Alcohol consumption and cause-specific mortality in older men: Whitehall-1 study of London civil servants

The relationship between alcohol consumption and cause-specific mortality in adults aged ≥ 70 years remain unclear. This study assessed the associations between alcohol consumption with risks of cause-specific mortality in older men. This study included 4,582 London Civil Servants from the 1997-98 Whitehall-I Study resurvey with no prior cardiovascular disease or cancer. Alcohol consumption was self-reported by postal questionnaires and classified as abstainers (lifelong non-drinkers), ex-drinkers, or current drinkers. Current drinkers were further categorised by weekly intake: <7, 7-13, 14-27, 28-41, and ≥ 42 units/week. During a mean follow up of 11.8 years, 4194 deaths (91%) occurred. Compared with light drinkers (< 7 units/week), all-cause mortality risk was highest among ex-drinkers (HR: 1.21, 95% CI 1.11-1.32) and those consuming ≥ 42 units/week (HR: 1.38, 95% CI 1.15-1.67). Among current drinkers, increased alcohol consumption was associated with a higher risk of all-cause mortality (HR: 1.05, 95% CI 1.01-1.08 per 10 units/week) and non-vascular mortality (HR: 1.05, 95% CI 1.01-1.09), but not vascular mortality (HR: 1.04, 95% CI 0.99-1.10). The findings were unaltered by excluding deaths in the first five years of follow-up. The study distinguished ex-drinkers from never-drinkers and excluded participants with major disease to minimise the potential for reverse-causation bias. Alcohol consumption in older men was associated with a higher risk of all-cause mortality, with heavy drinkers experiencing a 38% higher mortality risk than light drinkers.