Alcohol problems and all-cause mortality in men and women: predictive capacity of a clinical screening tool in a 21-year follow-up of a large , UK-wide, general population-based survey

Batty, G. David, Hunt, Kate, Emslie, Carol, Lewars, Heather and Gale, Catharine R. (2009) Alcohol problems and all-cause mortality in men and women: predictive capacity of a clinical screening tool in a 21-year follow-up of a large , UK-wide, general population-based survey. Journal of Psychosomatic Research, 66 (4), 317-321. (doi:10.1016/j.jpsychores.2008.09.021).

Abstract

Objective: While the relation between alcohol consumption and mortality has been well explored, little is known about the link between alcohol problems and mortality in general population-based studies, particularly among women. This was the objective of the present study
Methods: In this prospective cohort study, 5333 non-abstaining individuals (2539 women) from the UK-wide Health and Lifestyle Survey (aged 42.9 years at study induction) completed the CAGE questionnaire of alcohol problems and participated in a medical examination in 1984/1985; they were then followed up for mortality experience until 2005. Results: Alcohol problems at baseline were less common in women (2.4%) than in men (7.8%). A total of 21 years of follow-up gave rise to 1201 deaths. Elevated rates of mortality were evident in persons reporting symptoms of alcohol problems in comparison to those who did not. In genderstratified analyses, alcohol problems were more strongly associated with mortality risk in women (age-adjusted hazards ratio: 2.25; 95% confidence interval: 1.22–4.12) than in men (1.49; 1.12–1.99), although this effect modification was not statistically significant (P value for interaction=0.125). Controlling for a range of covariates—including socioeconomic position, co-morbidity (somatic and psychiatric), and alcohol intake—had essentially no impact on these associations.
Conclusion: The CAGE questionnaire may have some utility in routine health assessments in the general population.

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Contributors

Author: Catharine R. Gale

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