Marital status and alcohol use among older adults: the mediating roles of depressive symptoms and loneliness.

OBJECTIVES

To examine associations of baseline marital status and partnership-status trajectories with alcohol use, gender differences, and potential mediation by depressive symptoms and loneliness.

METHODS

Participants were 5071 adults (53.6% women; 65-85 years) in the 2016 and 2021 Gerontological Regional Database waves in Northern Sweden and Western Finland. Partnered status included marriage, cohabitation, or living-apart-together; unpartnered status included single, divorced, or widowed. Partnership-status trajectories distinguished those who remained or transitioned to unpartnered status from those who remained or transitioned to partnered status. AUDIT-C assessed 2021 abstinence, low-risk (scores 1-3), hazardous drinking (≥4), and binge drinking (≥6 drinks/occasion at least monthly). Elevated depressive symptoms were defined as GDS-4 ≥ 2. Inverse-probability-weighted multinomial, logistic, and mediation models were estimated.

RESULTS

At baseline, unpartnered respondents were more likely to abstain than partnered respondents. Unpartnered trajectories were associated with abstinence (adjusted relative risk ratio = 1.40, 95% CI = 1.16-1.68), but not binge drinking (adjusted odds ratio = 0.97, 95% CI = 0.66-1.43). Among women, unpartnered trajectories were associated with lower hazardous drinking and binge drinking. No indirect effects via depressive symptoms or loneliness were observed.

CONCLUSION

Unpartnered older adults were more likely to abstain. Among women, partnership was associated with hazardous and binge drinking. These patterns may reflect shared drinking environments and partnership-related social contexts rather than psychological distress following marital loss.