Non-linear association between alcohol and incident frailty among community-dwelling older people: A dose-response meta-analysis

Kojima, Gotaro; Iliffe, Steve; Liljas, Ann; Walters, Kate

doi:10.5582/bst.2017.01237

Cited by 16 publications

(16 citation statements)

References 10 publications

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“…Firstly, this study confirmed the previous findings that older age, being female, lower education, poor self-rated health, smoking and low level of physical activity were all significantly positively associated with (pre-)frailty [4,21]. As the focus of this study, we found that problematic drinkers had a higher risk of (pre-)frailty, while non-problematic drinkers had neither higher nor lower risk of (pre-)frailty compared with non-drinkers, which was not consistent with previous findings [13,14,16,24]. A recent longitudinal study also found that moderate drinking had no protective benefit of frailty [25].…”

Section: Discussioncontrasting

confidence: 82%

“…Previous studies [13,14] have measured quantity of alcohol consumption, such as light (1-98 g/week), moderate (99-196 g/week), and high consumption (> 196 g/week) [16], whereas we screened for problematic drinking with the validated CAGE scale. These previous studies did not adjust for the key confounding factors, such as self-rated health condition, smoking, physical activity, which were controlled in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Two meta-analyses even concluded contradictory conclusions, one [13] found that heavier alcohol consumption is associated with lower incident frailty compared with no alcohol consumption among community-dwelling middle-aged and older. The other one [14] found that moderate alcohol consumption is associated with a lower risk of frailty, while higher consumption levels is associated with a higher risk of frailty. Another meta-analysis [15] indicated that alcohol consumption is not associated with sarcopenia, which is one important component of frailty.…”

Section: Introductionmentioning

confidence: 98%

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Association between alcohol consumption and frailty in three Chinese cities

Nie¹,

Gr²,

Verma³

et al. 2020

Preprint

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Background: Frailty is often described as a condition of the elderly but affects all age groups, alcohol consumption is associated with frailty. The aim of this study is to examine the associations between alcohol consumption pattern (ACP) and frailty in three cities in adults. . Methods: A cross-sectional study was conducted in three cities in China from June 2017 to October 2018. In total, 20,716 residents aged ≥18 years old were selected by using a multi-level stage sampling procedure. Alcohol consumption pattern was assessed by CAGE four-item questionnaire. Frailty was measured by a validated Chinese version of the FRAIL scale. Multinomial logistic regressions were used to examine the association of ACP with pre-frailty and frailty after controlling for varied covariates. Results: In general, the prevalence of pre-frailty and frailty was 35.25% and 11.42%, respectively. After controlling for covariates and interaction of age and ACP, non-problematic drinkers neither had association with pre-frailty(OR: 1.13, 95%CI:0.97-1.31) nor with frailty(OR:0.86,95%CI:0.68-1.12), while problematic drinkers had high odd ratios of pre-frailty(OR: 1.35, 95%CI:1.06-1.72) and frailty(OR:1.52, 95%CI:1.02-2.26) compared with non-drinker. Conclusions: our study found a positive association between problematic drinking and (pre-) frailty, no relationship between non-problematic drinking and (pre-) frailty compared with non-drinking among whole Chinese population. Based on previous findings and ours, we conclude it is important for the prevention of frailty to advocate zero drinking among whole population. Keywords: alcohol consumption, frailty, life course

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Association between alcohol consumption and frailty in three Chinese cities

Nie¹,

Gr²,

Verma³

et al. 2020

Preprint

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“…Exploratory analysis was undertaken to examine the shape of the association of continuous health behavior variables, alcohol consumption, and physical activity with onset of frailty ( S1 and S2 Figs, respectively). Based on this exploratory analysis and findings in previous studies [ 32 , 33 ], healthy behaviors were defined as follows: “Non-current smoking,” “Moderate alcohol consumption” [ 23 ], “Physically active” [ 31 ], and “Consumption of fruits and vegetables at least twice a day.” In addition, the number of healthy behaviors at age 50 was calculated for each participant and ranged between 0 (no healthy behaviors) and 4 (all healthy behaviors).…”

