Moderate Alcohol Intake and Risk of Functional Decline: The Health, Aging, and Body Composition Study

Authors

  • Cinzia Maraldi MD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Tamara B. Harris MD, MS,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Anne B. Newman MD, MPH,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Stephen B. Kritchevsky PhD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Marco Pahor MD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Annemarie Koster PhD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Suzanne Satterfield MD, DrPH,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Hilsa N. Ayonayon PhD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Renato Fellin MD,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • Stefano Volpato MD, MHP,

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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  • for the Health ABC study

    1. From the *Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, ItalyLaboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PennsylvaniaSticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina#Institute on Aging, University of Florida, Gainesville, Florida**University Of Tennessee Health Science Center, Memphis, Tennessee; and ††Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
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Address correspondence to Cinzia Maraldi, Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Via Savonarola 9, 44100, Ferrara, Italy. E-mail: mrlcnz@unife.it

Abstract

OBJECTIVES: To investigate the prospective relationship between alcohol consumption and incident mobility limitation.

DESIGN: Cohort study.

SETTING: The Health Aging and Body Composition study, conducted in Memphis, Tennessee, and Pittsburgh, Pennsylvania.

PARTICIPANTS: Three thousand sixty-one adults aged 70 to 79 without mobility disability at baseline.

MEASUREMENTS: Incidence of mobility limitation, defined as self-report at two consecutive semiannual interviews of any difficulty walking one-quarter of a mile or climbing stairs, and incidence of mobility disability, defined as severe difficulty or inability to perform these tasks at two consecutive reports. Alcohol intake, lifestyle-related variables, diseases, and health status indicators were assessed at baseline.

RESULTS: During a follow-up time of 6.5 years, participants consuming moderate levels of alcohol had the lowest incidence of mobility limitation (total: 6.4 per 100 person-years (person-years); men: 6.4 per 100 person-years; women: 7.3 per 100 person-years) and mobility disability (total: 2.7 per 100 person-years; men: 2.5 per 100 person-years; women: 2.9 per 100 person-years). Adjusting for demographic characteristics, moderate alcohol intake was associated with lower risk of mobility limitation (hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.55–0.89) and mobility disability (HR=0.66, 95% CI=0.45–0.95) than never or occasional consumption. Additional adjustment for lifestyle-related variables substantially reduced the strength of the associations (HR=0.85, 95% CI=0.66–1.08 and HR=0.81, 95% CI=0.56–1.18, respectively). Adjustment for diseases and health status indicators did not affect the strength of the associations, suggesting that lifestyle is most important in confounding this relationship.

CONCLUSION: Lifestyle-related characteristics mainly accounted for the association between moderate alcohol intake and lower risk of functional decline over time. These findings do not support a direct causal effect of alcohol intake on physical function.

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