Skip to main content

Advertisement

SpringerLink
Log in

Smoking, alcohol intake, and frailty in older Korean adult men: cross-sectional study with nationwide data

  • Research Paper
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

Key summary points

AbstractSection Aim

This study aimed to investigate the effects of both smoking and alcohol intake on frailty in Korean community-dwelling older adults considering other health-related behaviors and socioeconomic status.

AbstractSection Findings

Frailty prevalence differed according to smoking status and alcohol intake. The increased frailty risk in the smoking and non-alcohol-intake group compared with the non-smoking and alcohol-intake group may be due to the “alcohol paradox”.

AbstractSection Message

Comprehensive approach should be applied to understanding frailty in older adults that considers both smoking status and alcohol intake.

Abstract

Purpose

Smoking and alcohol intake are major causes of negative health outcomes and may be co-inherited traits. However, little is known about the association of frailty with smoking and alcohol intake in older adults.

Methods

Community-dwelling older men (N = 1426) aged 70–84 years were divided into four groups: 1) non-smoking (< 100 cigarettes in life-time) and non-alcohol intake (< one time/month); 2) smoking (≥ 100 cigarettes) and alcohol intake (≥ one time/month); 3) non-smoking with alcohol intake; and 4) smoking and no alcohol intake. Frailty was assessed with a modified version of the Cardiovascular Health Study (CHS) frailty index, the Korean version of the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight (KFRAIL) index, the Korean Frailty Index (KFI), and the Study of Osteoporotic Fracture (SOF) frailty index. Frailty risks were estimated with multiple logistic regression models after adjusting for age, income, education, residence, marital status, hospitalization, physical activity, comorbidities, and levels of vitamin B12, aspartate aminotransferase, and gamma-glutamyl transferase.

Results

Frailty differed according to smoking and alcohol status. Frailty in the smoking and non-alcohol-intake group was significantly higher according to the CHS frailty index (Odds ratio = 1.592; 95% confidence interval [CI] 1.032–2.455), KFRAIL (CI 1.613, 1.037–2.509), and KFI (CI 1.869, 1.115–3.131) compared with the non-smoking and alcohol-intake group. However, there was no increased frailty risk in the other study groups.

Conclusion

Frailty prevalence differed depending on smoking status and alcohol intake in older Korean men. Therefore, we should adopt a comprehensive approach to understanding frailty in older adults that considers both smoking and alcohol intake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cesari M, Prince M, Thiyagarajan JA, De Carvalho IA, Bernabei R, Chan P et al (2016) Frailty: an emerging public health priority. J Am Med Dir Assoc 17(3):188–192. https://doi.org/10.1016/j.jamda.2015.12.016

    Article  PubMed  Google Scholar 

  2. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156

    Article  CAS  Google Scholar 

  3. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC (2012) Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 60(8):1487–1492. https://doi.org/10.1111/j.1532-5415.2012.04054.x

    Article  PubMed  Google Scholar 

  4. Santos-Eggimann B, Spagnoli J, Junod J, Cuénoud P (2009) Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol Ser A 64A(6):675–681. https://doi.org/10.1093/gerona/glp012

    Article  Google Scholar 

  5. Kim KJ, Shin J, Choi J, Won CW (2018) Discrepancies in the prevalence of known frailty scales: Korean Frailty and Aging Cohort Study. Ann Geriatr Med Res 22(3):137–144. https://doi.org/10.4235/agmr.2018.22.3.137

    Article  Google Scholar 

  6. Mello Ade C, Engstrom EM, Alves LC (2014) Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review. Cad Saude Publ 30(6):1143–1168

    Article  Google Scholar 

  7. Ottenbacher KJ, Graham JE, Al Snih S, Raji M, Samper-Ternent R, Ostir GV et al (2009) Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Public Health 99(4):673–679. https://doi.org/10.2105/ajph.2008.143958

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hubbard RE, Searle SD, Mitnitski A, Rockwood K (2009) Effect of smoking on the accumulation of deficits, frailty and survival in older adults: a secondary analysis from the Canadian Study of Health and Aging. J Nutr Health Aging 13(5):468–472

    Article  CAS  Google Scholar 

  9. Lee JS, Auyeung TW, Leung J, Kwok T, Woo J (2014) Transitions in frailty states among community-living older adults and their associated factors. J Am Med Dir Assoc 15(4):281–286. https://doi.org/10.1016/j.jamda.2013.12.002

    Article  PubMed  Google Scholar 

  10. Chen LK, Hwang AC, Liu LK, Lee WJ, Peng LN (2016) Frailty is a geriatric syndrome characterized by multiple impairments: a comprehensive approach is needed. J Frailty Aging 5(4):208–213. https://doi.org/10.14283/jfa.2016.109

    Article  PubMed  Google Scholar 

  11. Shah M, Paulson D, Nguyen V (2017) Alcohol use and frailty risk among older adults over 12 years: the health and retirement study. Clin Gerontol. https://doi.org/10.1080/07317115.2017.1364681

