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Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study
Author(s) -
Keyes Katherine M.,
Calvo Esteban,
Ornstein Katherine A.,
Rutherford Caroline,
Fox Matthew P.,
Staudinger Ursula M.,
Fried Linda P.
Publication year - 2019
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.14125
Subject(s) - confounding , medicine , demography , observational study , body mass index , gerontology , mortality rate , national death index , epidemiology , environmental health , confidence interval , hazard ratio , surgery , sociology
Background Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single–time point consumption assessments and minimal confounder adjustments. Methods We report on 16 years of follow‐up from the Health and Retirement Study ( HRS ) cohorts born 1931 to 1941 ( N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time‐varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time‐invariant confounders included baseline age, education, sex, and race. Results After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI : 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4‐fold increases in mortality rates for men and ~9‐fold increases for women to change the results. Conclusions There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large‐scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.