Background Hazardous drinking among older adults is a growing concern, however there is limited research on the effect of chronic versus acute hazardous drinking among older people, and how the effects vary across life. This study among older adults, explores the association of positive AUDIT-C scores across life with objective biomarkers of cardio-metabolic health.
Methods Analyses were undertaken among 4820 civil servants aged 59–83 years, within the prospective Whitehall II study, who answered the life-grid AUDIT-C inventory during the 2011–2012 survey and provided biological measurements (264 non-drinkers were excluded). Lifetime hazardous drinking groups were defined using a threshold of ≥5, at each decade of life from age 16 to 80+. These groups were as follows; never hazardous-drinker (reference), former hazardous-drinker1 (before age 50), former hazardous-drinker2 (after age 50), current hazardous-drinker (past hazardous-drinker sporadically), stable hazardous-drinker (hazardous-drinker in every decade). Similar groups were created for lifetime binge-drinking categories; never/former/current/stable binge-drinker (AUDIT-3 ≥2). Fully-adjusted linear regression was carried out on cardio-metabolic biomarkers including: waist circumference (WC, measured in cm), body mass index (BMI, kg/m2), total cholesterol (TC, mmol/L), systolic (SBP, mmHg) and diastolic (DBP, mmHg) blood pressure, gamma-glutamyl transferase (GGT), fatty-liver index scores (FLI) and lifetime hazardous/binge drinking as exposure, using STATA15. Covariates included sex, age, socio-economic position, ethnicity, smoking status, physical activity, BMI and fruit and vegetable consumption.
Results Over half of the sample had been a hazardous-drinker at some point; Current hazardous-drinkers (21%), former hazardous-drinkers1 (<age 50) (19%), former hazardous-drinkers2 (≥age 50) (11%) stable hazardous-drinker (5%). After adjusting for co-variates, hazardous-drinkers had a larger WC than never hazardous-drinkers (former hazardous-drinkers1 (β=1.17 [95% CI 0.25, 2.08]); (former hazardous-drinkers2 (1.88 [95% CI 0.77, 2.98]); current hazardous-drinkers (2.44 [1.55, 3.34]) and stable hazardous-drinkers (3.85 [2.23, 5.47])). A similar linear association along more current and frequent hazardous-drinking was also found with BMI. Current hazardous-drinkers had higher SBP (2.44 [1.19, 3.68]), log (GGT) (22.64 [18.27,27.02]) and FLI scores (4.05 [2.92, 5.18]) than never hazardous-drinkers, and so did stable hazardous-drinkers (sbp (2.78 [0.53, 5.04]), log(GGT) (17.94 [10.12, 25.75]), FLI (3.76, [1.75, 5.77])). Similar associations with waist, sbp, GGT, and FLI outcomes were found for lifetime binge-drinkers.
Conclusion Hazardous-drinking is common among older adults and may increase cardio-metabolic risk factors, this may be compounded by persistent hazardous-drinking across life. Population reductions in hazardous-drinking is likely to have immediate improvements in elderly, but also long lasting improvements with early intervention in the life course, particularly with weight gain. Future analyses will assess risk of lifetime hazardous-drinking and cardiovascular events and mortality.
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