The Depressive Symptoms and the Alcohol Drinking Behaviors: A Population-Based Longitudinal Study in Korea

Abstract

Objectives: Our study investigated the effects of changes in alcohol use behavior on depression symptoms and identified vulnerable subgroups among middle-aged and elderly individuals in South Korea. Methods: Data were obtained from the Korea Longitudinal Study on Aging (KLoSA) from 2006 to 2016. Subjects without depression symptoms were selected who scored <4 on the Center for Epidemiologic Studies’ Depression Scale since the inception of KLoSA in 2006. Alcohol use was assessed by the problem drinking screening questionnaire, consisting of five questions, with scores categorized as non-problem drinking (0 or 1) or problem drinking (≥2). Changes in individuals’ alcohol use were estimated based on the reports of two subsequent surveys. A generalized estimating equation (GEE) model was developed, adjusted for demographic, socioeconomic, and health-related factors as potential confounders. The multiple imputation-GEE method was utilized to account for missing data which were not at random. Results: A total of 2,905 individuals were included in this study. Depression symptoms significantly worsened when alcohol use remained as problem drinking (β=1.270, p<0.001) and when it deteriorated from non-problem to problem drinking (β=0.494, p=0.001). Positive change from problem drinking to non-problem drinking also worsened depression symptoms (β=0.278, p=0.024). Low education level, being single, unemployment, no regular exercise, current smoker, poor self-rated health (SRH), cognitive impairment, and hypertension were other significant risk factors related to depression. The sustained problem drinking and worsening change in alcohol use significantly exacerbated the depression in both poor and good SRH. Conclusions: Changes in alcohol use are strong risk factors of depression for middleaged and elderly adults. Efforts are required to identify such changes in individuals and to promote healthy drinking behavior in the context of primary care or regular health check-ups to protect the mental health of these population.