Alcohol consumption and all‐cause mortality in older adults in Spain: an analysis accounting for the main methodological issues

Ortolá, Rosario; López-Garcı́a, Esther; León‐Muñoz, Luz M.; Banegas, José R.; Rodríguez‐Artalejo, Fernando

doi:10.1111/add.14402

Cited by 44 publications

(42 citation statements)

References 43 publications

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“…While previous studies found that smoking was a risk factor for all-cause mortality [11], our results found no statistically signi cant difference, which is possibly explained by the quitter bias (people may stop smoking because they are in poor health and may be advised not to continue). The results of the risk study on alcohol consumption were basically consistent with the results of Ortolá et al, which showed that there was no statistically signi cant difference in mortality between light-to-moderate alcohol consumption and no alcohol consumption among people over 60 years old [34]. As well, we found the greater all-cause mortality risk among persons with underweight (BMI < 18.5 kg/m 2 ) in this study, which agreed with previous studies [21,35,36].…”

Section: Discussionsupporting

confidence: 89%

Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

He¹,

Zhang²,

Hu³

et al. 2020

Preprint

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Background: Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the combination of multimorbidity and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/combination) and all-cause mortality in Chinese older adults. Methods: We conducted a population-based study of 50,100 Chinese participants. Cox regression models were used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results: The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted Cox models, the hazard rations (HRs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.10 (1.01-1.20), 1.21 (1.10-1.33), and 1.46 (1.27-1.67), respectively (Ptrend <0.001). In the LTCs ≥ 2 category, the combination of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥ 75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years.Conclusions: The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly combinations.

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Section: Discussionsupporting

confidence: 89%

Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

He¹,

Zhang²,

Hu³

et al. 2020

Preprint

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“…While numerous studies have examined the relationship between alcohol consumption and mortality, methodological limitations have abounded. In a recent meta‐analysis (Stockwell et al., ), Stockwell and colleagues noted that of 87 studies, at least 65 used a reference group of abstainers that included former drinkers, suggesting the potential for selection bias (Licaj et al., ; Ortolá et al., ). Similar biases were highlighted in an additional meta‐analysis examining alcohol consumption and cardiovascular disease (Zhao et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…Relative to abstainers and heavy drinkers, moderate drinkers are wealthier and present more protective factors for cardiometabolic health (Cerdá et al., ; Dawson et al., ; French et al., ; Lang et al., ; Naimi et al., ; Rehm et al., ; Skog, ), and many studies do not have comprehensive information sufficient for confounder control. Further, the extent to which associations arise because of reverse causation (individuals reducing consumption due to illness) remains a threat to validity (Licaj et al., ; Ortolá et al., ; Stockwell et al., ). An instrumental variable approach like Mendelian randomization, which does not rely on standard confounder control, demonstrates little evidence for a protective effect of moderate consumption on cardiovascular disease (Cho et al., ; Holmes et al., ; Millwood et al., ; Taylor et al., ).…”

mentioning

confidence: 99%

Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study

Keyes

Calvo

Ornstein

et al. 2019

Alcoholism Clin & Exp Res

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Background: Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single-time point consumption assessments and minimal confounder adjustments.Methods: We report on 16 years of follow-up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time-varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time-invariant confounders included baseline age, education, sex, and race.Results: After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with~4-fold increases in mortality rates for men and~9-fold increases for women to change the results.Conclusions: There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large-scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.

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“…All patients with a history of EH, ranging from 3 months to 47 years, had normal-range blood pressure as they were on antihypertensive medication. As against the personal history of subjects, there was a very significant improvement in habits of smoking (≥5 cigarettes each day [26] ), alcohol consumption (≥140 g per week [27] ), and physical activity (>30 min of aerobic exercise ≥2 times per week [28] ) after post-diagnosis professional education in the EH group. All subjects in this study were of Han ethnicity.…”

Section: Methodsmentioning

confidence: 99%

KLHL3 single-nucleotide polymorphism is associated with essential hypertension in Chinese Han population

Hu²,

Xiang³

et al. 2019

Medicine

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Hypertension, including secondary and essential hypertension (EH) variants, is a multifactorial disease, affecting more than one billion people worldwide. Secondary hypertension results from mutations in the putative gene KLHL3 (Kelch-like protein 3); however, it has not been reported whether the KLHL3 gene polymorphisms are associated with EH. Here, we investigated the association between KLHL3 (rs2301708 and rs7444370) polymorphisms and EH in the Chinese Han population. This case–control study included 522 subjects—260 patients with EH and 262 normotensive controls matched for age, gender, body mass index (BMI), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), and levels of Na + , K + , and Cl − . The distribution of functional rs2301708 and rs7444370 polymorphisms within the KLHL3 gene was assessed through polymerase chain reaction (PCR) and restriction-fragment length polymorphism (RFLP). There was no significant difference in allelic and genotypic frequencies of KLHL3 rs2301708 between the EH and normotensive groups; however, the rs7444370 T allele and CT genotype in females was significantly associated with a protective effect against EH ( P = .001, P = .002; P = .019, P = .052), and the haplotype CT of rs2301708 and rs7444370 among females in the EH group was less than in the normotensive group ( P = .000; P = .007). The KLHL3 rs7444370 variant could be a protective factor in the pathogenesis of females’ EH.

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Alcohol consumption and all‐cause mortality in older adults in Spain: an analysis accounting for the main methodological issues

Cited by 44 publications

References 43 publications

Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

Relationship Between Multimorbidity, Combination and All-Cause Mortality Among Older Adults: A Retrospective Cohort Analysis

Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study

KLHL3 single-nucleotide polymorphism is associated with essential hypertension in Chinese Han population

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