Marital Status History and Alcohol Use and Problems Across the Lifespan

Marital transitions and stability are key social determinants of alcohol use, yet their impact across different life stages remains underexplored. This study utilizes a lifespan-oriented approach to examine longitudinal associations between marital status and alcohol consumption and problems and to investigate underlying sex differences.

Longitudinal data from two components (early mid-life and later-life) of the Collaborative Study on the Genetics of Alcoholism (COGA) were included, with participants averaging 33 (early mid-life) and 62 (later-life) years of age at their last interview. Participants were categorized into distinct groups based on their marital history across assessment waves: persistently married (reference), never married, divorced/separated, widowed, and three transition groups (into marriage, out of marriage, and mixed transitions). Alcohol use measures included past 12-month alcohol symptom counts, past 6-month typical drinks per week, and past 6-month maximum drinks consumed in 24 h. Generalized linear mixed models estimated cohort-specific risks.

Across both cohorts, alcohol consumption declined with age, while AUD symptom counts significantly increased (p < 0.001). In the later-life sample, never married individuals exhibited the highest likelihood of AUD symptoms (IRR = 3.82, p < 0.001). A significant sex interaction indicated widowhood was associated with a threefold increase in AUD symptoms (IRR = 3.46, p = 0.003), whereas widowhood was relatively protective among women (reference group). In the early mid-life sample, transitioning out of marriage emerged as a primary correlate of symptom escalation (IRR = 2.13, p < 0.001).

Marital stability buffers against AUD problems across the lifespan. However, the risks associated with marital instability are highly specific: marital exit poses a critical threat in early mid-life, while widowhood represents a profound vulnerability for older men. Interventions should be tailored with attention to life stage and sex-specific risks to mitigate alcohol-related harm during marital transitions.