Original Article

Osteoporosis International

, Volume 18, Issue 5, pp 593-602

First online:

Alcohol consumption, bone density, and hip fracture among older adults: the cardiovascular health study

  • K. J. MukamalAffiliated withDivision of General Medicine and Primary Care, Beth Israel Deaconess Medical CenterBeth Israel Deaconess Medical Center, General Medicine and Primary Care Research Program Email author 
  • , J. A. RobbinsAffiliated withDivision of General Medicine, University of California at Davis Medical Center
  • , J. A. CauleyAffiliated withDepartment of Epidemiology, University of Pittsburgh
  • , L. M. KernAffiliated withDepartments of Public Health and Medicine, Weill Medical College of Cornell University
  • , D. S. SiscovickAffiliated withDepartment of Medicine, University of WashingtonDepartment of Epidemiology, University of Washington

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access



Previous studies have found inconsistent relationships of alcohol consumption with risk of hip fracture, and the importance of bone mineral density and risk of falls in mediating such a relationship has not been determined.


As part of the Cardiovascular Health Study, a population-based cohort study of adults aged 65 years and older from four U.S. communities, 5,865 participants reported their use of beer, wine, and liquor yearly. We identified cases of hip fracture unrelated to malignancy or motor vehicle accidents using hospitalization discharge diagnoses. A subgroup of 1,567 participants in two communities underwent dual-energy x-ray absorptiometry scans to assess bone mineral density.


A total of 412 cases of hip fracture occurred during an average of 12 years of follow-up. There was a significant U-shaped relationship between alcohol intake and risk of hip fracture (p quadratic 0.02). Compared with long-term abstainers, the adjusted hazard ratios for hip fracture were 0.78 (95% confidence interval [CI], 0.61–1.00) among consumers of up to 14 drinks per week and 1.18 (95% CI, 0.77–1.81) among consumers of 14 or more drinks per week. Alcohol intake was associated with bone mineral density of the total hip and femoral neck in a stepwise manner, with approximately 5% (95% CI, 1%–9%) higher bone density among consumers of 14 or more drinks per week than among abstainers. These relationships were all similar among men and women.


Among older adults, moderate alcohol consumption has a U-shaped relationship with risk of hip fracture, but a graded positive relationship with bone mineral density at the hip.


Alcohol Bone mineral density Epidemiology Hip fracture Nutrition