title: Alcohol consumption in very old age and its association with survival: A matter of health and physical function.
abstract: BACKGROUND
  Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old.
  
  
  METHODS
  Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n=863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5-30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed.
  
  
  RESULTS
  Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant.
  
  
  CONCLUSIONS
  The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.
authors.affiliation: Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden. Electronic address: neda.agahi@ki.se.
authors.forename: Neda
authors.initials: N
authors.lastname: Agahi
authors.affiliation: Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Kelfve
authors.affiliation: Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
authors.forename: Carin
authors.initials: C
authors.lastname: Lennartsson
authors.affiliation: Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Institute for Gerontology, School of Health and Welfare, Jönköping University, Box 1026, 551 11 Jönköping, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Kåreholt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000401:mortality*; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016019:Survival Analysis
keywords: Alcohol; Laplace; Mortality; Oldest old; Survival