Alcohol consumption patterns and Long-Term Anxiety: The influence of Sex, Age, and income

Abstract

Objective: Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations between alcohol consumption frequency and quantity and subsequent anxiety, and tests whether these relationships were moderated by sex, age, and income level.

Methods: Participants were from a nationally representative sample of Australian adults (N = 21,405) from the Household, Income, and Labour Dynamics in Australia (HILDA) survey between 2006 and 2021. Linear mixed-effects models predicted anxiety based on alcohol consumption one-year prior up to eight times per participant. Moderation by sex (male, female), age-group (18-25, 26-37, 38-50, 51 + years), and income quartile were examined. Anxiety was measured using the Kessler-10 anxiety subscale and alcohol consumption was measured using self-reported alcohol consumption frequency (alcohol consumption occasions per week) and alcohol consumption quantity (standard drinks consumed on alcohol consumption occasions).

Results: An adjusted model demonstrated a small effect of frequency (IRR[95 % CI] = 0.98[0.98, 0.99]) and quantity (IRR[95 % CI] = 1.02[1.01, 1.03]) on anxiety one-year later. Age, but not sex nor income, moderated the relationship between alcohol consumption and anxiety. Specifically, frequency was associated with slightly lower longitudinal anxiety for 51 + year-olds (β[95 % CI] = -0.04[-0.05, -0.03]), but showed no association for 18-50-year-olds. Conversely, quantity was associated with slightly greater longitudinal anxiety for 51 + year-olds (β[95 % CI] = 0.03[.02, 0.05]) and 26-50-year-olds (β[95 % CI] = 0.02[.01, 0.03]), but not 18-25-year-olds.

Conclusions: While the impact of alcohol consumption on anxiety appears very small, divergent relationships of drinking frequency versus quantity on long-term anxiety seem to emerge across the lifespan. Drinking larger amounts per occasion appears associated with slight increases in anxiety from early adulthood, while drinking more frequently but in smaller amounts appears associated with slight decreases in anxiety in older adulthood.

Keywords: Age; Alcohol consumption; Anxiety; Frequency; Income; Longitudinal; Quantity; Sex.