Associations of lifetime abstention and past and current alcohol use with late-life mental health: a propensity score analysis

Drug Alcohol Depend. 2015 Apr 1:149:245-51. doi: 10.1016/j.drugalcdep.2015.02.008. Epub 2015 Feb 16.

Abstract

Background: Compared to the extensive research on the effects of alcohol intake on physical health, little research has been done on the effects of alcohol use/nonuse patterns on mental disorders in late life. This study examined associations between mental disorders and alcohol use/nonuse patterns among individuals aged 65+ years.

Methods: Data came from the public use files of the 2008 to 2012 National Survey on Drug Use and Health. Alcohol use/nonuse groups were lifetime abstainers, ex-drinkers, bingers, and nonbingers. Mental health problems were lifetime major depressive episode (MDE) and anxiety disorder, past-year MDE and anxiety disorder, and past-year serious suicidal ideation. To minimize selection biases resulting from a complex array of covariates, we implemented a generalized boosted model to generate propensity score weights on covariates. Then we employed logistic regression models with mental health outcomes as the dependent variables.

Results: The four alcohol use/nonuse groups did not differ in past-year MDE. However, odds ratios show that, relative to non-binge drinking, lifetime abstention decreased the odds of lifetime MDE by more than 60% (OR = 0.39, 95% CI = 0.23-0.68, p = .001) and the odds of lifetime anxiety disorder by almost half (OR = 0.55, 95% CI = 0.38-0.79, p = .002). Ex-drinkers were more likely than nonbingers to report past-year serious suicidal thoughts (OR = 2.29, 95% CI = 1.45-3.62, p < .001).

Conclusions: While lifetime abstainers had significantly better lifetime mental health histories than nonbingers, ex-drinkers had worse past-year mental health status. Since lifetime abstainers and ex-drinkers have significantly different characteristics, researchers should distinguish between these groups.

Keywords: Abstention; Alcohol use; Anxiety disorder; MDE; Suicidal thoughts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aging / psychology*
  • Alcohol Abstinence / psychology*
  • Alcohol Abstinence / statistics & numerical data*
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / psychology
  • Binge Drinking / epidemiology*
  • Female
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Prevalence
  • Propensity Score
  • United States / epidemiology