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Alcohol consumption, 29-y total mortality, and quality of life in men in old age^1,2,3

¹ From the Department of Medicine, Geriatric Clinic, University of Helsinki (AYS, TES, KP, and TAM), and the KTL-National Public Health Institute, Helsinki (VVS)

Background: The negative effects of excessive alcohol consumption are well known, but moderate alcohol consumption is advocated for health reasons.

Objective: We compared 29-y total mortality and quality of life in old age by alcohol consumption in midlife.

Design: Cardiovascular disease risk factors and alcohol consumption were assessed in 1974 in 1808 men (aged 40–55 y) of high socioeconomic status. At baseline, the men were without signs of chronic diseases. Baseline alcohol consumption was divided as zero (n = 116), moderate (1–349 g/wk; n = 1519), and high (>349 g/wk; n = 173). Quality of life was surveyed in 2000 with the RAND-36 (SF-36) health survey (n = 1216). Mortality was retrieved from registers during the 29-y follow-up.

Results: Median alcohol consumption in 1974 and in 2000 was 123 (interquartile range: 56–238) and 84 (28–168) g/wk, respectively, and was significantly correlated. Values of cardiovascular disease risk factors measured in 1974 increased with increasing alcohol consumption. During the 29-y follow-up, 499 men (27.6%) died; mortality was significantly higher among men with the highest alcohol consumption (37.6%) than in abstainers (25.0%) or in men with moderate (26.7%) consumption. Quality of life was not significantly associated with baseline alcohol consumption in responding survivors but was worst in men with high consumption when deaths during follow-up were accounted for.

Conclusions: In this male cohort of high socioeconomic status, only the highest alcohol consumption (>3 drinks/d) affected mortality, and it was associated with worse quality of life in old age. Moderate alcohol consumption in middle age offered no special benefits compared with abstinence over the long term.

Key Words: Alcohol • aging • mortality • quality of life • RAND-36 (SF-36)

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