Alcohol Screening Results in Elderly Male Veterans: Association with Health Status and Mortality

Authors

  • Isabelle Peytremann Bridevaux MD, MPH,

    1. From the *Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WashingtonDepartment of Medicine, University of Washington, Seattle, Washington.
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  • Katharine A. Bradley MD, MPH,

    1. From the *Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WashingtonDepartment of Medicine, University of Washington, Seattle, Washington.
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  • Chris L. Bryson MD, MS,

    1. From the *Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WashingtonDepartment of Medicine, University of Washington, Seattle, Washington.
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  • Mary B. McDonell MS,

    1. From the *Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WashingtonDepartment of Medicine, University of Washington, Seattle, Washington.
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  • Stephan D. Fihn MD, MPH

    1. From the *Northwest Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WashingtonDepartment of Medicine, University of Washington, Seattle, Washington.
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  • The Veterans Affairs (VA) Ambulatory Care Quality Improvement Project was funded by VA Health Services Research and Development Grants SDR-96–002 and IIR 99–376. Dr. Peytremann Bridevaux was supported by grants from the Fonds National Suisse de la Recherche Scientifique. Dr. Bradley is supported by a K23 Career Development Award (AA00313) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and is a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the NIAAA, or the Robert Wood Johnson Foundation.

Address correspondence to Isabelle Peytremann Bridevaux, MD, MPH, c/o Katharine A. Bradley, MD, MPH, MS 152, HSR & D VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108. E-mail: Isabelle.Peytremann-Bridevaux@hospd.ch

Abstract

Objectives: To evaluate the association between alcohol screening results and health status or mortality in elderly patients.

Design: Cross-sectional and longitudinal cohort studies.

Setting: Primary care clinics at seven Veterans Affairs medical centers.

Participants: A total of 16,958 male patients aged 65 and older.

Measurements: Alcohol screening questionnaires were used to divide patients into four mutually exclusive groups: drinkers who screened negative or positive for problem drinking and nondrinkers (in the previous year) who screened negative or positive for problem drinking. A subset of patients (n=12,491) completed a measure of health status, the Medical Outcomes Study Short Form (SF-36). All-cause mortality was ascertained using Veterans Affairs data over a mean follow-up of 2.8 years.

Results: Forty-eight percent of participants reported drinking in the previous year. Half of the drinkers and nondrinkers screened positive for problem drinking. The SF-36 item scores were consistently higher for drinkers than for nondrinkers and for patients who screened negative for problems than for those who screened positive. Similarly, survival was consistently better in drinkers than nondrinkers (mortality hazard ratio (HR)=0.74, 95% confidence interval (CI)=0.68–0.82) and in patients who screened negative for problem drinking than in those who screened positive (mortality HR=0.87, 95% CI=0.80–0.95). Nondrinkers who screened positive for problem drinking had the poorest health status and survival, whereas drinkers who screened negative for problem drinking had the best health status and survival.

Conclusion: Elderly patients who reported drinking alcohol and those who screened negative for problem drinking had consistently better health status and survival than those who did not drink and those who screened positive.

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