Research article
A Life‐Time of Hazardous Drinking and Harm to Health among Older Adults: Findings from the Whitehall II Prospective Cohort Study
Abstract
Aims
To investigate associations of life‐time heavy alcohol use and binge alcohol use with biomarkers of cardiometabolic health, liver function, cardiovascular disease (CVD) and mortality.
Design
Prospective cohort study with median follow‐up time to CVD incidence of 4.5 years.
Setting
London, UK: civil servants within the Whitehall II Study.
Participants
A total of 4820 alcohol use aged 59–83 years with biological measurements during the 2011–12 survey.
Measurements
Heavy alcohol use was defined as having an AUDIT‐C score ≥ 5 calculated at each decade of life, forming the following groups: never heavy alcohol user, former early (stopping before age 50), former later (stopping after age 50), current heavy alcohol user and consistent heavy alcohol user (heavy alcohol user at each decade of life).
Findings
More than half the sample had been heavy alcohol users at some point during their life‐time, comprising former early (< age 50) (19%), former later (≥ age 50) (11%), current (21%) and consistent heavy alcohol users (AUDIT‐C ≥ 5 across life (5%). After adjusting for covariates, waist circumference was larger with more persistent heavy alcohol use (e.g. compared with never heavy alcohol users, former early had increased waist circumference by 1.17 cm [95% confidence interval (CI) = 0.25‐2.08]; former later by 1.88 cm (CI = 0.77–2.98); current by 2.44 cm (CI = 1.50–3.34) and consistent heavy alcohol user by 3.85 cm (CI = 2.23–5.47). Current heavy alcohol users had higher systolic blood pressure (2.44 mmHg, CI = 1.19–3.68) and fatty liver index scores (4.05 mmHg, CI = 2.92–5.18) than never heavy alcohol users. Current heavy alcohol users [hazard ratio (HR) = 2.75, CI = 1.44–5.22) had an elevated risk of stroke, and former later heavy alcohol users had an elevated risk of non‐CVD mortality (HR = 1.93, CI = 1.19–3.14) than never heavy alcohol users. Life‐time binge alcohol use was associated with larger waist circumferences and poorer liver function compared with never binge alcohol users.
Conclusion
heavy alcohol use may increase cardiometabolic risk factors; this is made worse by persistent heavy alcohol use throughout life, particularly in relation to weight gain, suggesting benefits of early intervention.
Quotes
This suggests that the longer adults engage in heavy [alcohol use] the larger their waistline in older age. That is why it is beneficial, along with other health benefits, that adults reduce heavy drinking earlier rather than later,” said Dr Ng Fat, researcher of the study, as per, UCL News.
Early intervention and screening for alcohol consumption, as part of regular check-ups, could help reduce hazardous drinking among this demographic,” added Professor Annie Britton (UCL Institute of Epidemiology & Health Care), senior author on the study, as per UCL News.