Associations of lifetime abstention and past and current alcohol use with late-life mental health: a propensity score analysis.
BACKGROUND
Compared to the extensive research on the effects of alcohol intake on physical health, little research has been done on the effects of alcohol use/nonuse patterns on mental disorders in late life. This study examined associations between mental disorders and alcohol use/nonuse patterns among individuals aged 65+ years.


METHODS
Data came from the public use files of the 2008 to 2012 National Survey on Drug Use and Health. Alcohol use/nonuse groups were lifetime abstainers, ex-drinkers, bingers, and nonbingers. Mental health problems were lifetime major depressive episode (MDE) and anxiety disorder, past-year MDE and anxiety disorder, and past-year serious suicidal ideation. To minimize selection biases resulting from a complex array of covariates, we implemented a generalized boosted model to generate propensity score weights on covariates. Then we employed logistic regression models with mental health outcomes as the dependent variables.


RESULTS
The four alcohol use/nonuse groups did not differ in past-year MDE. However, odds ratios show that, relative to non-binge drinking, lifetime abstention decreased the odds of lifetime MDE by more than 60% (OR = 0.39, 95% CI = 0.23-0.68, p = .001) and the odds of lifetime anxiety disorder by almost half (OR = 0.55, 95% CI = 0.38-0.79, p = .002). Ex-drinkers were more likely than nonbingers to report past-year serious suicidal thoughts (OR = 2.29, 95% CI = 1.45-3.62, p < .001).


CONCLUSIONS
While lifetime abstainers had significantly better lifetime mental health histories than nonbingers, ex-drinkers had worse past-year mental health status. Since lifetime abstainers and ex-drinkers have significantly different characteristics, researchers should distinguish between these groups.
University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA.
C Nathan
CN
Marti
University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA. Electronic address: nchoi@austin.utexas.edu.
Namkee G
NG
Choi
University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, D3500, Austin, Texas, 78702, USA.
Diana M
DM
DiNitto
Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, 02906, USA.
Bryan Y
BY
Choi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology*; D064829:Alcohol Abstinence / Q000523:psychology* / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D063425:Binge Drinking / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D057216:Propensity Score; D014481:United States / Q000453:epidemiology
Abstention; Alcohol use; Anxiety disorder; MDE; Suicidal thoughts