Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis

Laramée, Philippe; Leonard, Saoirse; Buchanan-Hughes, Amy; Warnakula, Samantha; Daeppen, Jean‐Bernard; Rehm, Jürgen

doi:10.1016/j.ebiom.2015.08.040

Cited by 78 publications

(69 citation statements)

References 71 publications

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“…30,32 Therefore, our AUD cases are likely to be more severely affected than those ascertained from population-based interview studies. The stronger association with mortality for AUD observed in this vs prior samples 2,3 might result from the high average severity of our ascertained cases and, in particular, our use of medical registry, as among individuals with AUD in the general population, treatment is associated with increased mortality. 2 …”

Section: Discussionmentioning

confidence: 58%

“…This association is consistent with prior studies, 4,15,16,21 although considerably stronger than that estimated from 2 recent meta-analyses: 3.38 (95% CI, 2.98–3.84) in men, 4.57 (95% CI, 3.86–5.42) in women, 3 and 3.45 (95% CI, 2.96–4.02) in both sexes. 2 Congruent with prior findings, 3,14 the magnitude of this association varied substantially by age, being weakest in late adulthood.…”

Section: Discussionmentioning

confidence: 59%

“…Second, a previous meta-analysis showed that alcohol-dependent individuals who continued to drink heavily had significantly greater mortality than alcohol-dependent individuals who reduced their alcohol intake. 2 Third, 6 randomized clinical trials have shown that interventions leading to reduced drinking also reduced mortality rates. 28 …”

Section: Discussionmentioning

confidence: 99%

“…2–7 In 2000, excessive alcohol use accounted for 85 000 deaths a year in the United States, representing the third leading modifiable cause of death. 8 Alcohol-related deaths contributed to the marked increase in all-cause mortality in US white non-Hispanic men from 1999 to 2013.…”

mentioning

confidence: 99%

“…2,3,14–16 Because we cannot assume that the underlying mechanism will be constant across the lifespan, the ideal study would have sufficient sample size to clarify patterns of familial confounding across the lifespan. We describe such a study based on a Swedish national sample with AUD ascertained from medical, criminal, and pharmacy registries.…”

mentioning

confidence: 99%

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Alcohol Use Disorder and Mortality Across the Lifespan

Kendler

Sundquist

2016

JAMA Psychiatry

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IMPORTANCE Excess alcohol consumption and alcohol use disorders (AUDs) are associated with substantially increased mortality. Efforts to reduce this toll require an understanding of their causes. OBJECTIVE To clarify the degree to which the excess mortality associated with AUDs arises (1) from the predispositions of the person who develops AUD (and which would likely be shared by close relatives) and (2) as a direct result of AUD itself. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort and co-relative design study involving all individuals born in Sweden from 1940 to 1965 who had neither died nor migrated prior to 1973 or age 15 years (N = 2 821 036). They were followed up from January 1, 1973, until December 31, 2010. Alcohol use disorder was assessed from medical, criminal, and pharmacy registries. Half-siblings, full-siblings, and monozygotic twin pairs discordant for AUD were obtained from the Multi-Generation and Twin Register. MAIN OUTCOME AND MEASURE Death obtained from the Swedish Death registry. RESULTS Our cohort (1 447 887 males and 1 373 149 females) included 131 895 males and 42 163 females registered with AUD. The mean (SD) age at first AUD registration was 39 (13.4) years. We ascertained 127 347 and 76 325 deaths in the male and female subsamples, respectively. Controlling for sex, educational status, and year of birth, the mortality hazard ratio associated with AUD was 5.83 (95% CI, 5.76–5.90) and varied—with an inverted U-shaped function—by age. Examining the AUD-mortality association in the general population and in relative pairs discordant for AUD exposure demonstrated substantial familial confounding in early to mid-adulthood: the AUD-associated mortality hazard ratio was much lower in discordant close relatives than in the general population. In middle to late adulthood, evidence for familial confounding decreased with increasing evidence for a direct effect of AUD on elevated mortality. In the oldest age group (65–70 years), the mortality hazard ratios were similar across the population and all relative pairs, suggesting that the excess mortality was largely a result of having AUD. Adding years since onset of AUD to the model showed that both increasing age and increasing years of duration of AUD contributed to the reduction of familial confounding in the association between AUD and elevated mortality. CONCLUSIONS AND RELEVANCE Excess mortality associated with AUD arises both from the predispositions of the person who develops AUD and the direct result of having AUD. The effect of predisposition is more prominent early in the life course and in the early years of AUD. The direct effect of AUD becomes progressively more important later in life and with longer duration of AUD. These results have implications for interventions seeking to reduce the elevated AUD-associated mortality.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Alcohol Use Disorder and Mortality Across the Lifespan

Kendler

Sundquist

2016

JAMA Psychiatry

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Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013

et al. 2017

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Severity of alcohol dependence and mortality after 20 years in an adult general population sample

John

Rumpf

Hanke

et al. 2022

Int J Methods Psych Res

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Objectives To estimate mortality on grounds of the severity of alcohol dependence which has been assessed by two approaches: the frequency of alcohol dependence symptoms (FADS) and the number of alcohol dependence criteria (NADC). Methods A random sample of adult community residents in northern Germany at age 18 to 64 had been interviewed in 1996. Among 4075 study participants at baseline, for 4028 vital status was ascertained 20 years later. The FADS was assessed by the Severity of Alcohol Dependence Scale among the 780 study participants who had one or more symptoms of alcohol dependence or abuse and vital status information. The NADC was estimated by the Munich Composite International Diagnostic Interview among 4028 study participants with vital status information. Cox proportional hazard models were used. Results The age‐adjusted hazard ratio for the FADS (value range: 0–79) was 1.02 (95% confidence interval, CI: 1.016–1.028), for the NADC (value range: 0–7) it was 1.25 (CI: 1.19–1.32). Conclusions The FADS and NADC predicted time to death in a dose‐dependent manner in this adult general population sample.

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Risk of All-Cause Mortality in Alcohol-Dependent Individuals: A Systematic Literature Review and Meta-Analysis

Cited by 78 publications

References 71 publications

Alcohol Use Disorder and Mortality Across the Lifespan

Alcohol Use Disorder and Mortality Across the Lifespan

Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013

Severity of alcohol dependence and mortality after 20 years in an adult general population sample

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