    Article  PubMed  PubMed Central  Google Scholar 

  12. Strandberg AY, Trygg T, Pitkala KH, Strandberg TE (2017) Alcohol consumption in midlife and old age and risk of frailty: alcohol paradox in a 30-year follow-up study. Age Ageing. https://doi.org/10.1093/ageing/afx165

    Article  PubMed  Google Scholar 

  13. de Fiebre CM, Collins AC (1993) A comparison of the development of tolerance to ethanol and cross-tolerance to nicotine after chronic ethanol treatment in long- and short-sleep mice. J Pharmacol Exp Ther 266(3):1398–1406

    PubMed  Google Scholar 

  14. True WR, Xian H, Scherrer JF, Madden PA, Bucholz KK, Heath AC et al (1999) Common genetic vulnerability for nicotine and alcohol dependence in men. Arch Gen Psychiatry 56(7):655–661

    Article  CAS  Google Scholar 

  15. Jung HW, Yoo HJ, Park SY, Kim SW, Choi JY, Yoon SJ et al (2016) The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly. Korean J Intern Med 31(3):594–600. https://doi.org/10.3904/kjim.2014.331

    Article  PubMed  Google Scholar 

  16. Hwang HS, Kwon IS, Park BJ, Cho B, Yoon JL, Won CW (2010) The validity and reliability of Korean frailty index. J Korean Geriatr Soc 14(4):191–202

    Article  Google Scholar 

  17. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, Stone KL et al (2008) Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med 168(4):382–389. https://doi.org/10.1001/archinternmed.2007.113

    Article  PubMed  Google Scholar 

  18. Kyoung Jin K, Jinyoung S, Jaekyung C, Chang Won W (2018) Discrepancies in the prevalence of known frailty scales: Korean frailty and aging cohort study. Ann Geriatr Med Res 22(3):137–144

    Article  Google Scholar 

  19. Kang YWND, Hahn SH (1997) A validity study on the korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc 15(2):300–308

    Google Scholar 

  20. Jung IKKD, Joe SH, Lee HS (1997) A study of standardization of Korean Form of Geriatric Depression Scale (KGDS). J Korean Geriatr Psychiatry 1:61–72

    Google Scholar 

  21. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–M94

    Article  CAS  Google Scholar 

  22. Kim S, Kim M, Lee Y, Kim B, Yoon TY, Won CW (2018) Calf circumference as a simple screening marker for diagnosing sarcopenia in older Korean adults: the Korean frailty and aging cohort study (KFACS). J Korean Med Sci 33(20):e151. https://doi.org/10.3346/jkms.2018.33.e151

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ortola R, Garcia-Esquinas E, Leon-Munoz LM, Guallar-Castillon P, Valencia-Martin JL, Galan I et al (2016) Patterns of alcohol consumption and risk of frailty in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 71(2):251–258. https://doi.org/10.1093/gerona/glv125

    Article  PubMed  Google Scholar 

  24. Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G (2006) Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med 166(22):2437–2445. https://doi.org/10.1001/archinte.166.22.2437

    Article  PubMed  Google Scholar 

  25. Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S et al (2017) Factors influencing transitions between frailty states in elderly adults: the Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc 65(1):179–184. https://doi.org/10.1111/jgs.14515

    Article  PubMed  Google Scholar 

  26. Kojima G, Iliffe S, Walters K (2015) Smoking as a predictor of frailty: a systematic review. BMC Geriatr 15:131. https://doi.org/10.1186/s12877-015-0134-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Theou O, Cann L, Blodgett J, Wallace LM, Brothers TD, Rockwood K (2015) Modifications to the frailty phenotype criteria: systematic review of the current literature and investigation of 262 frailty phenotypes in the Survey of Health, Ageing, and Retirement in Europe. Ageing Res Rev 21:78–94. https://doi.org/10.1016/j.arr.2015.04.001

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by a grant of the Korea Health Technology R&D Project through the Korean Health Industry Development Institute (KHIDI), the Ministry of Health and Welfare, Republic of Korea (grant number: HI15C3153).

Author information

Authors and Affiliations

  1. Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea

    Jinyoung Shin, Kyoung Jin Kim & Jaekyung Choi

Authors
  1. Jinyoung Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kyoung Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaekyung Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jaekyung Choi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board (IRB) of Kyung Hee University Medical Centre, Seoul, Korea.

Informed consent

Informed consent was obtained from all individual participants included in this study. All participants provided written informed consent (IRB number: 2015-12-103).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shin, J., Kim, K.J. & Choi, J. Smoking, alcohol intake, and frailty in older Korean adult men: cross-sectional study with nationwide data. Eur Geriatr Med 11, 269–277 (2020). https://doi.org/10.1007/s41999-019-00271-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-019-00271-4

Keywords

Search

Navigation