Department of Psychology (A8000), University of Texas at Austin, Austin, Texas 78712, USA.
Alcohol Clin Exp Res. 2010 Nov;34(11):1961-71. doi: 10.1111/j.1530-0277.2010.01286.x. Epub 2010 Aug 24.
Growing epidemiological evidence indicates that moderate alcohol consumption is associated with reduced total mortality among middle-aged and older adults. However, the salutary effect of moderate drinking may be overestimated owing to confounding factors. Abstainers may include former problem drinkers with existing health problems and may be atypical compared to drinkers in terms of sociodemographic and social-behavioral factors. The purpose of this study was to examine the association between alcohol consumption and all-cause mortality over 20 years among 1,824 older adults, controlling for a wide range of potential confounding factors associated with abstention.
The sample at baseline included 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social-behavioral factors. Abstention was defined as abstaining from alcohol at baseline. Death across a 20-year follow-up period was confirmed primarily by death certificate.
Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers.
Findings are consistent with an interpretation that the survival effect for moderate drinking compared to abstention among older adults reflects 2 processes. First, the effect of confounding factors associated with alcohol abstention is considerable. However, even after taking account of traditional and nontraditional covariates, moderate alcohol consumption continued to show a beneficial effect in predicting mortality risk.
越来越多的流行病学证据表明，适量饮酒与中年及老年人总死亡率降低有关。然而，由于混杂因素的影响，适度饮酒的有益作用可能被高估了。戒酒者可能包括有现有健康问题的前酗酒者，并且在社会人口统计学和社会行为因素方面与饮酒者可能不同。本研究的目的是在控制与戒酒相关的广泛潜在混杂因素的情况下，研究 1824 名老年人饮酒与全因死亡率之间 20 年的关系。
基线时的样本包括 1824 名年龄在 55 至 65 岁之间的个体。基线数据库包括每日饮酒量、社会人口统计学因素、前酗酒状况、健康因素和社会行为因素的信息。戒酒定义为在基线时戒酒。20 年随访期间的死亡主要通过死亡证明确认。
仅控制年龄和性别，与适量饮酒者相比，戒酒者的死亡率风险增加了两倍多，重度饮酒者的风险增加了 70%，轻度饮酒者的风险增加了 23%。一个控制了前酗酒状况、现有健康问题以及关键社会人口统计学和社会行为因素以及年龄和性别的模型，大大降低了与适量饮酒者相比，戒酒者的死亡率效应。然而，即使在调整了所有协变量后，与适量饮酒者相比，戒酒者和重度饮酒者的死亡率风险仍然分别增加了 51%和 45%。
研究结果与以下解释一致，即与老年人的戒酒相比，适度饮酒的生存效果反映了两个过程。首先，与戒酒相关的混杂因素的影响是相当大的。然而，即使考虑到传统和非传统的协变量，适度饮酒在预测死亡率风险方面继续显示出有益的效果。
