CHRONIC CONDITION DISCORDANCE AND ALCOHOL USE AMONG OLDER COUPLES: THE MODERATING EFFECTS OF MARITAL QUALITY

Abstract

Abstract Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements that heighten self-management complexity) may be stressful and contribute to increased alcohol use over time among older adults, especially for those with greater marital stress. In this study, we examined how chronic condition discordance at the individual level (i.e., within individuals) and the couple level (i.e., between spouses) predicted alcohol use across an 8-year period, and whether these links varied by negative marital quality. The U.S. sample included 1,116 wives (M = 54 years) and husbands (M = 57 years) from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models controlled for age, minority status, education, and own and partner time-varying number of chronic health conditions and depressive symptoms. Wives with greater individual-level discordance reported fewer initial drinks per week. Marital quality moderated the links between chronic condition discordance and alcohol use over time. Notably, when husbands reported lower negative marital quality and had greater individual-level chronic condition discordance, they had faster decreases in their own drinks per week over time. By contrast, when husbands reported higher negative marital quality and had greater individual-level discordance, their wives had faster increases in drinks per week over time. Overall, these findings indicate that better quality marriages may protect against increased alcohol use for both wives and husbands in the context of greater chronic condition discordance among husbands.