Table 1.

Brief descriptive summaries of included studies with key limitations identified in quality appraisal

Article and country	Aims	Sample	Data collection methods and analysis	Author-identified key themes	Key limitations and comment on richness from quality appraisal
Abrahamson [66] (a) Sweden and Finland Abrahamson et al.[48] (b), Sweden	To investigate how old people—who during their lives have experienced the displacement of drinking’s moral border from soberness to moderate drinking—are presenting themselves, and their values, and attitudes towards alcohol To examine changes in women’s relationship to alcohol during the 1960s	n = 32, Age = 78–94, Drinking status = sober or moderate n = 25, Age = 61–94 years, Drinking status = light or moderate.	Written responses to autobiographical questions Qualitative thematic analysis Narrative construction and rhetoric motives	Sober repertoire; Moderation repertoire Scene and co-agents; Scene and counter-agents; Choice of the protagonist; Alcohol as agency	Lack of transparency in reporting of study design and methods; lack of exploration of study limitations and biases; thick description with reference to trends and contextual details. Inconsistent transparency in reporting; thick description in places with some contextual details and trends presented.
Aitken [59], New Zealand	To understand the meanings of alcohol use for older people who use alcohol and to understand older people’s reasons for drinking and identify the discourses they draw on to construct their alcohol use.	n = 18, Age = 53–74 years, Drinking status = responsible and potentially hazardous drinkers.	Semi-structured interviews, Discourse analysis	A ‘social life’ discourse; A ‘drinking to relax’ discourse; The ‘health issue’ discourse; A ‘problem’ discourse	Lack of transparency in reporting; thick description in places with some contextual details presented and many exemplary quotes
Billinger et al. 2012 [60], Sweden	Examines how older adults reason their relationship with alcohol and how they see the boundaries between what is acceptable and unacceptable drinking	n = 20, Age = 61–70 years, Drinking status: not reported.	Focus groups, Hermeneutic interpretation analysis	How the participants described the role of alcohol in their childhood; How participants described their first experience with alcohol; The participants’ definition of their current alcohol consumption; The boundary between acceptable and unacceptable alcohol use; Other people’s means of dealing with alcohol	No exploration of author biases presented; thick description rich with contextual detail, characteristics and trends.
Bobrova et al.[67], Russia	Investigated gender differences in drinking patterns and the reasons behind them among men and women in the Russian city of Novosibirsk	n = 44, Age = 48–63 years, Drinking status = abstainers, occasional drinkers, frequent drinkers and heavy drinkers.	Semi-structured interviews, Framework approach and inductive and thematic analysis	Traditional drinking patterns; Individual drinking patterns; Perceived reasons behind the gender differences in drinking	Lack of transparency in reporting; thinner description with some details presented of sample and context linked to study findings.
Burruss et al.[53], the USA	Exploring alcohol use among a subpopulation of older adults in congregate living, specifically a continuing care retirement community	n = 11, Age = 68–90 years, Drinking status = regular drinkers.	In-depth interviews, Thematic analysis	Drinking as habit/routine; Peers as catalysts for increased consumption; Alcohol use and congregate living	Lack of transparency in reporting; thick description of study findings supported with contextual detail.
Dare et al.[61], Australia	To explore What role does alcohol play in older people’s lives? What factors facilitate or constrain alcohol use in different residential settings? How does setting influence older people’s alcohol use?	n = 44, Age = 65–74 years, Drinking status = frequent drinkers, mostly low risk.	In-depth interviews, Thematic analysis	Alcohol and social engagement; Alcohol and relaxation; Alcohol, work and leisure; Social engagement; Social norms; Self-imposed regulations; Driving; Convenient and regular access to social activities; Driving and setting	Inconsistent transparency in reporting; thick description of study findings exploring differences between contexts.
del Pino et al.[49], the USA	To understand unhealthy alcohol use behaviours in socially disadvantaged, middle-aged and older Latino day labourers.	n = 14, Age = 50–64 years, Drinking status = occasional and frequent binge drinkers.	Semi-structured interviews, Grounded theory	Perceived consequences of unhealthy alcohol use on physical and mental health; The impact of unhealthy alcohol use on family relationships; The family as a key factor in efforts to change behaviour	Lack of transparency in reporting; thick description in places within context of individual characteristics, but no trends presented.
