The Effect of Moderate Alcohol Use on the Health of Older Adults in New Zealand: A scoping review and analysis of the Health, Work and Retirement Study

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Degree Grantor

The University of Auckland

Abstract

Background: Some studies have found a J-shaped relationship between alcohol and health where moderate drinking has the lowest risk of disease or mortality, and nondrinking and heavy drinking represent heightened risk. Researchers argue that this J-shaped relationship is spurious and a result of the ‘sick quitter’ effect and residual confounding factors. Rigorous research that accounts for these methodological limitations could further elucidate these inconclusive findings. Aim: To undertake 1) a review of the existing literature on the effect of moderate alcohol consumption on health outcomes, and 2) secondary data analyses of a New Zealand (NZ) cohort study looking at the effect of light to moderate alcohol consumption on health-related quality of life (measured using the SF-12) and cancer risk in adults (≥ 50 years). Method: A scoping review was undertaken to summarise the methods and findings on literature on the health effect of moderate drinking in older adults. Secondary data analyses was conducted with eight waves of data from 3,959 older NZ adults from the Massey University Health, Work and Retirement Study (HWR) after accounting for the ‘sick quitter’ effect and socioeconomic status (SES). The HWR cohort data was analysed to evaluate the effect of moderate drinking on SF-12 scores cross-sectionally and longitudinally. National health record data linked to the HWR data was analysed to assess cancer outcomes of moderate drinking. Results: The scoping review identified 42 cohort studies. The review highlighted that existing research on the effect of moderate drinking on mortality, depression, mental health and dementia is often contradictory. However, there was consistent evidence that moderate drinking only had a significant protective effect on bone health indicators. Cross-sectional analyses of the HWR cohort found that alcohol consumption had a positive linear association with SF-12 physical health scores in older females, but not in males. Longitudinal analyses found consistent alcohol consumption over time by females significantly increased physical health SF-12 scores over time, compared to lifetime abstainers, but no effect was noticed for males. Alcohol consumption at baseline did not significantly affect cancer risk, irrespective of gender. Conclusion: The contradictory findings of the scoping review highlighted the need for longitudinal studies to assess the effect of moderate drinking on health in older adults whilst accounting for the ‘sick quitter’ effect. Secondary analyses found discrepant health effects of moderate drinking between genders, suggesting that future research should study the effects of alcohol based on different characteristics (e.g. gender, age, and ethnicity).

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