Abstract
BACKGROUND: modifiable behavioural risk factors including smoking and alcohol consumption are major contributing or actual causes of mortality. OBJECTIVE: to examine the effect of alcohol intake on all-cause mortality in older adults. DESIGN AND SETTING: prospective population-based cohort study of residents of a California, United States retirement community. SUBJECTS: 8,877 women and 5,101 men (median age, 74 years) who in the early 1980s completed a postal health srvey incluing details on alcohol consumption. METHODS: participants were followed for 23 years (1981-2004) including two follow-up questionnaires (in 1992 and 1998) asking about current alcohol intake. Age-adjusted and multivariate-adjusted risk ratios of death and 95% confidence intervals were calculated separately for men and women, using proportional hazard regression. RESULTS: of the 8,644 women and 4,980 men with complete information on the variables of interest and potential confounders, 6,930 women and 4,456 men had died (median age, 87 years). Both men and women who drank alcohol had decreased mortality compared with non-drinkers. Those who drank two or more drinks per day had a 15% reduced risk of death. The reduced risk was not limited to one type of alcohol. Stable drinkers (those who reported drinking both at baseline and follow-up) had a significantly decreased risk of death compared with stable non-drinkers. Those who started drinking at follow-up also had a significantly lower risk. Women who quit drinking were at increased risk of death. CONCLUSION: in elderly men and women, moderate alcohol intake exhibits a beneficial effect on mortality. Those who quit may do so for health reasons that affect mortality.