Edgar et al.[50], the UK	Investigate how the process of retiring and ageing shapes alcohol use and its role in the lives of retired people Explore the meaning and uses of alcohol in retirement Explore the lives of older people more broadly, including social networks, interests and family life Capture the intersections of gender, age and socioeconomic status in shaping the experience of retirement and how it relates to alcohol use. This was achieved by including men and women, three specific age groups, and those from areas categorised as ‘more deprived’ and ‘less deprived’, according to the Scottish Index of Multiple Deprivation (SIMD) Consider service and policy implications flowing from an enhanced understanding of alcohol use in later years.	n = 40, Age = 55–81 years, Drinking status = current or non-drinkers.	Semi-structured interviews, Thematic analysis	Routes into retirement; drinking routines; ‘keeping busy’: work and leisure in retirement; adapting to changing social networks; processes offering protection: adapting drinking routines	Inconsistent transparency in reporting; thick description of findings presented, supported by contextual detail with trends conveyed.
Gell et al.[51], the UK	To explore What purpose(s) does drinking serve for older adults? What kind of knowledge do older adults have of the relationship between health and alcohol consumption? Why do older adults change (or maintain) their alcohol consumption over time? What mechanisms lead to a change or maintenance of alcohol consumption behaviour in older adults after change in health?	n = 19, Age = 59–80 years, Drinking status = abstainers, low-level drinkers, mid-level drinkers or high-level drinkers.	Semi-structured interviews, Thematic and framework analysis	Current alcohol consumption among interview participants; Changes in alcohol consumption among interview participants; Psychological capability; Reflective motivation; Automatic motivation; Physical opportunity; Social opportunity	Thick description of findings; quotes at times appeared to be used out of original context to support the points made.
Haarni and Hautamaki [52], Finland	To analyse the relationship third-age people have with alcohol: how does long life experience affect drinking habits and what are those habits actually like in the everyday life of older adults?	n = 31, Age = 60–75 years, Drinking status = current- or ex-consumers of alcohol.	Biographical and semi-structured interviews, Content and biographical analysis	Different kinds of drinking career; The ideal of moderation; Ageing, generation and period of time	Study limitations were not considered in reporting; thick description of study findings with contextual detail provided; quotes at times appeared to be used out of original context to support the points made.
Johannessen et al.[64], Norway	To investigate older peoples’ experiences with and reflections on the use and misuse of alcohol and psychotropic drugs among older people	n = 16, Age = 65–92 years, Drinking status = experience with drinking but no known history of misuse.	Narrative interviews, Phenomenological-hermeneutic analysis	To be a part of a culture in change; To explain use and misuse	Potential biases of research team were not explored; thin description of study findings with no discussion of sample characteristics or trends in the data.
Joseph [54], Canada	To examine the alcohol-infused leisure practices of a group of older Afro-Caribbean men in Canada and the ways alcohol consumption at cricket grounds plays an integral role in the reproduction of club members’ gender as well as their homeland cultures, age, class and national identities	n = not reported due to study design, Age = 44–74 years, Drinking status = leisurely drinkers.	Observations and interviews, Inductive analysis	Drunkenness as a mask of physical degeneration; Drunkenness as temporal escape from femininity and family; Alcohol brands as class and (trans)nationality markers	Insufficient reporting of study limitations; thick description of study findings presented with rich contextual detail.
Kim [55], Canada	To explore the drinking behaviour of older Korean immigrants	n = 19, Age = 62–83 years, Drinking status = mostly (63%) drank more than once a week.	Semi-structured focus groups, Thematic analysis	Reasons for drinking among men versus women; Health and alcohol; Signs of problem drinking; drinking in immigrant life; Reasons for a change in drinking behaviour; Religion	Potential biases of research team were not explored; thick description of study findings with trends explored and rich contextual detail provided.
Reczek et al.[65], the USA	To provide insight into the processes that underlie the alcohol trajectories of mid- to later-life men’s and women’s heavy alcohol use identified in the quantitative results	n = 88, Age = 40–89 years, Drinking status = self-reported heavy alcohol users.	In-depth interviews, Inductive analysis	The gendered context of (re)marriage; The gendered context of divorce	Inconsistent transparency in reporting; potential biases of research team were not explored; thick description of study findings presented with rich contextual detail and exploration of trends.
Sharp [56], the USA	To understand the communication between community-based older adults and their physicians regarding their alcohol use	n = 11, Age = 79 years (mean), Drinking status = frequent drinkers.	Semi-structured interviews, Interpretive phenomenological analysis	Factors that hinder alcohol conversations; Characteristics that promote positive patient-doctor relationships	Unclear whether the sample was appropriate for the purpose of the study as most participants had never discussed alcohol use with their physician; thin description of study findings with no supporting excerpts or exploration of trends.
