The proposed research is a prospective cohort study of alcohol consumption patterns and mortality in 4,960 pairs of adult, male, veteran U.S. twins born in 1917-27. Drinking practices were surveyed twice, in 1967-70 and 1983-85, by extensive epidemiologic questionnaires that included medical symptoms, smoking and food habits, leisure time activities, and demographic and psychosocial variables. Mortality data are complete as of December 31, 1988. The available data set provides a unique opportunity, at minimal cost, to explore mortality- related consequences of different patterns and levels of alcohol use, controlling for genetic effects. Such analyses are impossible in any conventional cohort of unrelated individuals. The proposed data analyses will also provide important information about the contributions of genes and environment to drinking habits and their changes in late adulthood. We plan to investigate relationships with sociodemographic variables such as marital status and twin closeness, reported in other twin populations, and examine new relationships with work characteristics, retirement, and the Type A behavior pattern. Three research questions are to be addressed in the proposed study: (1)Is the risk of death--specifically, death from trauma, heart disease, stroke, and digestive and oral cavity cancers--higher among heavy alcohol users than among other drinkers and abstainers? (2)Is the inherited liability for drinking behavior increased or diminished under particular sociocultural conditions, such as marital status and occupational history? (3)Are individual psychosocial characteristics, such as Type A behavior and social support, able to distinguish those who have reported changes in drinking habits from those who have not?
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