Alcohol Dependence Linked to High Risk for Premature Death

Pam Harrison

October 18, 2012

Individuals who are alcohol dependent have a higher mortality risk than their nondependent counterparts, and this risk is particularly high among women, new research shows.

Ulrich John, PhD, from the University Medicine Greifswald, in Germany, and colleagues found that annualized death rates were 4.6-fold higher among alcohol-dependent women and 1.9-fold higher among alcohol-dependent men compared with the general population.

"Excess mortality is clearly revealed by the data, as all noted deaths occurred prematurely," the investigators write.

"These findings support evidence that seems to reveal higher relative risks for several alcohol-attributable causes of death among severely drinking women than among severely drinking men," they add.

The study was published October 16 in Alcoholism: Clinical and Experimental Research.

According to the researchers, little is known about excess mortality and its predictors among alcohol-dependent individuals in the general population.

For the study, they interviewed 4093 individuals from the general population. Of these, 153 individuals met criteria for alcohol dependence, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV); data on 149 participants were available for analysis 14 years later.

Approximately 20% of the alcohol-dependent sample died during the 14-year follow-up period.

The mean age at death was 60 years for women and 58 years for men — about 20 years younger than the general population.

A total of 34 patients, or 22.8%, of the alcohol-dependent cohort had received treatment at a specialized inpatient alcohol dependence unit at some point during the 14-year follow-up period; 6.7% had used inpatient detoxification services.

However, the investigators note, participation in a specialized inpatient alcohol dependence treatment program did not result in longer survival.

Indeed, the main predictors of premature death among alcohol-dependent individuals included participation in inpatient detoxification treatment, severity of alcohol dependence, alcohol-related problems, and poor self-rated general health.

Among survivors, a high mortality risk remained, because at the time of follow-up, survivors had a 33.6 pack-year history of cigarette smoking by the time they reached a mean age of 41.2 years.

"Because of this particularly high exposition, further excess mortality attributable to smoking must be expected," the authors write.

Data derived for the study were part of the Transitions in Alcohol Consumption and Smoking (TACOS) project funded by the German Federal Ministry of Education, Science, Research and Technology. The authors have disclosed no relevant financial relationships.

Alcohol Clin Exp Res. Published online October 16, 2012. Abstract