Stanojevic-Jerkovic et al.[70], Slovenia	To describe drinking patterns in older people, to identify the most common risk factors and protective factors for hazardous or harmful drinking, older people’s empowerment for resisting social pressure to drink and their knowledge about low risk drinking limits	n = 20, Age = 63–89 years, Drinking status = current drinkers, abstainers or occasional drinkers.	Focus groups, Thematic analysis	Factors that stimulate drinking; Factors hindering drinking; Factors that for some people encourage drinking, for others hinder it; Behaviour in a drinking company; Seeking for help; Familiarity with the recommendations for low-risk drinking; Further findings	Potential biases of research team were not explored; thick description of study findings with rich contextual detail and some exploration of trends.
Tolvanen [72], Finland	To examine the ways in which older people in Finland talk about their use of alcohol. It also aims to shed light on the meaning of alcohol use in the context of social ageing	n = 40, Age = 60–89 years, Drinking status: not reported.	Structured interviews, Discourse and conversation analysis	Alcohol use as discussed by older people; Who is the ‘one’ who drinks?	Insufficient transparency in reporting; questionable suitability of data for qualitative analysis; thick description of findings with contextual trends presented.
Tolvanen and Jylha [62], Finland	To explore how alcohol use was constructed in life story interviews with people aged 90 or over	n = 181, Age = 90+ years, Drinking status = abstainers and current drinkers.	Semi-structured/life story interviews, Discourse analysis	I and others: The use of alcohol as a moral issue; Men’s and women’s drinking; Alcohol as a man’s destiny and a threat to the happiness of homes; Alcohol use as part of social interaction; Alcohol use as a health issue	Inconsistent transparency in reporting; limitations and potential biases of research team were not explored; thick description of findings in places with trends presented; limited discussion of findings in relation to participant characteristics.
Vaz De Almeida et al.[63], Europe (Denmark, Germany, Italy, Poland, Portugal, Spain, Sweden and the UK)	To explore social and cultural aspects of alcohol consumption in a sample of older people living in their own homes, in eight different European countries	n = 644, Age = 65–74 years, Drinking status = non-dependent.	Semi-structured interviews, Grounded theory	Alcohol consumption narratives of older people; Gender differences in the narratives; Specific cultural differences between the eight countries	Inconsistent transparency in reporting; reported methods of analysis did not appear compatible with data collected; thinner description of data with some exploration of trends but descriptive themes; quotes lacked depth where presented.
Ward et al.[57], the UK	To generate a wider evidence base by exploring the circumstances in which older people drink, the meaning that drinking alcohol has for them and its impact, acknowledging that this can be a pleasurable and positive experience, as well as something that can have adverse health, financial, personal and interpersonal impacts	n = 21, Age = mid 50 s to late 80 s (years), Drinking status = regular drinkers who may or may not have a problem with their level of alcohol consumption.	Semi-structured interviews and focus groups, Thematic analysis	Drinking practices and styles; What affects drinking styles; Seeking help	Inconsistent transparency in reporting; insufficient exploration of limitations and biases; thick description of findings with some trends presented.
Watling and Armstrong [58], Australia and Sweden	To identify attitudes that might influence drink-driving tendency among this group of women and further show how these attitudes vary across countries	n = 30, Age = 52 years (mean), Drinking status = low-risk or risky drinkers.	Semi-structured interviews, Thematic analysis	Findings were not organised under theme headings	Potential biases of research team were not explored; thinner description of findings with inconsistent provision of contextual data.
Wilson et al.[71] (a), Haighton et al.[69] (b), Haighton et al.[68] (c), the UK	To elucidate the views of older individuals aged over 50 years about alcohol consumption, health and well-being, to inform future targeted prevention in this group To gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol-related health issues in people aged 50 and over Explored concurrent alcohol and medication use, as well as the use of alcohol for medicinal purposes, in a sample of individuals in mid to later life	n = 51, Age = 51–95, Drinking status = abstainers, occasional drinkers, moderate drinkers, heavy drinkers, recovering dependent drinkers and dependent drinkers.	In-depth interviews and semi-structured focus groups, Grounded theory and discursive analysis	Alcohol identities; Health and changing drinking behaviour; gendered patterns of drinking Drinking in mid to later life; Deciding to change; Experiences of primary care; Experience of detoxification and rehabilitation; Experience of counselling and therapy Drinking and using medication regardless of consequences; Health professionals being unaware of alcohol use; Reducing or stopping alcohol consumption because of medication; using alcohol to self-medicate; differences related to gender and age	Potential biases of research team were not explored; thick description on findings with trends presented and rich contextual detail. Inconsistent transparency in reporting; thick description of findings with trends presented and rich contextual detail. Inconsistent transparency in reporting; thick description of data with rich contextual detail.