Alcohol Consumption Amount, Drinking Pattern, and the Trajectory of Multimorbidity: A Prospective Cohort Study

This study aimed to investigate the impacts of both alcohol consumption amount and drinking pattern on the progression from healthy to first noncommunicable disease (FNCD), subsequently to multimorbidity, and ultimately to death. We conducted this analysis in the UK Biobank cohort (N = 284 744). Multimorbidity was defined as the coexistence of at least two noncommunicable diseases, including cancer, chronic respiratory disease, cardiovascular disease, and Type 2 diabetes. Multistate model was used to estimate the impacts of alcohol consumption on the whole trajectory of multimorbidity. Guidelines harmful drinkers showed increased risks of all five transitions of multimorbidity than nondrinkers, with hazard ratios (95% CI) 1.16 (1.09, 1.23) and 1.10 (1.00, 1.22) for transitions from baseline to FNCD, and then to multimorbidity, and 1.40 (1.22, 1.61), 1.37 (1.23, 1.54), and 1.41 (1.19, 1.67) for transitions from baseline, FNCD, and multimorbidity to death. Similar associations were found for spirits and beer consumption, but not red wine. For drinking patterns, drinking without food was associated with higher risks of four transitions except death from multimorbidity than drinking with food. Our results indicate that both alcohol consumption amount and drinking pattern exert important effects on almost all phases of multimorbidity development.