Effects of Alcohol Intake on Mortality among Older Adults

The effects of alcohol consumption in people over age 65 may be modified by metabolic changes, reduced body mass, and increased comorbid conditions. Researchers in Australia analyzed data from 2 prospective cohorts—men aged 65–79 years (n=11,727) and women aged 70–75 years (n=12,432) at baseline—and assessed the relationship between alcohol intake and total and cause-specific mortality at 10-year follow-up. Alcohol use was assessed based on days of use per week and quantity consumed per day. Results were adjusted for potential confounders.

• Compared with older adults who consumed alcohol less than once per week, the risk of all-cause mortality was reduced in men who consumed ≤4 standard drinks* per day and in women who consumed 1–2 drinks per day. Similar results were observed for deaths due to cardiovascular disease.

• The total mortality risk among men and women who consumed 1–2 drinks per day was significantly lower (between 20–30%) than that of subjects who reported no consumption in a typical week.

• The risk of mortality was largely unaffected by frequency of drinking among men and women who drank 1–2 drinks per day; i.e., mortality risk was the same whether drinking at this level occurred 1–2 days per week or 7 days per week.

• Men in all frequency categories who consumed ≥9 drinks per day had a higher mortality risk (hazard ratios 1.29 to 1.51) than nondrinkers.

Comments:

The argument for lower limits of regular alcohol use for older people has been based largely on theoretical concerns. In this study, these concerns did not translate into a higher risk for all-cause mortality; instead, consuming 1–2 drinks per day (versus no drinking) was associated with a 20–30% lower mortality risk. Although the authors also reported that 1–2 nondrinking days per week reduced mortality risk further in men (but not in women), the data presented do not support such a finding.

R. Curtis Ellison, MD

Reference:

McCaul KA, Almeida OP, Hankey GJ, et al. Alcohol use and mortality in older men and women. Addiction. 2010;105(8):1391–1400.