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Lifestyle factors also played a role; smokers were more likely to have higher scores, and higher pack-years were associated with higher scores. Some surprises emerged as well, Dr. Chang said, noting that higher levels of physical activity were associated with midrange scores. Reasons for this are unknown, but speculative possibilities include that exercise and moderate drinking may be correlated lifestyle patterns or perhaps those with higher physical activity think that exercise attenuates the effects of alcohol.
As for depression, a past history of that illness was associated with higher prevalence in the low-score groups, and current mild depression was associated with the lowest- and highest-score categories.
The U-shaped curve persisted after adjusting for confounders, although the magnitude in the higher-score group was attenuated, she noted.
Habitual alcohol consumption
Habitual alcohol consumption was measured in all VITAL study subjects, and the preliminary findings also suggest that non-Latino whites (vs. other racial/ethnic groups) and men have the highest prevalence of daily alcohol consumption, and that black and Asian participants have lower prevalence of daily alcohol consumption and are more likely to report never or rarely using alcohol.
Interestingly, in multivariable models adjusting for demographic and other lifestyle and health factors, weekly or daily alcohol use was associated with lower likelihood of mild depressive symptoms when compared with rare use and nonuse of alcohol, and with lower likelihood of problems with interest, sadness, low energy, appetite or weight change, concentration, and psychomotor activity.
As for the relationship between alcohol consumption and mood, there were no significant interactions by age, and generally none by gender, but the threshold for an association between alcohol frequency and scores on the Patient Health Questionnaire (PHQ) – a tool, based in part on DSM criteria, for screening, diagnosing, monitoring, and measuring the severity of depression – did differ by gender. Specifically, weekly use and daily use were significantly associated with lower PHQ scores in men, but only monthly and weekly use were associated with lower PHQ scores in women, she said.
Dr. Chang noted, however, that while the number of subjects who didn’t provide complete information was small (less than 2%), it is important, because those with heavy and problem drinking often do not report their alcohol intake.
These early findings underscore the complexity of alcohol use and its effects on older adults. Understanding of the subject and its relationship with depression and anxiety is evolving.
“We’re getting clues,” she said, adding that “this study will really help us a lot, but it’s not a straightforward relationship. … It’s obviously impacted by clinical and personal factors, and we desperately need much greater clarity, because I think that alcohol and drug use will certainly compromise the treatment of depression and anxiety in later life.”
“It’s something that we really need to be aware of,” she said.
Sponsors/collaborators for this study are Brigham and Women’s Hospital and the National Institute of Mental Health. Dr. Chang reported receiving royalties from Up to Date, but had no other relevant disclosures.