Alcohol screening results in elderly male veterans: association with health status and mortality.
OBJECTIVE
To evaluate the association between alcohol screening results and health status or mortality in elderly patients.


METHODS
Cross-sectional and longitudinal cohort studies.


METHODS
Primary care clinics at seven Veterans Affairs medical centers.


METHODS
A total of 16,958 male patients aged 65 and older.


METHODS
Alcohol screening questionnaires were used to divide patients into four mutually exclusive groups: drinkers who screened negative or positive for problem drinking and nondrinkers (in the previous year) who screened negative or positive for problem drinking. A subset of patients (n=12,491) completed a measure of health status, the Medical Outcomes Study Short Form (SF-36). All-cause mortality was ascertained using Veterans Affairs data over a mean follow-up of 2.8 years.


RESULTS
Forty-eight percent of participants reported drinking in the previous year. Half of the drinkers and nondrinkers screened positive for problem drinking. The SF-36 item scores were consistently higher for drinkers than for nondrinkers and for patients who screened negative for problems than for those who screened positive. Similarly, survival was consistently better in drinkers than nondrinkers (mortality hazard ratio (HR)=0.74, 95% confidence interval (CI)=0.68-0.82) and in patients who screened negative for problem drinking than in those who screened positive (mortality HR=0.87, 95% CI=0.80-0.95). Nondrinkers who screened positive for problem drinking had the poorest health status and survival, whereas drinkers who screened negative for problem drinking had the best health status and survival.


CONCLUSIONS
Elderly patients who reported drinking alcohol and those who screened negative for problem drinking had consistently better health status and survival than those who did not drink and those who screened positive.
Bridevaux
Isabelle Peytremann
IP
Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, Washington 98108, USA. Isabelle.Peytremann-Bridevaux@hospd.ch
Bradley
Katharine A
KA
Bryson
Chris L
CL
McDonell
Mary B
MB
Fihn
Stephan D
SD
D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D003430:Cross-Sectional Studies; D015577:Geriatric Assessment; D006304:Health Status; D006787:Hospitals, Veterans; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*