Background: Depression and cardiovascular disease (CVD) increase the risk of institutionalization among the elderly. Alcohol consumption has been positively related to depression but negatively associated with CVD, yet little is known about how these three factors jointly affect risk of institutionalization. Methods: We examined risk of institutionalization over a 6-year period among 3900 elderly Kaiser Permanente Northwest members who responded to a baseline health status survey. In preliminary analyses, we used logistic regression procedures to predict institutionalization for 30 days or more, adjusting for age, sex, marital status, income and frailty. Results: Elderly people with a pharmacy-based indicator of depression were more likely to be institutionalized (OR 1.68, 95% CI=1.29-2.18), while those who drank more frequently were less likely to be institutionalized (OR 0.85, 95% CI=0.72-0.99). These effects were modified by the presence of a CVD indicator (also pharmacy-based) at baseline. Among persons with CVD, the depression indicator continued to predict increased risk of institutionalization (OR 1.88, 95% CI=1.34-2.65) while alcohol consumption did not. Conversely, for those without an indication of CVD at baseline, alcohol consumption reduced risk of institutionalization (OR 0.75, 95% CI=0.58-0.96), and depression was no longer predictive. Conclusions: Among the elderly, the effects of alcohol consumption and depression on risk of institutionalization interact with history of CVD. More frequent alcohol use among those who do not have a history of CVD reduces risk of institutionalization, while depression places the elderly with histories of CVD at increased risk.
Learning Objectives: At the conclusion of the presentation, the participant will be able to describe the joint effects of frequency of alcohol consumption, depression, and cardiovascular disease on institutionalization among the elderly
Keywords: Alcohol Use, Elderly
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.