Substance Use
Psychosocial stressors and high-volume drinking in later life: Sex-specific associations in the Health and Retirement Study, 2006–2022 Suzanne G. McLone* Suzanne McLone McLone McLone McLone McLone McLone McLone McLone McLone McLone McLone Department of Epidemiology, Boston University School of Public Health
Major lifecourse psychosocial stressors may affect the risk of high-volume drinking in later life. We used US Health and Retirement Study data from 2006–2022 (up to 9 waves per respondent), restricting the sample to respondents age ≥50 years in 2006 with no missing psychosocial data (women: n=8,630; men: n=5,952). Exposures were self-reported of three psychosocial stressors occurring prior to 2006: 1. Adverse childhood experiences (9 items); 2. Lifetime traumatic experiences (7 items), and; 3. Major lifetime discrimination experiences (7 items). Our longitudinal outcome was high-volume drinking based on NIAAA standards, but excluding heavy episodic drinking (>7 drinks/week for women; >14 for men). We ran sex-stratified mixed models with random intercepts and a logit link to assess associations between each psychosocial stressor and high-volume drinking, adjusting for sociodemographic, health, and lifestyle variables. Separate models were estimated to include stressor-by-age interactions. Ages were centered at age 50 for all models. Among women, major lifetime discrimination experiences were associated with lower odds of high-volume drinking (OR=0.73; 95% CI: 0.55–0.97) on average during follow-up. Among men, lifetime traumatic experiences were associated with lower odds of high-volume drinking (OR=0.86; 95% CI: 0.72-1.02) on average during follow-up. No stressor-by-age interactions were observed for women. There was equivocal evidence that adverse childhood experiences was associated with age-related cchange in the odds of high-volume drinking for men (interaction per decade: OR=0.91; 95% CI: 0.83-1.01). Findings suggest that certain psychosocial stressors are associated with lower high-volume alcohol use patterns in middle- and older-aged adults. Additionally, findings demonstrate that associations between psychosocial stressors and high-volume drinking in later life differ by sex and stressor domain and may change from middle age to older adulthood.
