Aged ; Aged, 80 and over ; Alcohol Drinking* ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population* ; Suicide/statistics & numerical data*
Keywords
ALCOHOL ; Cohort studies ; MORTALITY ; SUICIDE
Abstract
BACKGROUND: The evidence from prospective studies on whether greater usual alcohol consumption is associated with a higher risk of death by suicide in the general population is inconclusive.
METHODS: 6163 participants (2635 men; 3528 women) in a 1985 survey among rural residents in Korea aged 55?years and above were followed until 2008. A Cox model was used to calculate HRs of suicide death after adjustment for demographic, socioeconomic and health-related confounders.
RESULTS: 37 men and 24 women died by suicide. Elderly persons who consumed alcohol daily, 70?g alcohol (5 drinks) or more per drinking day, or 210?g alcohol (15 drinks) or more per week had higher suicide mortality (p<0.05), compared with non-drinkers. An increase of one drinking day per week (HR=1.17, 95% CI 1.05 to 1.31), 70?g (5 drinks) additional alcohol intake per drinking day (HR=1.38, 95% CI 1.13 to 1.70), and 140?g (10 drinks) additional alcohol intake per week was associated with a 17%, 38% and 12% higher risk of suicide death, respectively. Women had a higher relative risk of suicide death associated with alcohol consumption, compared with men.
CONCLUSIONS: A greater frequency and amount of usual alcohol consumption was linearly associated with higher suicide death. Given the same amount of alcohol consumption, women might have a higher relative risk of suicide than men. Our findings support 'the lower the better' for alcohol intake, no protective effect of moderate alcohol consumption, and a sex-specific guideline (lower alcohol threshold for women) as actions to prevent suicide death.