Marital status and alcohol use among older adults: the mediating roles of depressive symptoms and loneliness

Objectives: To examine associations of baseline marital status and partnership-status trajectories with alcohol use, gender differences, and potential mediation by depressive symptoms and loneliness. Methods: Participants were 5071 adults (53.6% women; 65–85 years) in the 2016 and 2021 Gerontological Regional Database waves in Northern Sweden and Western Finland. Partnered status included marriage, cohabitation, or living-apart-together; unpartnered status included single, divorced, or widowed. Partnership-status trajectories distinguished those who remained or transitioned to unpartnered status from those who remained or transitioned to partnered status. AUDIT-C assessed 2021 abstinence, low-risk (scores 1–3), hazardous drinking (≥4), and binge drinking (≥6 drinks/occasion at least monthly). Elevated depressive symptoms were defined as GDS-4 ≥ 2. Inverse-probability-weighted multinomial, logistic, and mediation models were estimated. Results: At baseline, unpartnered respondents were more likely to abstain than partnered respondents. Unpartnered trajectories were associated with abstinence (adjusted relative risk ratio = 1.40, 95% CI = 1.16–1.68), but not binge drinking (adjusted odds ratio = 0.97, 95% CI = 0.66–1.43). Among women, unpartnered trajectories were associated with lower hazardous drinking and binge drinking. No indirect effects via depressive symptoms or loneliness were observed. Conclusion: Unpartnered older adults were more likely to abstain. Among women, partnership was associated with hazardous and binge drinking. These patterns may reflect shared drinking environments and partnership-related social contexts rather than psychological distress following marital loss.