honest are they with the GPs?" }, { "speaker": "Tina Lam", "startTime": "1587.09", "endTime": "1640.0349", "body": "Yeah. Look. I think it depends on the relationship you have with the GP, and I think that could be generalised to all the other relationships you have in your life. So if you've got good rapport with someone, then you can have these open chats. When we were conducting our in-depth interviews with our research participants, we did have a a number of folks who were a little bit anxious about telling their friends and family about reducing their alcohol use. They were afraid that, you know, oh, they might feel uncomfortable because they're drinking and, you know, I'm stepping down. But actually, by and large, people found that their friends and family were really supportive. They wanted what was best for the individual. The person said, look. I'm wanting to cut down because I wanna be healthier. Family and friends were really supportive of that. In Merrin's case, for example, her husband decided to support her as well by also cutting down." }, { "speaker": "Tracy Parish", "startTime": "1640.8099", "endTime": "1662.585", "body": "And yet when you go out for dinner with people, every single time, if you're not drinking, when you're older, they ask you why. And when you're younger, they often say, are you pregnant? They'll say to women straight out. But we don't say to them, why aren't you having the bread roll? Or why aren't you having dessert? Why do we feel as a culture that we can actually be that upfront about it?" }, { "speaker": "Tina Lam", "startTime": "1662.6649", "endTime": "1682.7999", "body": "Yeah. That's that's a great question, and I think that has to do with the normalisation, if you will, of alcohol within Australian culture. And I'm as I mentioned before, that culture is changing. So the younger generations are drinking less and less. When we talk about the age of first drinking, that's increasing more and more every single year." }, { "speaker": "Tina Lam", "startTime": "1682.88", "endTime": "1698.565", "body": "If young people do decide to drink, they're starting later. They're drinking less. So I think they're I think it's important to emphasise that culture is not static. It's composed of individuals. Individuals change, and those individuals influence others." }, { "speaker": "Tina Lam", "startTime": "1698.565", "endTime": "1718.015", "body": "You know, the younger generation are just more aware of the health effects of alcohol and how that impacts on their choice to drink alcohol and that in turn encouraging some of the older generation to, okay, maybe not have alcohol every single family and friends gathering. Maybe we can just have it, you know, on the occasion. It doesn't have to be the default." }, { "speaker": "Taya Collyer", "startTime": "1718.415", "endTime": "1724.015", "body": "Yeah. So the youth giving permission, giving permission to the older Australians to make that choice." }, { "speaker": "Tina Lam", "startTime": "1724.015", "endTime": "1728.4", "body": "Yes. Absolutely. Just demonstrating that that's an option. Actually, it is a choice." }, { "speaker": "Taya Collyer", "startTime": "1728.4", "endTime": "1755.2549", "body": "Mhmm. And, Tracy, you were talking about honesty in the clinic, which we know for reporting behaviors and reporting drug use in particular, it's hard to be honest with your care team. And that is one of the strengths of our Data Platform at the National Centre for Healthy Ageing because we're able to get a handle on issues like this without having to get up in someone's face and say, \"hello we're doing a study about alcohol. How often do you engage in the following behaviours?\"" }, { "speaker": "Taya Collyer", "startTime": "1755.61", "endTime": "1784.6951", "body": "We're able to look at the hospital data in a very passive and non confronting way to get a picture of these trends over time. And at the National Centre for Healthy Ageing, we've been able to link with the Beyond 50 cohort and keep an eye on this over time in a quiet, non confronting, but also in an accurate way. We're not relying on people looking us in the face and saying, hey. I am engaging in the following embarrassing behavior. That's a real strength of our platform." }, { "speaker": "Taya Collyer", "startTime": "1784.6951", "endTime": "1795.1499", "body": "Can't wait to see the results. So what's a practical thing that our listeners can do next time they're at a bar or are at home and are thinking about having a drink?" }, { "speaker": "Tina Lam", "startTime": "1795.23", "endTime": "1833.465", "body": "Yeah. One practical thing is that they can just be a lot more conscious and mindful about why they're drinking. So sometimes we just sit down out of a matter of habit and pour ourselves a glass of wine, and we find that a lot of the people who have made recent changes, they came to that conscious realisation that, like, actually, I can make, you know, a fairly easy healthier change. But just by dropping times when I'm just drinking out of habit, it's not actually really doing that much for me, and, you know, I don't feel, you know, that much changed afterward. Even those small reductions are gonna have big benefits for your lifestyle." }, { "speaker": "Tina Lam", "startTime": "1833.865", "endTime": "1855.9199", "body": "And we do tend to underestimate how much we drink. This is just like a general life and research finding. Definitely. So we have in Australia, we count drinks by using standard drinks, and that's 10 grams of alcohol. We're not supposed to have any more than sort of four standard drinks per session to sort of remain in those low risk drinking standards." }, { "speaker": "Tina Lam", "startTime": "1856.08", "endTime": "1862.175", "body": "But four standard