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Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general population. Aims of the study were to describe differences in pain, alcohol consumption and use of painkillers among two 60 year old birth cohorts stratified by gender. Methods Participants were recruited from the Skåne centre of The Swedish National study on Aging and Care, a multicentre, prospective, longitudinal study. The sample comprised 60 year old men and women born between 1941 and 1943 and recruited to the study between 2001 and 2004 (n=663) and 60 year old men and women born in the period 1952-1954 and recruited to the study between 2013 and 2015 (n=924). Specially trained research staff conducted the interviews. For descriptive statistics the variables were presented in total numbers, percentages, mean and standard deviation, and 1st and 3rd quartile are also shown. The sample was divided into four groups: men and women born in the period 1941-1943, men and women born in the period 1952-1954, respectively. Results No difference in alcohol intake was detected between the two birth cohorts. All participants, regardless of pain or not, reported alcohol use below the specified risk level for both sexes. Teetotallers were more common in the 1952-1954 male cohort, 128 (29%), p&lt;0.029. Two hundred and eighty one Men born between 1952 and 1954 reported pain (59.0%), compared to 173 men born between 1941 and 1943 (51.6%), p&lt;0.034. There was no difference between the male cohorts in use of painkillers, p&lt;0.062. No difference was found between the two female cohorts in terms of pain, p&lt;0.144. One hundred and ten women in the 1941-43 cohort used painkillers (53.1%) compared to 119 women born between 1952 and 1954 (40.1%), p&lt;0.004. When comparing men and women with pain born between 1941 and 1942, men with moderate pain use more alcohol, 157 g/month (q1 10, q3 365) than women, 44 g/month (q1 0, q3 134), p&lt;0.001. Men with severe pain also use more alcohol, 96 g/month (q1 17, q3 324) than women, 27 g/month (q1 0, q1 118), p&lt;0.030, and when those with pain were merged into a group, men use more alcohol, 175 g/month (q1 31, q3 356), than women, 68 g/month (q1 1, q3 207), p&lt;0.001. This also applies to the later cohort; men, 132 g/month (q1 22, q3 270), compared to women, 76 g/month (q1 8, q3 182), p&lt;0.001. When merging all pain into one group women use more painkillers both in the 1941-43 cohort, men (39.9%) compared to women (53.1%), p&lt;0.010 and in the 1952-54 cohort, men (18.5%) compared to women (26.6%), p&lt;0.003. Use of analgesics and alcohol is common but the highest percentage is among women born between 1941 and 1943, 45 (48.9%). Conclusions Pain and alcohol use are common among 60 year old women and men. A gender difference is that women use more painkillers. In the 1941-43 cohort almost every second woman with moderate pain who took painkillers also consumed alcohol. Implications It is time to alert prescribers that a large section of the population uses alcohol combined with painkillers. More research is needed to better understand the long-term perspective on health when using both painkillers and alcohol.

Pain and alcohol: a comparison of two cohorts of 60 year old women and men: findings from the Good Aging in Skåne study