title: Alcohol problems and all-cause mortality in men and women: predictive capacity of a clinical screening tool in a 21-year follow-up of a large, UK-wide, general population-based survey.
abstract: OBJECTIVE
  While the relation between alcohol consumption and mortality has been well explored, little is known about the link between alcohol problems and mortality in general population-based studies, particularly among women. This was the objective of the present study
  
  
  METHODS
  In this prospective cohort study, 5333 non-abstaining individuals (2539 women) from the UK-wide Health and Lifestyle Survey (aged 42.9 years at study induction) completed the CAGE questionnaire of alcohol problems and participated in a medical examination in 1984/1985; they were then followed up for mortality experience until 2005.
  
  
  RESULTS
  Alcohol problems at baseline were less common in women (2.4%) than in men (7.8%). A total of 21 years of follow-up gave rise to 1201 deaths. Elevated rates of mortality were evident in persons reporting symptoms of alcohol problems in comparison to those who did not. In gender-stratified analyses, alcohol problems were more strongly associated with mortality risk in women (age-adjusted hazards ratio: 2.25; 95% confidence interval: 1.22-4.12) than in men (1.49; 1.12-1.99), although this effect modification was not statistically significant (P value for interaction=0.125). Controlling for a range of covariates--including socioeconomic position, co-morbidity (somatic and psychiatric), and alcohol intake--had essentially no impact on these associations.
  
  
  CONCLUSIONS
  The CAGE questionnaire may have some utility in routine health assessments in the general population.
authors.affiliation: MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. david-b@sphsu.mrc.ac.uk
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.forename: Kate
authors.initials: K
authors.lastname: Hunt
authors.forename: Carol
authors.initials: C
authors.lastname: Emslie
authors.forename: Heather
authors.initials: H
authors.lastname: Lewars
authors.forename: Catharine R
authors.initials: CR
authors.lastname: Gale
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000401:mortality*; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology