Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study. (5th July 2019) - Keyes, Katherine M.
Abstract : 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. Abstract : Low levels of alcohol consumption promote longevity in the golden years. Analyzing data from almost 8, 000 older adults followed for almost two decades, Keyes et al. demonstrate that heavy drinking predicts mortality, and while moderate drinking in old age is associated with a longer life, it is those who are healthy enough to moderately drink who have the biggest benefit.