drinks can actually be a little bit hard to quantify unless you're sort of looking at a packaged item" }, { "speaker": "Taya Collyer", "startTime": "1862.335", "endTime": "1862.735", "body": "Yeah. I couldn't." }, { "speaker": "Tina Lam", "startTime": "1863.295", "endTime": "1881.66", "body": "... on the back, on the back, of the can or something. So if you're pouring a glass of wine, it can actually be quite hard to estimate what a standard drink is. And a standard drink for wine is only a 100 mls. So if you think about a shot glass, that's 30 mls. You can imagine pouring basically three shot glasses in a tiny bit." }, { "speaker": "Tina Lam", "startTime": "1881.66", "endTime": "1904.09", "body": "Three shot glasses of wine is one standard drink. So starting off with the thought like, do I actually want that drink at this point in time? If you do decide you want to have that drink, then being conscious about how much you drink. So counting your drinks, counting your bottle caps, or, you know, trying to estimate the best you can in how much you pour in your glass." }, { "speaker": "Taya Collyer", "startTime": "1904.0901", "endTime": "1914.7549", "body": "So, Tina, if someone's got their headphones on and they're listening to this podcast and they're thinking, okay. It's time for me to really take some action here. What's the port of call? Where where should they go?" }, { "speaker": "Tina Lam", "startTime": "1915.235", "endTime": "1954.72", "body": "Yeah. So this might be a great starting point for some general information, something similar that you'd similar to a chat that you might have with a friend, but I would most certainly encourage you to get in contact with your favourite clinician. That might be your GP, your specialist, your pharmacist, someone that you feel like you can really chat to. So for example, if you're on the if you're drinking higher quantities of alcohol and, you know, wanting to cut down, you might need some medical supervision there. So if you're if you find that when you don't drink, you seem to get quite anxious and, you know, you're you're starting to get the shakes, then we wouldn't recommend that, you know, you just stop without medical assistance." }, { "speaker": "Taya Collyer", "startTime": "1954.72", "endTime": "1955.0399", "body": "Mhmm." }, { "speaker": "Tina Lam", "startTime": "1955.0399", "endTime": "1974.095", "body": "That very much requires some supervision. But in terms of the general message, it'd be to say, you know, look. You're you're not in it alone if you wanna change. There's lots of people out there. Have a listen to some of our stories, or even better, have a chat with your family and friends." }, { "speaker": "Tina Lam", "startTime": "1974.095", "endTime": "1980.02", "body": "You might find that they also are in a similar situation, and you guys might be able to support one another on your journey." }, { "speaker": "Taya Collyer", "startTime": "1980.26", "endTime": "1992.7401", "body": "And, listeners, just a reminder that we haven't got a doctor in the room today, and this podcast is useful information for you, but it is not medical advice. Please talk to your own GP and your own treating team for advice that is tailored to you." }, { "speaker": "Tracy Parish", "startTime": "1993.035", "endTime": "1999.6749", "body": "And our final question, which we're going to ask all our guests who are on this program, what does healthy ageing mean to you?" }, { "speaker": "Tina Lam", "startTime": "1999.915", "endTime": "2036.975", "body": "So I think a lot of the time my science nerd brain says, look, a lot of the time traditionally was defined as lifespan, so extending your life for as long as possible. But I think these days, we're a lot more nuanced about it, and we're thinking more and more about the quality of life. So quality of life means that, you know, you're able to do the things that you want to do for longer and without the impediments of illnesses. And if you're thinking of maintaining that healthier lifestyle for longer and getting the benefits from that healthy lifestyle, then it's worth, you know, reducing or even quitting alcohol." }, { "speaker": "Tracy Parish", "startTime": "2037.44", "endTime": "2041.44", "body": "Thanks so much to Tina for being our special guest today and to you, Taya." }, { "speaker": "Taya Collyer", "startTime": "2041.44", "endTime": "2042.48", "body": "No worries, Tracy." }, { "speaker": "Tracy Parish", "startTime": "2042.48", "endTime": "2075.5598", "body": "We've learned today why are older Australians are drinking more, not less. We hope it's helped in some way. You've been listening to Help! I'm Ageing, a podcast from the National Centre for Healthy Ageing. We are proudly driving innovation and transforming health and care through research so we can all lead healthier lives as we age, especially those most at risk. If you want to know more, check out our website at ncha.org.au. If you like this episode, and I know you did, Taya, please tell your friends, your family, your colleagues, and share it widely. The more, the merrier." }, { "speaker": "Taya Collyer", "startTime": "2075.5598", "endTime": "2079.72", "body": "When you're doing your shopping, just drop it in, at the checkout, or at the deli." }, { "speaker": "Tracy Parish", "startTime": "2079.72", "endTime": "2096.225", "body": "Anytime. Just weave it into a conversation. The more people we can reach, obviously, the greater impact the research can have in helping people age well. There is still so much more to talk about in this series. So join us next time for more real stories, real evidence, real insights about healthy ageing." }, { "speaker": "Tracy Parish", "startTime": "2096.3052", "endTime": "2098.271", "body": "Tune in wherever you listen to your podcasts." } ] }