Alcohol intake and its relationship with bone mineral density, falls, and fracture risk in older men.
OBJECTIVE
To examine the association between alcohol intake and problem drinking history and bone mineral density (BMD), falls and fracture risk.


METHODS
Cross-sectional and prospective cohort study.


METHODS
Six U.S. clinical centers.


METHODS
Five thousand nine hundred seventy-four men aged 65 and older.


METHODS
Alcohol intake and problem drinking histories were ascertained at baseline. Follow-up time was 1 year for falls and a mean of 3.65 years for fractures.


RESULTS
Two thousand one hundred twenty-one participants (35.5%) reported limited alcohol intake (<12 drinks/y); 3,156 (52.8%) reported light intake (<14 drinks/wk), and 697 (11.7%) reported moderate to heavy intake (> or =14 drinks/wk) in the year before baseline. One thousand one men (16.8%) had ever had problem drinking. In multivariate models, as alcohol intake increased, so did hip and spine BMD (P for trend < .001). Greater alcohol intake was not associated with greater risk for nonspine or hip fractures. Men with light intake, but not moderate to heavy intake, had a lower risk of two or more incident falls (light intake: relative risk (RR) = 0.77, 95% confidence interval (CI) = 0.65-0.92; moderate to heavy intake: RR = 0.83, 95% CI = 0.63-1.10) than abstainers. Men with problem drinking had higher femoral neck (+1.3%) and spine BMD (+1.4%), and a higher risk of two or more falls (RR = 1.59; 95% CI = 1.30-1.94) than those without a history of problem drinking and similar total hip BMD and risk of fracture.


CONCLUSIONS
In older men, recent alcohol intake is associated with higher BMD. Alcohol intake and fracture risk is unclear. Light alcohol intake may decrease the risk of falling, but a history of problem drinking increased fall risk.
Cawthon
Peggy M
PM
Research Institute, California Pacific Medical Center, San Francisco, California 94107, USA. pcawthon@sfcc-cpmc.net
Harrison
Stephanie L
SL
Barrett-Connor
Elizabeth
E
Fink
Howard A
HA
Cauley
Jane A
JA
Lewis
Cora E
CE
Orwoll
Eric S
ES
Cummings
Steven R
SR
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D015519:Bone Density / Q000187:drug effects*; D003430:Cross-Sectional Studies; D000431:Ethanol / Q000009:adverse effects* / Q000494:pharmacology; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors
D000431:Ethanol