Testing the mediating mechanism of alcohol use on the association between retirement and depressive symptoms in the United States using generalized mixed effect models

Objectives: Both alcohol use and the prevalence of depression-depressive disorders, among older adults have increased over the past several decades and have been associated with increased morbidity and mortality. To our knowledge, the interactions between retirement, depression, and alcohol use have not yet been examined. This study aims to longitudinally explore the mediating role of alcohol use on the association between retirement and depressive symptoms in the United States, comparing individuals who are retired and not retired, while also exploring individuals who transitioned into and out of retirement at different times. Method: Data from the Health and Retirement Study (waves 1994 to 2020) were used. Respondents aged 50 years and older who had valid information on retirement status and had observations for at least 3 waves were included in our sample (n = 27,575; nt = 193,642). A generalized longitudinal mixed-effect model was conducted on depressive symptoms (CESD-8). Direct, indirect, and total effects were calculated to test the mediating mechanism of alcohol use. Results: Retirement was associated with increased depressive symptoms (b = 0.04, p < 0.05), while moderate alcohol use was associated with decreased depressive symptoms (b = -0.09, p < 0.05), and binge drinking was associated with increased depressive symptoms (b = 0.06, p < 0.05). Alcohol played a mediating role in the association between retirement and depressive symptoms, with moderate use serving as a protective factor. Conclusion: Screening and treating depression and alcohol misuse among older adults is key to promoting longer and healthier lives. Providing alternative coping mechanisms to heavy alcohol consumption for retirees is crucial.