Alcohol Consumption and Risk of Incident Frailty: The English Longitudinal Study of Aging

Abstract

Background: Alcohol consumption is a common modifiable lifestyle factor. Alcohol may be a risk factor for frailty, however there is limited evidence in the literature. Objective: The objectives of this study were to examine the association of alcohol consumption with the risk of incident frailty. Methods: This is a prospective panel study of 2544 community-dwelling people aged 60 years and older in England. Frailty status defined by frailty phenotype criteria was measured at baseline and 4 years later. Participants free of frailty at baseline were divided into five groups based on quantity of self-reported alcohol consumption per week with cut-points at 0, 7, 14 and 21 UK units per week. Adjusted odds ratios (OR) were calculated for incident frailty according to the alcohol consumption using logistic regression models. Results: Compared with the low consumption group (>0 and <7 units per week), incident frailty risk over 4 years was significantly higher among non-drinkers (OR=1.71, 95% confidence interval (CI)=1.12-2.60, p value=0.01), after controlling for socio-demographic confounders. In a supplementary analysis this became non-significant after further adjustment for baseline health status. Heavy drinkers (> 21 units per week) had a significantly lower incident frailty risk (unadjusted OR=0.45, 95% CI=0.27-0.75, p<0.01), which became nonsignificant on adjustment for socio-demographic factors (OR=0.64, 95% CI=0.37-1.13, p=0.12). Conclusions/Implications: We found that non-drinkers were more likely than those with low alcohol consumption to develop frailty, but this appeared to be explained by poorer baseline health status. No evidence was found for an association between becoming frail and high levels of alcohol consumption. Future studies with information on life-course history of alcohol use, especially for those classified as non-drinkers in old age, is warranted.

The association between medication or alcohol use and the incidence of frailty: a retrospective cohort study

“…This sub-analysis result is in accordance with a 30-year follow-up study published by Strandberg et al [7] where alcohol use was shown to be an independent risk factor for developing frailty in old age among men who had high alcohol consumption during mid-life [7]. Previous authors have suggested that alcohol use in old age might be the result of reverse causality, whereby older adults with health problems choose to limit or reduce their alcohol use even before the presentation of frailty [6,7,40]. Death before old age is another important consideration influencing the relationship between alcohol use and frailty risk in shortterm follow-up studies on older adults [6,7].…”

“…Additionally, incidence of prefrailty in the FP-population was 34.4%. The difference between the two measures is considerable but consistent with published literature [39,40]. The meta-analysis on frailty incidence reported 4.6% pooled incidence of frailty among robust older adults aged 60 years and older during a median follow-up of three years.…”

“…Death before old age is another important consideration influencing the relationship between alcohol use and frailty risk in shortterm follow-up studies on older adults [6,7]. Furthermore, Kojima et al found that high association between nondrinkers and frailty might be explained by poorer baseline health status [40]. Although the model in our study was adjusted for several baseline health status conditions, there is still possibility of residual confounding.…”

Prevalence and associated factors for frailty among elder patients in China: a multicentre cross-sectional study

“…In our study, frailty was more prevalent in patients with a history of alcohol use. However, Gotaro Kojima et al found that nondrinkers seem more likely than those with low alcohol consumption to develop frailty with a sample of 2544 community-dwelling people [28]. The link between frailty and alcohol may depend on the drinking patterns, the amount of alcohol consumed on each occasion and cumulative alcohol consumption [29].…”

Alcohol Drinking and Health in Ageing: A Global Scale Analysis of Older Individual Data through the Harmonised Dataset of ATHLOS

“…Despite rapid population ageing and the inconsistent findings about the relationship between alcohol intake and various ageing-related concepts [ 11 , 12 , 13 ] (e.g., frailty, sarcopenia), there are no global epidemiological data on the effect of alcohol consumption on healthy ageing. In particular, although recently interesting population-based results on the effect of alcohol or healthy lifestyle habits on health have been reported [ 14 , 15 ] there is no multi-national study with individual data investigating the relationship between alcohol drinking and healthy ageing, for individuals over the age of 65, that allows for regional and temporal comparisons.…”