Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors
Original Investigation
Summary
Researchers found that no amount of alcohol benefits heart health, and already light alcohol intake increases cancer risk among older adults.
The large new study shows that virtually any amount of alcohol increases the cancer risk of older people. And the study also reveals there are zero heart benefits in older adults from alcohol use. The study tracked 135,103 adults aged 60 and older for 12 years. The findings were published in JAMA Network Open.
The researchers classified alcohol use patterns as occasional, low risk, moderate risk, and high risk. The study defined light alcohol use as a mean alcohol intake of up to 20 grams a day for men and up to 10 grams daily for women. For example, in the United States, a standard alcoholic drink is 14 grams of alcohol.
Compared with occasional alcohol use, high-risk alcohol intake is linked with a 1.33 times greater risk for cancer and a 1.21 times higher risk for cardiovascular death. Moderate alcohol use came with a 1.1 times higher risk for cancer and a 1.15 times higher risk for cardiovascular death.
Cancer risk ‘from the first drop’
We did not find evidence of a beneficial association between low [alcohol use] and mortality,” said Dr. Rosario Ortolá, an assistant professor of preventive medicine and public health at Universidad Autónoma de Madrid and the lead author of the paper, as per New York Times reporting.
On the other hand, alcohol probably raises the risk of cancer from the first drop.”
Dr. Rosario Ortolá, Assistant professor, Preventive medicine and public health, Universidad Autónoma de Madrid, lead author of the paper
Higher risks of death and disease from light alcohol use
The researcher led by Dr. Ortolá found that older adults who are light alcohol users face higher risks of dying if they have health-related or socioeconomic risk factors. Another finding is that consuming mostly wine and drinking alcohol only with meals moderated the risk, particularly of death from cancer. The reasons were not entirely clear, Dr. Ortolá said, according to the New York Times. It may mostly reflect the effect of healthier lifestyles overall, slower alcohol absorption, or nonalcoholic components of beverages.
This is one of the first studies to examine the issue of health and socioeconomic risk factors in older people and their risk to suffer from alcohol harms.
Among those with socioeconomic or health-related risk factors – such as living in a lower-income neighborhood or having an existing health issue – low-risk alcohol use still was linked with a 1.15 times greater risk of dying with cancer. Low-risk and moderate-risk alcohol intake patterns were linked with a 1.14 times and 1.17 times higher mortality from all causes, respectively; low-risk alcohol users were 1.25 times more likely to die from cancer and moderate-risk alcohol users were 1.36 times more likely to die from cancer, the data showed, as per Mc Knights Long-Term Care News.
Key Points
Question
Do health-related or socioeconomic risk factors modify the link between alcohol consumption patterns with mortality among older alcohol users?
Findings
This cohort study in 135, 103 older alcohol users found that even low-risk alcohol use is linked with higher mortality among older adults with health-related or socioeconomic risk factors. Wine preference and consuming alcohol only with meals are linked with attenuating the excess mortality associated with alcohol consumption.
Meaning
This cohort study identified inequalities in the detrimental health outcomes associated with alcohol that should be addressed to reduce the high disease burden of alcohol use.
Abstract
Importance
Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors.
Objective
To examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors.
Design, Setting, and Participants
This prospective cohort study used data from the UK Biobank, a population-based cohort. Participants were current alcohol users aged 60 years or older. Data were analyzed from September 2023 to May 2024.
Exposure
According to their mean alcohol intake in grams per day, participants’ alcohol use patterns were classified as occasional: ≤2.86 g/d, low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d).
Main Outcomes and Measures
Health-related risk factors were assessed with the frailty index, and socioeconomic risk factors were assessed with the Townsend deprivation index. All-cause and cause-specific mortality were obtained from death certificates held by the national registries. Analyses excluded deaths in the first 2 years of follow-up and adjusted for potential confounders, including alcohol use patterns and preferences.
Results
A total of 135, 103 participants (median age, 64.0 years; 67,693 [50.1%] women) were included.
In the total analytical sample, compared with occasional alcohol use:
- high-risk alcohol intake was linked with higher all-cause (hazard ratio [HR], 1.33), cancer (HR, 1.39), and cardiovascular (HR, 1.21) mortality;
- moderate-risk alcohol intake was linked with higher all-cause (HR, 1.10;) and cancer (HR, 1.15) mortality, and
- low-risk alcohol intake was linked with higher cancer mortality (HR, 1.11).
While no associations were found for low- or moderate-risk alcohol intake patterns vs occasional alcohol use among individuals without socioeconomic or health-related risk factors, low-risk alcohol intake was linked with higher cancer mortality (HR, 1.15) and moderate-risk alcohol intake with higher all-cause (HR, 1.10) and cancer (HR, 1.19) mortality among those with health-related risk factors; low-risk and moderate-risk alcohol use patterns were linked with higher mortality from all causes (low risk: HR, 1.14; moderate risk: HR, 1.17) and cancer (low risk: HR, 1.25; moderate risk: HR, 1.36) among those with socioeconomic risk factors.
Wine preference (>80% of alcohol from wine) and consuming alcohol with meals showed small protective associations with mortality, especially from cancer, but only in alcohol users with socioeconomic or health-related risk factors and was associated with attenuating the excess mortality associated with high-, moderate- and even low-risk alcohol use.
Conclusions and Relevance
In this cohort study of older alcohol users from the UK, even low-risk alcohol use was associated with higher mortality among older adults with health-related or socioeconomic risk factors. The attenuation of mortality observed for wine preference and consuming alcohol only during meals requires further investigation, as it may mostly reflect the effect of healthier lifestyles, slower alcohol absorption, or nonalcoholic components of beverages.
Additional sources
New York Times: “Older Adults Do Not Benefit From Moderate Drinking, Large Study Finds”
Medical Express: “Even light drinking harms health of older adults: Study”
McKnights Long-Term Care News: “Study: Less drinking still comes with death risk in older adults with socioeconomic, health issues”
Medical Daily: “Cancer Risk ‘From The First Drop’: Study Warns Even Light Drinking Risky To Elderly”