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Ortolá, Rosario; García-Esquinas, Esther; Carballo-Casla, Adrián; Sotos-Prieto, Mercedes; Banegas, José R.; Rodríguez-Artalejo, Fernando
Drug and alcohol dependence, 06/2022, Letnik: 235Journal Article
The protective health effects of light alcohol consumption are debated due to potential selection biases, reverse causation and confounding. We examined cross-sectional and prospective associations of alcohol consumption patterns with unhealthy aging among older drinkers addressing these methodological issues. 2081 lifetime drinkers aged 65 + years from the Seniors-ENRICA-2 cohort followed-up for 2.4 years were classified as occasional (average lifetime alcohol intake g/day ≤1.43), low-risk (men: >1.43–20; women: >1.43–10), moderate-risk (men: >20–40; women: >10–20) and high-risk drinkers (men: >40; women: >20; or binge drinkers). A Mediterranean drinking pattern (MDP) was defined as occasional/low-risk drinking, wine preference and drinking only with meals. Unhealthy aging was measured with a 52-item health deficit accumulation index (DAI), with higher values indicating more health deficits. A 10-g/day increment in lifetime average alcohol intake was cross-sectionally associated with a higher DAI among all drinkers (mean difference 95% confidence interval = 0.35 0.16, 0.53) and moderate-/high-risk drinkers (0.41 0.17, 0.65), but not among occasional/low-risk drinkers. Also, the DAI was 1.35 (0.06, 2.65) points higher in high-risk versus low-risk drinkers and 2.07 (0.59, 3.60) points higher in non-adherers versus adherers to the MDP. Most associations strengthened when restricting analyses to individuals with lower disease burden and did not generally remain after 2.4 years. We found no evidence of a beneficial association between low-risk alcohol consumption and unhealthy aging, but a detrimental one for high-risk drinking, which strengthened when accounting for reverse causation, although attenuated over the follow-up likely due to selective attrition of those less resilient to the harmful effects of alcohol. •No beneficial association was found between low-risk alcohol consumption and unhealthy aging.•High-risk lifetime drinking was cross-sectionally associated with unhealthy aging.•This association attenuated over the 2.4-year follow-up likely due to selective attrition.
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