Alcohol Use, Bone Density, and Hip Fractures in Older Adults

Moderate drinking has been consistently linked with higher bone mineral density but not hip fracture risk. Researchers in this study analyzed the impact of alcohol consumption on hip fracture risk using data from a study of 5865 adults aged 65 and older from 4 U.S. communities.

All participants had reported their alcohol use yearly and had their hospital records examined for hip fracture diagnoses. A subgroup of 1567 in 2 communities underwent a single scan to assess bone mineral density (BMD).

• During about 12 years of follow-up, 412 hip fractures occurred.
• In analyses adjusted for potential confounders (e.g., age, sex, weight), light-to-moderate drinkers had a lower risk of hip fracture than abstainers while heavy drinkers had a higher risk (e.g., hazard ratio [HR], 0.9 for 1–6 drinks per week, 1.3 for ≥14 drinks per week; P for trend=0.02).
• Results for men and women were similar.
• Among participants who underwent scans, BMD of both the total hip and femoral neck increased as consumption increased. 

Comments:

Among older adults, alcohol consumption has a U-shaped relationship with hip fracture risk but a graded positive relationship with bone mineral density of the hip. This suggests that the higher hip fracture risk among heavier drinkers may be due to unmeasured, non-BMD factors. For example, this study did not directly examine fall incidence, which may have been associated with both alcohol consumption and hip fracture risk.

Julia H. Arnsten, MD, MPH

Reference:

Mukamal KJ, Robbins JA, Cauley JA, et al. Alcohol consumption, bone density, and hip fracture among older adults: the Cardiovascular Health Study. Osteoporos Int. 2007;18(5):593–602.