title: Moderate alcohol use, health status, and mortality in a prospective Chinese elderly cohort.
abstract: OBJECTIVE
  A U-shaped relation between alcohol use and mortality may be due to biological hormesis, differential response (i.e., effect modification) by health status or changes in alcohol use with ill-health and aging (i.e., reverse causality).We examined whether alcohol had the same association with mortality in healthy and unhealthy older people.
  
  
  METHODS
  We used Cox regression analysis to examine the association of alcohol with mortality by health status in a population-based cohort of 56,167 people (65+ years), enrolled during July 1998 to December 2000 in Hong Kong.
  
  
  RESULTS
  After a mean follow-up of 4.1 years, there were 3,819 deaths in 54,087 subjects. Adjusted for age, socioeconomic position and lifestyle, both occasional and moderate types of alcohol use were associated with lower mortality compared to never-drinkers, relative risk (RR) 0.72 (95% confidence interval [CI] 0.63-0.83) and 0.73 (95% CI 0.59-0.90) in men and 0.77 (95% CI 0.64-0.94) and 0.54 (95% CI 0.29-1.01) in women. However, these associations were not maintained in those with good health status: RR 1.02 (95% CI 0.74-1.39) and 1.09 (95% CI 0.71-1.68) in men and 0.63 (95% CI 0.36-1.12) and 1.27 (95% CI 0.40-4.01) in women.
  
  
  CONCLUSIONS
  Moderate alcohol use may only be beneficial for older adults in poor health.
authors.affiliation: Department of Community Medicine and School of Public Health, The University of Hong Kong.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Sun
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
authors.forename: Wai Man
authors.initials: WM
authors.lastname: Chan
authors.forename: Kin Sang
authors.initials: KS
authors.lastname: Ho
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology / Q000401:mortality*; D044466:Asian People / Q000706:statistics & numerical data; D002423:Cause of Death; D003710:Demography; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D011446:Prospective Studies