A recent study found that moderate alcohol consumption in older adults was associated with an increased risk of death, especially from cancer.

The cohort study, published in JAMA Network Open, explored the relationship between alcohol consumption patterns and 12-year mortality among adults aged 60 and older, particularly focusing on individuals with health-related or socioeconomic risk factors. The study utilized data from 135,103 current drinkers with a median age of 64 years from the UK Biobank. The investigators sought to determine if these risk factors modified the associations between alcohol intake and mortality outcomes.

Participants were categorized into four groups based on their mean daily alcohol consumption: occasional (≤2.86 g/d), low-risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate-risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d), and high-risk (men: >40.00 g/d; women: >20.00 g/d) drinkers. Health-related risk factors were assessed using the frailty index, while socioeconomic risk factors were measured by the Townsend deprivation index. The study excluded deaths occurring within the first two years of follow-up to reduce reverse causation and adjusted for potential confounders. Importantly, occasional drinkers were used as the reference group rather than abstainers.

During the median follow-up period of 12.4 years, the researchers documented 15,833 deaths, including 7,871 cancer-related and 3,215 cardiovascular-related deaths. Compared with occasional drinkers, low-risk drinkers had a higher risk of cancer mortality (HR, 1.11; 95% CI, 1.01-1.22). Moderate-risk drinkers demonstrated increased risks for both all-cause mortality (HR, 1.10; 95% CI, 1.03-1.18) and cancer mortality (HR, 1.15; 95% CI, 1.05-1.27). High-risk drinkers exhibited significantly elevated risks for all-cause mortality (HR, 1.33; 95% CI, 1.24-1.42), cancer mortality (HR, 1.39; 95% CI, 1.26-1.53), and cardiovascular mortality (HR, 1.21; 95% CI, 1.04-1.41).

The excess mortality associated with alcohol consumption was more pronounced in individuals with health-related or socioeconomic risk factors. Even low-risk drinkers in these groups had a significantly higher risk of cancer mortality.

Wine preference and drinking only during meals were associated with lower all-cause mortality in participants with health-related (HR, 0.92; 95% CI, 0.87-0.97) and socioeconomic risk factors (HR, 0.84; 95% CI, 0.78-0.90). These patterns also reduced cancer mortality in those with health-related (HR, 0.92; 95% CI, 0.86-0.99) and socioeconomic risk factors (HR, 0.85; 95% CI, 0.78-0.94). Adhering to these patterns attenuated the excess mortality risks associated with higher alcohol intake across various risk levels. The study authors noted that these findings may be due to factors such as lifestyle differences or slower alcohol absorption when drinking with meals, rather than protective effects of the alcohol itself.

The researchers acknowledged several limitations, including the use of self-reported alcohol intake, potential residual confounding, and the study's focus on a predominantly White UK population, which may limit generalizability to other groups. They also noted that their findings challenge previous research suggesting protective effects of low to moderate alcohol consumption.

"These results have important public health implications because they identify inequalities in the detrimental health outcomes associated with alcohol that should be addressed to reduce the high burden of disease of alcohol use," concluded investigators.

Authors reported no conflicts of interest.