Alcohol, drinking pattern and all-cause mortality in Czech ageing cohort after 22 years of follow-up

Abstract Background High alcohol consumption has been hypothesised to partly explain the high morbidity and mortality in Central and Eastern Europe. We have previously assessed short and medium effects in Eastern European cohort, but the long-term effects in older subjects have not been investigated in the region. Aim The aim is to assess how drinking in midlife affects all-cause mortality risk at older ages, after long-term follow-up. Methods We used data from the Czech arm of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) prospective cohort. Random population sample of 8,856 men and women aged 45-69 years in 2002 were followed-up for average 18.2 (max 22.6) years. Drinking volume, frequency and pattern were estimated from the graduated frequency questionnaire. Deaths were obtained from national mortality registers. Cox regression was used to estimate hazard ratios (HR) with 95 % confidence intervals (CIs) for associations between alcohol measures and all-cause mortality by decade of follow up time. Results 3,020 participants died during follow up. In fully adjusted models, the HR for mortality of those who drank more than 20 litre of pure ethanol per year, compared to those drinking less than 1 litre per year, was 1.22 (95%CI 0.86 to 1.72) and 1.32 (95%CI 1.05 to 1.66) in the first and second decade of follow-up, respectively. Binge drinking also increased long-term mortality (although not significantly); those who drank at least 180ml of ethanol on one occasion at least once a week, compared to non-binging individuals, had HR 1.43 (0.78 to 2.61) and 1.28 (0.83 to 1.98) in the first and second decade of follow-up. Effects were similar in men and women. Conclusions Alcohol intake in midlife exhibits a long-term effect on mortality of older persons; the effect does not seem to diminish with time. This output was supported by the NPO SYRI, LX22NPO5101, funded by Next Generation EU. #NGEU Key messages • Heavy alcohol drinking and heavy binge drinking are determinants of all-cause mortality, and it seems it does not diminish over time. • Policymakers should continue advocating for programmes reducing alcohol consumptions.