Swedish women with alcohol dependence: survival and cause-specific mortality compared with matched controls

Over the last decades alcohol intake has decreased among the Swedish men but been on the rise among the women, thus leading to an increased risk of alcohol dependence (AD) and related consequences among the Swedish women. The aim of this study was therefore to compare the mortality between women with AD and population-matched controls.

Data were retrieved from the medical records of 2,037 women with AD at the Addiction Centre in Malmö in 1970-2013 and followed up until 2019. They were matched by sex, age, and calendar year with a control group from the general population in Region Skåne. For persons who died during follow-up, death certificates were obtained from the national registers to obtain time and cause of death. The mortality was compared between the groups as observed vs. expected, cumulative survival was assessed by comparing the survival rates of the women with AD to those of the control group. The cumulative survival was calculated as observed compared to expected.

The cumulative survival and standardized life expectancy were significantly reduced for the women with alcohol dependence compared to the matched controls; T1/2 = 21 vs. 11, p < 0.05 and OR 1.9 CI 1.73-2.02, respectively. More women with alcohol addiction passed away due to accidental and intended causes of death (15.5% vs. 2.8%, p < 0.05). Their cause-specific mortality was significantly increased for mental health disorders, respiratory and digestive diseases, but significantly lower for cardiovascular and cancer diseases.

This study showed that the mortality among Swedish women with long term alcohol dependence was significantly increased, thereby suggesting a need for a special focus on this group.