Usual alcohol consumption and suicide mortality among the Korean elderly in rural communities: Kangwha Cohort Study

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.

Keywords: ALCOHOL; Cohort studies; MORTALITY; SUICIDE.

Figure 1

HRs of suicide death by alcohol consumption-related variables according to sex. Covariables included in the Cox model were age at enrolment (continuous variable), smoking status (current smoker, past smoker, never smoker), body mass index (kg/m²; <18.5, 18.5–24.9, ≥25), hypertension (measured blood pressure ≥140/90 mm Hg or on regular medication; yes, no), self-rated health compared to the same age group (good or fair, poor), marital status (living with a spouse, not living with a spouse), education (ever, never) and occupation (non-agriculture, agriculture).