"Alcohol dependence" and death: survival analysis of the Baltimore ECA sample from 1981 to 1995.
Study Goal
The researchers aimed to determine the association between alcohol-use disorders (including "alcohol abuse" and "dependence") and the 14-year risk of death in a community sample.
Results Summary
The study found that alcohol-use disorders and heavy alcohol consumption were associated with a higher risk of death and a younger median age of death. The Diagnostic Interview Schedule (DIS) diagnosis of alcohol-use disorder predicted mortality beyond just heavy drinking.
Population
3,481 adult household residents from the NIMB Baltimore Epidemiologic Catchment Area survey.
Effective Dosage
Not specified
Duration
14-year follow-up (1981 to 1993-1996)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
alcohol abuse and/or dependence | increase | risk of death | adult household residents | adjusted relative risk = 1.3 | was associated with a higher risk of death | #1 |
alcohol abuse and/or dependence | decrease | median age of death | adult household residents | - | was associated with a younger median age of death | #2 |
heavy alcohol consumption | increase | risk of death | adult household residents | - | was associated with a significantly elevated risk of death | #3 |
DIS diagnosis of alcohol use disorder | increase | mortality | adult household residents | - | helped predict mortality over and above a prediction based solely upon heavy drinking | #4 |
OBJECTIVE: Evidence is provided about the association between "alcohol-use disorders" and the 14-year risk of death in a community sample. Most prior descriptions of this association come from treatment samples. METHOD: 3,481 adult household residents were recruited into the NIMB Baltimore Epidemiologic Catchment Area survey and interviewed in 1981. The Diagnostic Interview Schedule (DIS) was employed to assess alcohol drinking and other drug-taking behaviors, and to determine fulfillment of DSM-III criteria for "alcohol abuse" and/or "dependence" diagnoses. Participants were followed-up in 1993-1996, by which time 24% of the sample had died. Median age of death was estimated for persons with and without alcohol disorders, and for "heavy" and "nonheavy" drinkers. Cox proportional hazards models adjusted for the influence of age, sex, race, "drug-use disorders," and tobacco smoking. RESULTS: "Alcohol abuse" and/or "dependence" was associated with a higher risk of death and a younger median age of death (adjusted relative risk = 1.3, p = .016). "Heavy" alcohol consumption was also associated with a significantly elevated risk of death. The DIS diagnosis of "alcohol use disorder" helped predict mortality over and above a prediction based solely upon "heavy drinking" (p < .01). CONCLUSIONS: These findings indicate that the observed increased risk of death associated with "alcohol dependence" is not limited to cases severe enough to have been treated but is also present among cases in the household population.