Older men who take fewer drinks a week, but also suffer from diseases that could be aggravated by alcohol or cause problems with the medications which they take while drinking alcohol, face the risk of higher death rates, when compared with men who drink less or more but don't have any such complications.
Older men who drank moderately or heavily and had accompanying comorbidities that could be worsened by alcohol use such as gout or ulcer disease, or who took medications that could interact negatively with alcohol use, such as sedatives or pain medications, had 20 percent higher mortality rates than other drinkers.
Previous studies have found that moderate drinking can reduce risks for vascular disease and death, said Dr. Alison Moore, associate professor of geriatrics at the David Geffen School of Medicine at UCLA, and the study's lead researcher.
"None of these studies have specifically looked at the interaction of alcohol use and conditions or medications that may be unsafe with even moderate amounts of alcohol use," she said. "This study shows that while moderate alcohol use may be fine for people who don't have other conditions that could be worsened by the use of alcohol, such alcohol use may not be fine if you take common medications for sleep, or for arthritis pain, or have depression, or have some gastrointestinal condition."
The researchers found that 2,673 people (1,379 men and 1,294 women) from the initial survey had died by the time of the follow-up survey approximately 20 years later. Of those who abstained from drinking, 65 percent (76 percent of men and 60 percent of women) had died. Of the drinkers considered to be not-at-risk, 62 percent had died (68 percent of men, 56 percent of women), and of the drinkers considered to be at-risk, 70 percent had died (77 percent of men, 49 percent of women).
In analyses including men and women, at-risk drinkers had a 12 percent increased risk for death and abstainers had an 8 percent increased risk for death as compared to not-at-risk drinkers. In analyses done separately for men and women, men at-risk drinkers had a 20 percent increased risk of death as compared to not-at-risk drinkers, while abstainers had no increase in risk for death. Among women, neither at-risk drinkers nor abstainers had increased risks for death compared to not-at-risk drinkers.
One reason for the gender discrepancy may be that women simply don't drink as much as men, Moore said. Only 89 women in the sample were considered at-risk drinkers, versus 336 men.
"So it's possible we couldn't see any effect on death rates for women, because there were too few at-risk drinking women," she said.
The findings suggest that lower drinking thresholds should be recommended for older adults with specific but common comorbidities.