@article{ref1,
title="Alcohol consumption and all-cause mortality in older adults in Spain: an analysis accounting for the main methodological issues",
journal="Addiction",
year="2019",
author="Ortolá, Rosario and García-Esquinas, Esther and López-García, Esther and León-Muñoz, Luz M. and Banegas, José R. and Rodriguez-Artalejo, Fernando",
volume="114",
number="1",
pages="59-68",
abstract="BACKGROUND AND AIMS: Observational evidence that light-to-moderate alcohol consumption lowers mortality is questioned because of potential selection biases and residual confounding. We assess the association between alcohol intake and all-cause death in older adults after accounting for those methodological issues. <br><br>METHODS: Data came from 3045 individuals representative of the non-institutionalized population aged ≥60 years in Spain. Participants were recruited in 2008-2010, when they reported current and lifetime alcohol intake; drinkers were classified as occasional (<1.43g/day), light (1.43 to <20g/day for men and 1.43 to <10g/day for women), moderate (20 to <40g/day for men and 10 to <20g/day for women) or heavy (≥40g/day for men and ≥24g/day for women)/binge. Participants were followed-up through 2017 to assess vital status. In analyses, ex-drinkers were removed from the abstainer group and were classified according to their lifetime intake to address the &quot;abstainer bias&quot;. Moreover, analyses were replicated in individuals without functional limitations, and excluded deaths in the first year of follow-up, to address reverse causation. Also, occasional drinkers were used as reference in some analyses to reduce the &quot;healthy drinker/survivor&quot; bias. <br><br>RESULTS were adjusted for many covariates to minimize residual confounding. <br><br>RESULTS: Compared with never-drinkers, the hazard ratio (95% confidence interval) of mortality for light drinkers was 1.05 (0.71-1.56) and 1.20 (0.72-2.02) in those without functional limitations. Corresponding values for moderate drinkers were 1.28 (0.81-2.02) and 1.55 (0.87-2.75), and for heavy/binge drinkers 1.85 (1.07-3.23) and 2.15 (1.09-4.22). <br><br>RESULTS were consistent when occasional drinkers were used as reference. Among drinkers without functional limitations, the hazard ratio (95% confidence interval) of mortality per 10g/day of alcohol was 1.12 (1.02-1.23). <br><br>CONCLUSION: After accounting for potential biases, light-to-moderate drinking among people 60+ years of age appears to have no statistically significant benefit on mortality compared with abstention from alcohol. By contrast, heavy/binge drinking shows higher death risk compared with abstention from alcohol. Alcohol intake appears to have a positive dose-response with mortality among drinkers.<br><br>This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0965-2140",
doi="10.1111/add.14402",
url="http://dx.doi.org/10.1111/add.14402"
}