Psychosocial stressors and high-volume drinking in later life: Sex-specific associations in the Health and Retirement Study, 2006–2022
Abstract
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.

