Alcohol and Sedative Use in Belgian Older Adults: A Cross-Sectional Observational Study on Associations With Lifetime Sexual Victimization

Background Sexual violence (SV) in older adults is an underexplored public health issue with important mental health impact. Few studies examined its relationship with alcohol and sedative use in later life. This cross-sectional observational study aimed to assess prevalence of alcohol and sedative use in Belgian older adults, examine associations with lifetime SV, and explore moderating sociodemographic, health, and psychosocial factors. Methods Between July 2019 and March 2020 a random sample of 513 adults aged 70 years and older living in Belgium completed structured face-to-face interviews assessing SV (measured with 17 behaviorally specific questions), mental health, and alcohol and sedative use. Participants were selected via cluster random probability sampling using a random walk approach. Stepwise logistic regression analyzed associations between lifetime SV and substance use, adjusting for sociodemographic, health, and psychosocial factors. Results Lifetime SV was reported by 44.2%; past-year SV by 8.4%. Hazardous alcohol use occurred in 22.4%, sedative use in 38.8%. Women with lifetime SV were nearly three times more likely to engage in hazardous drinking (OR = 2.94, 95% CI: 1.58-5.47, P = 0.001), whereas no association was observed in men. Sedative use was associated with female sex, being a care recipient, and depressive symptoms, but not with lifetime sexual victimization. Conclusions Hazardous alcohol and sedative use are prevalent in older adults in Belgium. Lifetime SV increases the risk of hazardous drinking in older women, highlighting the need for sex- and trauma-sensitive screening and targeted substance use interventions for older adults.