Abstract
BackgroundThe literature from developed countries suggests a relationship between alcohol use and quality of life and social engagement, where harmful drinkers have lower quality of life and less social engagement. Despite the high rates of harmful alcohol use in South Africa, little is known about the association between drinking pattern and quality of life and social engagement in this context. We aimed to determine if quality of life and social engagement varied across different drinking patterns among older South African adults, contributed to drinking pattern when controlling for socio-demographic factors, and varied differentially between genders.MethodsThis is a secondary analysis of data from the Survey on Global Ageing and Adult Health (SAGE). Alcohol use was measured as self-reports of use over the previous seven days, and we constructed gender-specific alcohol variables. The WHO Quality of Life-scale was used to measure quality of life, and social engagement was measured by frequency of participation in social activities. We used ANOVA to observe differences in quality of life and social engagement scores across drinking patterns, and regression models were used to identify factors independently associated with drinking pattern.ResultsThere were 2572 (84.4%) lifetime abstainers, and 475 (15.6%) persons who had a drink in the last 7 days. In bivariate analysis, quality of life was lowest among at risk drinking men compared to abstainers (OR = 0.21, p = 0.02), although this association was not significant in adjusted analysis. Social engagement did not vary statistically significantly across the drinking patterns in the total sample or within gender.ConclusionsQuality of life and social engagement were not independently associated with drinking pattern among older adults in South Africa in this sample. In order to better understand their alcohol use, further exploratory research is warranted to identify other potentially relevant subjective factors of alcohol use among older adults in South Africa.
Highlights
The literature from developed countries suggests a relationship between alcohol use and quality of life and social engagement, where harmful drinkers have lower quality of life and less social engagement
This paper addresses the following research questions: (a) How does subjective quality of life and self-reported social engagement differ between lifetime abstainers, ‘low risk’ and ‘at risk’ drinkers stratified by gender?; (b) Does quality of life and social engagement contribute to drinking pattern assignment among men and women separately when controlling for sociocultural factors and smoking?; and, (c) Are there differences at the item level of the quality of life and social engagement scales between drinking patterns, stratified by gender?
Quality of life and social engagement differences across drinking pattern stratified by gender In bivariate analysis, quality of life varied statistically significantly among men, where at risk drinking men had the lowest score, and was significantly lower relative to lifetime abstainers (OR = 0.21, 95% CI 0.06, 0.81, p = 0.02)
Summary
The literature from developed countries suggests a relationship between alcohol use and quality of life and social engagement, where harmful drinkers have lower quality of life and less social engagement. Despite the high rates of harmful alcohol use in South Africa, little is known about the association between drinking pattern and quality of life and social engagement in this context. The harmful use of alcohol can impact disease symptom severity and progression of common chronic illnesses, in addition to negatively affecting personal relationships, social engagement and overall quality of life [3,4]. Studies from developed countries have identified a linear or inverse J-shaped relationship between quality of life and alcohol use, such that at the higher levels of alcohol use, including persons diagnosed with alcohol use disorders, quality of life is lower compared to moderate or low risk users and alcohol abstainers [5,6]. Less is known about how quality of life predicts alcohol use, a causal relationship in this direction is theoretically plausible
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