Alcohol dependence and risk of somatic diseases and mortality: A cohort study in 19,002 men and women attending alcohol treatment

AIMS: To (1) estimate sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol dependent individuals versus a control population, and in the same population to (2) estimate sex-specific risks of dying from the examined somatic diseases.

DESIGN: Register-based matched cohort study. Alcohol dependent individuals were identified from an alcohol treatment database. Controls were randomly selected from the Danish Civil Registration System. Information on somatic diseases obtained from the Danish National Patient Registry and causes of death obtained from the Cause of Death Registry. Cox proportional hazards model was applied to estimate Hazard ratios (HRs).

SETTING: Denmark.

PARTICIPANTS: 19,002 alcohol dependent individuals and 186,767 controls.

MEASUREMENTS: Outcome variables included 11 disease groups and 29 sub-groups, defined according to the International Classification of Diseases (ICD). The main predictor variable was diagnosis of alcohol dependence according to ICD.

FINDINGS: Alcohol dependent men and women compared with controls had statistically significantly higher risks of all disease groups and the majority of sub-groups when analysed as disease events. HRs were elevated for well-established alcohol-related diseases but also for diseases such as dementia (Men, HR: 2.0; 95% CI: 1.6-2.3. Women, HR: 2.4; 95% CI: 1.8-3.2), psoriasis (Men, HR: 4.3; 95% CI: 3.5-5.2. Women, HR: 5.4; 95% CI: 3.7-7.8) and breast cancer in men (HR: 3.3; 95% CI: 1.6-7.0). Similar results were found when disease groups and sub-groups were analysed as causes of death.

CONCLUSIONS: Alcohol dependent men and women have significantly higher risks of a comprehensive spectrum of somatic diseases, both as disease events and as causes of death, relative to individuals from the general population.