Alcohol use and functional disability among cognitively impaired adults.
BACKGROUND
The extent to which alcohol exposure increases risk for functional disability among older adults with cognitive impairment has not previously been assessed.


OBJECTIVE
To examine the potential relationship between alcohol use and functional disability among older cognitively impaired adults.


METHODS
Retrospective medical record review.


METHODS
Hospital-based geriatric assessment center.


METHODS
Two hundred forty-two consecutive participants with Mini-Mental Status Examination scores of < or = 24.


METHODS
Proxy-reported alcohol intake was classified in categories of never, former, light (< 1 drink/week), moderate (> or = 1 but < 14 drinks/week), and heavy (> or = 14 drinks/week) drinkers, and functional status was determined by proxy-reported performance in seven basic (BADL) and seven instrumental (IADL) activities of daily living (0 = poorest function and 14 = best function).


RESULTS
Compared with never drinkers, moderate drinkers demonstrated higher mean BADL (12.2 vs 11.4, P = .033) and IADL scores (6.6 vs 5.6, P = .067), whereas heavy drinkers had higher BADL (12.8 vs 11.4, P = .019) but lower IADL scores (4.8 vs 5.6, P = .425). Former drinkers demonstrated both lower BADL (10.8 vs 11.4, P = .107) and IADL scores (3.9 vs 5.6, P = .011) compared with never drinkers. Evaluation of a potential dose-response effect was limited due to low numbers of light and heavy drinkers.


CONCLUSIONS
Among cognitively impaired adults, moderate and heavy drinkers demonstrated better BADL function, whereas former drinkers had poorer IADL function, compared with never drinkers. Prospective studies that incorporate additional measures of exposure (e.g., cumulative lifetime consumption) and function (e.g., performance-based tests) may provide a more comprehensive understanding of alcohol's effects among older cognitively impaired adults.
Clinical Epidemiology Unit, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA.
M C
MC
Reid
J
J
Concato
V R
VR
Towle
C S
CS
Williams
M E
ME
Tinetti
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000145:classification / Q000150:complications* / Q000175:diagnosis; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires