Mohebbi Mohammadreza, Davoodian Najmeh, Ganjali Shiva, Beilin Lawrence J, Berk Michael, Forbes Malcolm, McNeil John J, Nelson Mark R, Ryan Joanne, Wolfe Rory, Woods Robyn L, Lotfaliany Mojtaba
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine-Barwon Health Geelong, Geelong, VIC 3220, Australia.
Nutrients. 2025 Aug 20;17(16):2688. doi: 10.3390/nu17162688.
BACKGROUND/OBJECTIVES: Evidence suggests a J-shaped association between alcohol consumption and depression, but it remains unclear whether this reflects a true causal effect, reverse causation, or methodological bias. This uncertainty is particularly relevant in older adults, who are at increased risk for both depression and alcohol-related harms. This study aimed to examine the association between varying levels of alcohol consumption and depression risk in community-dwelling older adults. METHODS: We analyzed 16,563 community-dwelling older adults (mean age 75.1 ± 4.6 years) from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Alcohol intake, reported at baseline and follow-up, was categorized as abstinent, occasional, moderate, or above-guideline. Both intention-to-treat (classified by baseline alcohol consumption, regardless of later changes) and per-protocol (using annual time-updated alcohol consumption ) analyses were performed. To address confounding, informative censoring, and selection bias, we applied marginal structural models with inverse probability weighting. RESULTS: In per-protocol analyses, abstainers (OR 1.17), occasional drinkers (OR 1.11), and above-guideline drinkers (OR 1.15) were significantly associated with a higher risk of depression compared with moderate drinkers, consistent with a J-shaped association. Sensitivity analyses excluding former drinkers and those with baseline depressive symptoms showed similar results. The association remained robust after adjusting for social isolation, social support, social interactions, physical activity, pain, sleep duration, sleep difficulties, and sleep medication use ( = 14,892; Australian sub-sample), and did not differ by sex. CONCLUSIONS: Moderate alcohol consumption was associated with the lowest depression risk, confirming a J-shaped relationship after comprehensive confounder adjustment.
背景/目的:有证据表明饮酒与抑郁症之间存在J形关联,但尚不清楚这是反映了真正的因果效应、反向因果关系还是方法学偏差。这种不确定性在老年人中尤为重要,因为他们患抑郁症和与酒精相关危害的风险更高。本研究旨在探讨社区居住的老年人不同饮酒水平与抑郁风险之间的关联。 方法:我们分析了来自阿司匹林减少老年人事件(ASPREE)试验的16563名社区居住的老年人(平均年龄75.1±4.6岁)。在基线和随访时报告的酒精摄入量分为戒酒者、偶尔饮酒者、适度饮酒者或高于指南饮酒者。进行了意向性分析(按基线酒精摄入量分类,无论后期变化如何)和符合方案分析(使用年度更新的酒精摄入量)。为了解决混杂、信息删失和选择偏倚问题,我们应用了具有逆概率加权的边际结构模型。 结果:在符合方案分析中,与适度饮酒者相比,戒酒者(OR 1.17)、偶尔饮酒者(OR 1.11)和高于指南饮酒者(OR 1.15)与抑郁症风险较高显著相关,这与J形关联一致。排除既往饮酒者和有基线抑郁症状者的敏感性分析显示了类似结果。在调整社会隔离、社会支持、社会互动、身体活动、疼痛、睡眠时间、睡眠困难和睡眠药物使用后(n = 14892;澳大利亚子样本),该关联仍然稳健,且在性别上无差异。 结论:适度饮酒与最低的抑郁风险相关,在全面调整混杂因素后证实了J形关系。
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