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

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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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 http://www.chs-nhlbi.org.

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Authors and Affiliations

  1. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA

    K. J. Mukamal

  2. Division of General Medicine, University of California at Davis Medical Center, Sacramento, CA, USA

    J. A. Robbins

  3. Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA

    J. A. Cauley

  4. Departments of Public Health and Medicine, Weill Medical College of Cornell University, New York, NY, USA

    L. M. Kern

  5. Department of Medicine, University of Washington, Seattle, WA, USA

    D. S. Siscovick

  6. Department of Epidemiology, University of Washington, Seattle, WA, USA

    D. S. Siscovick

  7. Beth Israel Deaconess Medical Center, General Medicine and Primary Care Research Program, 1309 Beacon Street, 2nd Floor, Brookline, MA 02446, USA

    K. J. Mukamal

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  1. K. J. Mukamal
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  2. J. A. Robbins
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  3. J. A. Cauley
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  4. L. M. Kern
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  5. D. S. Siscovick
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Corresponding author

Correspondence to K. J. Mukamal.

Additional information

Funding: NIH contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01-HC-45133, N01-HC-75150 and N01- HC-15103, and intra-agency agreements Y02-AG-4-0251 and 1-Y02-HC-40205.

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Mukamal, K.J., Robbins, J.A., Cauley, J.A. et al. Alcohol consumption, bone density, and hip fracture among older adults: the cardiovascular health study. Osteoporos Int 18, 593–602 (2007). https://doi.org/10.1007/s00198-006-0287-7

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