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

Abstract

BackgroundCompared 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. MethodsData 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. ResultsThe 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). ConclusionsWhile 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.