Changes in health status predict changes in alcohol consumption in older adults: the Seniors-ENRICA cohort
Abstract
Background: Some of the previously reported health benefits of low-to-moderate alcohol consumption may derive from health status influencing alcohol consumption rather than the opposite. We examined whether health status changes influence changes in alcohol consumption, cessation included. Methods: Data came from 571 current drinkers aged ≥60 years participating in the Seniors-ENRICA cohort in Spain. Participants were recruited in 2008–2010 and followed-up for 8.2 years, with four waves of data collection. We assessed health status using a 52-item deficit accumulation (DA) index with four domains: functional, self-rated health and vitality, mental health, and morbidity and health services use. To minimise reverse causation, we examined how changes in health status over a 3-year period (wave 0–wave 1) influenced changes in alcohol consumption over the subsequent 5 years (waves 1–3) using linear/logistic regression, as appropriate. Results: Compared with participants in the lowest tertile of DA change (mean absolute 4.3% health improvement), those in the highest tertile (7.8% worsening) showed a reduction in alcohol intake (β: –4.32 g/day; 95% CI –7.00 to –1.62; p trend=0.002) and were more likely to quit alcohol (OR: 2.80; 95% CI 1.54 to 5.08; p trend=0.001). The main contributors to decreasing drinking were increased functional impairment and poorer self-rated health, whereas worsening self-rated health, onset of diabetes or stroke and increased prevalence of hospitalisation influenced cessation. Conclusions: Health deterioration is related to a subsequent reduction and cessation of alcohol consumption contributing to the growing evidence challenging the protective health effect previously attributed to low-to-moderate alcohol consumption.
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Ill health could be related to a reduction or cessation of alcohol consumption, introducing potential bias due to reverse causality, when interest is in studying the effect of alcohol consumption on subsequent health.
“In turn, ill health could be related to a reduction or cessation of alcohol consumption, introducing potential bias due to reverse causality, when interest is in studying the effect of alcohol consumption on subsequent health.4 5”
From Strengthening the Reporting of Observational Studies in Epidemiology using Mendelian Randomisation (STROBE-MR): explanation and elaboration. (2021) · cites this paper as [5]
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Skrivankova, V. W., Richmond, R. C., Woolf, B. A. R., Davies, N. M., Swanson, S. A., VanderWeele, T. J., Timpson, N. J., Higgins, J. P. T., Dimou, N., Langenberg, C., et al. (2021) · BMJ · doi:10.1136/bmj.n2233 · Cited by 1,648 · see citing works
- Authors
- Ortolá, R., García-Esquinas, E., Soler-Vila, H., Ordovas, J. M., López-García, E., & Rodríguez-Artalejo, F.
- Affiliations
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- Corresponding author
- Ortolá, Rosario
- ORCID
- Ortolá, Rosario
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2018-10-30
- Volume
- 73
- Issue
- 2
- Pages
- 123-129
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- OpenAlex
- W2899048641
- Cited by
- 12
- References
- 38
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- CIBER of Epidemiology and Public Health
- Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE
- JPI-A Healthy Diet for a Healthy Life, State Secretary of R+D+I
- Plan Nacional sobre Drogas
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- alcohol consumption, older adults, health status change, reverse causality, alcohol cessation, functional disability, self-rated health, vitality, mental health, morbidity, hospitalization, diabetes mellitus, stroke
- MeSH terms
- Aged, Alcohol Drinking, Female, Health Status, Humans, Male, Middle Aged, Socioeconomic Factors, Spain, Cohort Studies, Health Behavior, Logistic Models, Self Report
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