Osteoporosis International

, Volume 18, Issue 5, pp 593–602 | Cite as

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

  • K. J. Mukamal
  • J. A. Robbins
  • J. A. Cauley
  • L. M. Kern
  • D. S. Siscovick
Original Article



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 



The research reported in this article was supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01 HC-15103 from the National Heart, Lung, and Blood Institute, which has approved the paper. The bone density scans were funded by the National Institute on Aging (intra-agency agreements Y02-AG-4-0251 and 1-Y02-HC-40205). A full list of participating CHS investigators and institutions can be found at


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • K. J. Mukamal
    • 1
    • 7
  • J. A. Robbins
    • 2
  • J. A. Cauley
    • 3
  • L. M. Kern
    • 4
  • D. S. Siscovick
    • 5
    • 6
  1. 1.Division of General Medicine and Primary CareBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Division of General MedicineUniversity of California at Davis Medical CenterSacramentoUSA
  3. 3.Department of EpidemiologyUniversity of PittsburghPittsburghUSA
  4. 4.Departments of Public Health and MedicineWeill Medical College of Cornell UniversityNew YorkUSA
  5. 5.Department of MedicineUniversity of WashingtonSeattleUSA
  6. 6.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  7. 7.Beth Israel Deaconess Medical CenterGeneral Medicine and Primary Care Research ProgramBrooklineUSA

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