Mortality in men with drinking problems: a 20-year follow-up

Area of Science:

• Public Health
• Epidemiology
• Addiction Medicine

Background:

• Alcohol dependence is a significant public health concern with known associations with increased mortality.
• Long-term follow-up studies are crucial for understanding the full impact of alcohol problems on lifespan and causes of death.

Purpose of the Study:

• To analyze mortality patterns and causes of death in a cohort of married men with a history of alcohol dependence over a 20-year period.
• To quantify the excess mortality associated with varying levels of alcohol dependence.
• To identify specific causes of death and assess years of life lost.

Main Methods:

• A 20-year prospective follow-up study of 99 married men with diagnosed drinking problems.
• Mortality data and death certificates were collected and analyzed.
• Causes of death were classified using the International Classification of Diseases (Ninth Revision).
• Observed/expected mortality ratios were calculated for the cohort and subgroups based on dependence severity.

Main Results:

• Forty-four deaths occurred in the cohort, with an overall observed/expected mortality ratio of 3.64.
• Mortality excess was most pronounced in the 45-54 year age group.
• The most common causes of death were carcinoma of the bronchus and circulatory system diseases.
• Severely dependent individuals had a higher mortality ratio (4.41) compared to moderately dependent individuals (2.93).
• Injury and poisoning resulted in the greatest years of life lost per death.
• Chronic alcoholism was mentioned on only 4 out of 43 death certificates.

Conclusions:

• Men with alcohol dependence face substantially elevated mortality risks, particularly from cancer and cardiovascular diseases.
• The severity of alcohol dependence correlates with increased mortality risk.
• Standard death certification may underrepresent the role of chronic alcoholism as a cause of death.