Article

Alcohol problems and all-cause mortality in men and women: predictive capacity of a clinical screening tool in a 21-year follow-up of a large, UK-wide, general population-based survey.

MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
Journal of psychosomatic research (impact factor: 2.91). 05/2009; 66(4):317-21. DOI:10.1016/j.jpsychores.2008.09.021
Source: PubMed

ABSTRACT While the relation between alcohol consumption and mortality has been well explored, little is known about the link between alcohol problems and mortality in general population-based studies, particularly among women. This was the objective of the present study
In this prospective cohort study, 5333 non-abstaining individuals (2539 women) from the UK-wide Health and Lifestyle Survey (aged 42.9 years at study induction) completed the CAGE questionnaire of alcohol problems and participated in a medical examination in 1984/1985; they were then followed up for mortality experience until 2005.
Alcohol problems at baseline were less common in women (2.4%) than in men (7.8%). A total of 21 years of follow-up gave rise to 1201 deaths. Elevated rates of mortality were evident in persons reporting symptoms of alcohol problems in comparison to those who did not. In gender-stratified analyses, alcohol problems were more strongly associated with mortality risk in women (age-adjusted hazards ratio: 2.25; 95% confidence interval: 1.22-4.12) than in men (1.49; 1.12-1.99), although this effect modification was not statistically significant (P value for interaction=0.125). Controlling for a range of covariates--including socioeconomic position, co-morbidity (somatic and psychiatric), and alcohol intake--had essentially no impact on these associations.
The CAGE questionnaire may have some utility in routine health assessments in the general population.

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Keywords

5333 non-abstaining individuals
 
95% confidence interval
 
age-adjusted hazards ratio
 
alcohol consumption
 
alcohol problems
 
CAGE questionnaire
 
co-morbidity
 
Elevated rates
 
follow-up
 
gender-stratified analyses
 
general population
 
Lifestyle Survey
 
mortality experience
 
mortality risk
 
persons
 
prospective cohort study
 
routine health assessments
 
UK-wide Health