Volume 54, Issue 11 p. 1649-1657

Alcohol Intake and Its Relationship with Bone Mineral Density, Falls, and Fracture Risk in Older Men

Peggy M. Cawthon PhD, MPH

Peggy M. Cawthon PhD, MPH

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Stephanie L. Harrison MPH

Stephanie L. Harrison MPH

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Elizabeth Barrett-Connor MD

Elizabeth Barrett-Connor MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Howard A. Fink MD, MPH

Howard A. Fink MD, MPH

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Jane A. Cauley DrPH

Jane A. Cauley DrPH

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Cora E. Lewis MD

Cora E. Lewis MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Eric S. Orwoll MD

Eric S. Orwoll MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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Steven R. Cummings MD

Steven R. Cummings MD

From the * Research Institute, California Pacific Medical Center, San Francisco, California Department of Family and Preventive Medicine, School of Medicine, University of California at San Diego, La Jolla, California Geriatric Research Education and Clinical Center, Center for Chronic Disease Outcomes Research, and § Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and # Department of Medicine, Oregon Health and Science University, Portland, Oregon.

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First published: 11 October 2006
Citations: 86
Address correspondence to Peggy M. Cawthon, PhD, MPH, Research Institute, California Pacific Medical Center, 185 Berry Street, Lobby 4, Suite 5700, San Francisco, CA 94107. E-mail: [email protected]

An abstract of this paper was submitted to the International Osteoporosis Foundation World Congress on Osteoporosis, June 2006, Toronto, Canada.

Abstract

OBJECTIVES: To examine the association between alcohol intake and problem drinking history and bone mineral density (BMD), falls and fracture risk.

DESIGN: Cross-sectional and prospective cohort study.

SETTING: Six U.S. clinical centers.

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

MEASUREMENTS: 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 (≥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.

CONCLUSION: 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.