Association of Alcohol and Tobacco Consumption with Depression Severity in the Oldest Old. Results from the Age Different Old Age Cohort Platform.

This study aimed to examine the association of alcohol and tobacco use with severity of depression in older age. Analyses were performed on a pooled data set (n = 3724) from two German old-age cohort studies (LEILA 75+, 6 follow-ups and AgeCoDe/AgeQualiDe, 9 follow-ups). Depressive symptoms were assessed via two screening scales for depression (CES-D and GDS-15) which were harmonized for pooled analysis. A mixed-effects linear regression model for the total sample and additional stratified models for men and women were used. Smoking at baseline was significantly associated with a higher level of depression severity (β = 0.142, 95% CI: 0.051-0.233, p = 0.002), whereas drinking was significantly associated with a decreased level of depression (β = -0.069, 95% CI: -0.119--0.021, p = 0.005). Concurrent substance use at baseline increased longitudinal depression severity (β = 0.193, 95% CI: 0.011-0.375, p = 0.037). Analyses stratified by gender showed a significant inverse association between drinking and depressive symptoms in men (β = -0.138, 95% CI: -0.231--0.045, p = 0.004), but not in women (β = -0.060, 95% CI: -0.120-0.001, p = 0.052). Given the burden of major depression, it is important that health care providers, especially primary care physicians, assess and monitor lifestyle factors, even at older ages.