Section: Methodsmentioning

confidence: 99%

Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: A longitudinal study

et al. 2020

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Background Frailty is associated with increased risk of various health conditions, disability, and death. Health behaviors are thought to be a potential target for frailty prevention, but the evidence from previous studies is based on older populations with short follow-ups, making results susceptible to reverse causation bias. We examined the associations of healthy behaviors at age 50, singly and in combination, as well as 10-year change in the number of healthy behaviors over midlife with future risk of frailty. Methods and findings In this prospective cohort study of 6,357 (29.2% women; 91.7% white) participants from the British Whitehall II cohort, healthy behaviors—nonsmoking, moderate alcohol consumption, ≥2.5 hours per week of moderate to vigorous physical activity, and consumption of fruits or vegetables at least twice a day—were measured at age 50, and change in behaviors was measured between 1985 (mean age = 44.4) and 1997 (mean age = 54.8). Fried’s frailty phenotype was assessed in clinical examinations in 2002, 2007, 2012, and 2015. Participants were classified as frail if they had ≥3 of the following criteria: slow walking speed, low grip strength, weight loss, exhaustion, and low physical activity. An illness–death model accounting for both competing risk of death and interval censoring was used to examine the association between healthy behaviors and risk of frailty. Over an average follow-up of 20.4 years (standard deviation, 5.9), 445 participants developed frailty. Each healthy behavior at age 50 was associated with lower risk of incident frailty: hazard ratio (HR) after adjustment for other health behaviors and baseline characteristics 0.56 (95% confidence interval [CI] 0.44–0.71; p < 0.001) in nonsmokers, 0.73 (95% CI 0.61–0.88; p < 0.001) for moderate alcohol consumption, 0.66 (95% CI 0.54–0.81; p < 0.001) for ≥2.5 hours of physical activity per week, and 0.76 (95% CI 0.59–0.98; p = 0.03) for consumption of fruits or vegetables at least twice a day. A greater number of healthy behaviors was associated with reduced risk of frailty, with the HR for each additional healthy behavior being 0.69 (95% CI 0.62–0.76; p < 0.001) and the HR for having all versus no healthy behaviors at age 50 being 0.28 (95% CI 0.15–0.52; p < 0.001). Among participants with no or 1 healthy behavior in 1985, those who increased the number of healthy behaviors by 1997 were at a lower risk of frailty (mean follow-up = 16 years) compared with those with no such increase: the HR was 0.64 (95% CI 0.44–0.94; p = 0.02) for change to 2 healthy behaviors and 0.57 (95% CI 0.38–0.87; p < 0.001) for change to 3–4 healthy behaviors in 1997. The primary limitation of this study is potential selection bias during the follow-up due to missing data on frailty components. ...

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“…For example, a meta-analysis of three cohort studies showed that higher alcohol consumption is associated with lower incident frailty risks, 23 whereas a recent dose-response meta-analysis suggested heavy drinking (at least 30 grams of alcohol per day) may have a negative impact on frailty. 26 However, the apparent beneficial effect of alcohol may be confounded by a number of factors, 23 one of which is that the reference group used in these studies was non-drinkers, who are known to have a worse health profile than drinkers and may not be drinking because of ill health. 27 Therefore the objectives of this study were to examine the association of alcohol consumption with the risk of incident frailty controlling for important confounders and addressing methodological limitations of an appropriate comparator group.…”

Section: Introductionmentioning

confidence: 99%

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

Kojima

Jivraj

Iliffe

et al. 2019

Journal of the American Medical Directors Association

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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.

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Non-linear association between alcohol and incident frailty among community-dwelling older people: A dose-response meta-analysis

Cited by 16 publications

References 10 publications

Association between alcohol consumption and frailty in three Chinese cities

Association between alcohol consumption and frailty in three Chinese cities

Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: A longitudinal study

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

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