Episodic Heavy Drinking and 20‐Year Total Mortality Among Late‐Life Moderate Drinkers

Abstract

Background Analyses of moderate drinking have focused overwhelmingly on average consumption, which masks diverse underlying drinking patterns. This study examined the association between episodic heavy drinking and total mortality among moderate-drinking older adults. Methods At baseline, the sample was comprised of 446 adults aged 55 to 65: 74 moderate drinkers who engaged in episodic heavy drinking and 372 regular moderate drinkers. The database at baseline also included a broad set of sociodemographic, behavioral, and health status covariates. Death across a 20-year follow-up period was confirmed primarily by death certificate. Results In multiple logistic regression analyses, after adjusting for all covariates, as well as overall alcohol consumption, moderate drinkers who engaged in episodic heavy drinking had more than two times higher odds of 20-year mortality in comparison to regular moderate drinkers. Conclusions Among older moderate drinkers, those who engage in episodic heavy drinking show significantly increased total mortality risk compared to regular moderate drinkers. Episodic heavy drinking—even when average consumption remains moderate—is a significant public health concern.

Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers

“…First, we focused on the effects of pattern of drinking. In contrast to our earlier findings among average moderate drinkers (Holahan et al, 2014) and consistent with Schoenborn et al (2014), we anticipated that pattern of drinking would not be significantly related to mortality when level of drinking is high. Next, extending this rationale, we focused on the effects of level of drinking.…”

Impacts of Alcoholism in Public Health: A Systematic Review

“…A third important dependence reason for alcohol abuse was verified in many European countries, where excessive drinking in men varies by level of education and income, with the least educated and those earning lower income being at higher risk [53]. A similar outcome were found in USA, where, compared with moderate drinkers who were episodic heavy drinkers, regular moderate drinkers were significantly higher on SES (Socioeconomic Status) [89].…”

“…To better understand this event, Lapham and colleagues worked with AUDIT-C (Alcohol Use Disorders Identification Test -Consumption) to find that the probability of converting to a positive screen varied widely based on age, gender, and initial negative screen score (range 2.1 to 38.9%) [88]. In particular, older patients and those with the lowest scores on their initial negative screen were least likely to convert to a positive subsequent screen on AUDIT-C [88], despite the fact that episodic heavy drinking is frequent among middle-aged and older adults [89]. Besides, it was demonstrated that those with an AUDIT score of 20 or more are not only more likely to have functional impairment but also that psychiatric morbidities are more common in this group [90].…”

“…The episodes of heavy drinking concentrate alcohol's toxicity and are linked to mortality through diverse disease and behavioral pathways [91,89]. Those men who typically consumed 6 or more bottles of beer per drinking occasion had substantially increased total mortality compared with men who typically consumed < 3 bottles of beer per drinking occasion [89] and moderate drinkers who were episodic heavy drinkers in comparison with regular moderate drinkers showed 3 times more likely to be problem drinkers at baseline and more than 2 times increase in the odds of total mortality during the 20-year period [89]. Advances in alcohol research have shown that patterns and average quantity of alcohol use may influence the outcomes of alcoholrelated diseases and conditions [9].…”

“…Available studies indicate the most common form of simultaneous drug use involves alcohol and marijuana [92,93,73,74,75,40], whilst tobacco smoking continues, worldwide, to be the most harmful health behavior associated with premature disease and death [94,95,89]. Another substance highly mixed with alcohol are energy drinks, which has raised concerns about their impact on health of consumers owing to the risk of caffeine intoxication.…”