Net Lifetime Health Effects of Alcohol Use & Abuse

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DESCRIPTION (provided by applicant): While the association of alcohol consumption and the risk of many specific disease entities has been investigated in great detail, there are serious deficiencies in knowing the overall relation of alcohol consumption to health and disease throughout the adult lifespan. Given that alcohol has both detrimental and possibly beneficial effects, it is important to know its net effects on the risk of death and of a number of diseases and health conditions that may relate, either positively or inversely, to its use or abuse. We propose to use data collected over 27-55 years among the 10,000+ subjects in the population-based Framingham Study to relate the amount and pattern of alcohol consumption over a large part of their adult lifetime to two of the most important aspects of life: (a) survival (total mortality) and (b) indices of cognitive function. We will also relate alcohol consumption to indices of disability and to a number of other diseases and conditions affected by alcohol intake, including liver disease, accidents, specific cancers, hypertension, coronary disease, stroke, other cardiovascular diseases, seizures, syncope, falls and fractures. The Framingham Study is unique in being able to provide repeated measurements of the amount and pattern of alcohol use and measures of health and disease over what is essentially the entire adult lifespan (until old age for most and until death for more than one half of subjects). The proposed study would carry out an extensive review of health information collected at every encounter with each subject throughout follow up, classify each subject at each encounter according to alcohol consumption (amount and pattern of drinking), identify those with alcohol use disorders, prepare a complete dataset of diseases and causes of death (currently complete only for cardiovascular disease and cancer), and then examine the relation of alcohol use and alcohol use disorders to total mortality (overall and by age strata) and to indices of cognitive function assessed repeatedly over time. The net effects of varying amounts and patterns of drinking would be related to outcomes at different ages. The study will produce a unique dataset and will provide information that should improve our knowledge of the net effects of alcohol throughout adult life.