A major Australian study published in The Lancet Public Health has found that a tailored online program can help older adults aged 60–75 significantly reduce risky alcohol use, cutting consumption by an average of five standard drinks per month.

The large-scale trial, known as Rethink My Drink, was led by researchers from UNSW Sydney and the University of Sydney. It tested a four-module online self-help program designed specifically for older adults, comparing it with a standard information-only control.

Developed with clinician input, the modules replicated the information and skills typically provided in therapy, offering a practical and accessible tool for those seeking to reduce alcohol use.

Addressing a Growing Health Concern

High-risk alcohol use among older Australians is an emerging public health issue. While overall drinking rates have declined in recent decades, risky drinking has remained steady or even increased in later life. National data show nearly one in five Australians in their 60s exceed recommended guidelines, placing them at greater risk of long-term harms.

Alcohol is a key modifiable risk factor for dementia, yet its impact in older adults often goes under-recognised. Rising consumption has been accompanied by increases in alcohol-related disease and mortality, including liver disease and liver cancer in those aged 70 and older. Globally, premature deaths related to alcohol use are concentrated among people aged 50–69.

Meaningful Reductions in Alcohol Use

The randomised controlled trial included 888 participants across Australia. After 12 months, those who completed the Rethink My Drink program reduced their alcohol use by more than 36 drinks per month on average. Compared with the control group, participants in the treatment group consumed five fewer standard drinks per month, a reduction researchers describe as meaningful at a population level.

“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,” said Dr Louise Mewton, Program Lead in Lifespan and Brain Health Research at the University of Sydney’s Matilda Centre.

Dr Mewton, who commenced the project at UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA), said the findings fill a critical gap in prevention strategies for older adults.

“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,” she said.

Exploring Links to Brain Health

Alcohol use is a major contributor to global disease burden and is associated with more than 200 health conditions. In later life, it is also a key modifiable risk factor for dementia, with alcohol use disorders linked to a more than threefold increase in dementia risk.

The study also explored whether reducing alcohol intake could improve cognitive function. Participants who completed the online program showed improvements in cognitive performance over time, though these were not significantly greater than those in the control group.

“We also found that 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 said.

Scalable, Accessible and Ready for Rollout

The Rethink My Drink program was co-designed with older adults to ensure the content was relevant, accessible and easy to use. Delivered entirely online, it represents a low-cost, scalable approach that could be implemented nationally, including in rural or underserved communities.

“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,” said Dr Mewton.

Dr Mewton, a visiting researcher at CHeBA, was awarded a World Class Research Large Grant from the Dementia Centre for Research Collaboration (DCRC) to lead the work.

Co-Director of CHeBA and UNSW co-author Professor Perminder Sachdev AM said the findings highlight the potential of digital health tools to address major public health challenges.

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

The broader aim of the Rethink My Drink project is to determine whether brief, accessible self-help programs can reduce alcohol consumption, minimise alcohol-related harms, and ultimately help protect brain health and quality of life in older adults.