Does Drinking Increase the Risk of Falls and Fractures in Older Men?

Alcohol use may influence the risk of bone fracture through its effects on bone mineral density (BMD) and fall risk. To examine this possibility, researchers assessed alcohol use and BMD at baseline, falls over about 1 year, and fractures over about 4 years in 5974 men aged 65 or older. Analyses were adjusted for potential confounders (e.g., age, weight, height).

• BMDs of the femoral neck, total hip, and lumbar spine were slightly greater in moderate and heavier drinkers than in nondrinkers and in subjects with, versus without, current binge drinking. Femoral neck and lumbar spine BMDs were also greater in subjects who ever had problem drinking.*

• The risk of >2 falls over 1 year was lower in moderate drinkers than in nondrinkers (relative risk [RR] 0.8). Risk was higher, however, in subjects with, versus without, a history of binge drinking on most days or problem drinking (RRs 1.4 and 1.6, respectively). Drinking heavier amounts or current binge drinking did not affect risk.

• Incident fractures were not significantly associated with any of the drinking measures.

Comments:

In this large cohort of older men, drinking appeared to influence the risk of falls but not fractures. It is unknown whether the small increase in bone mineral density associated with alcohol use protects against fractures. Still, fall risk should be carefully assessed in older men who drink, especially those with a history of binge or problem drinking.

Kevin L. Kraemer, MD, MSc

Reference:

Cawthon PM, Harrison SL, Barrett-Connor E, et al. Alcohol intake and its relationship with bone mineral density, falls, and fracture risk in older men. J Am Geriatr Soc. 2006;54(11):1649–1657.