Critique 251: Does moderate drinking increase, or decrease, the risk of falls in middle aged or elderly adults? 2 October 2021

Tan GJ, Tan MP, Luben RN, Wareham NJ, Khaw K-T, Myint PK.  The relationship between alcohol intake and falls hospitalization: Results from the EPIC-Norfolk.  Geriatr Genontology Int 2021;21:657-663.

Authors’ Abstract

Aim: To evaluate the relationship between habitual alcohol consumption and the risk of falls hospitalization.

Methods: The EPIC-Norfolk is a prospective population-based cohort study in Norfolk, UK. In total, 25,637 community dwelling adults aged 40–79 years were recruited. Units of alcohol consumed per week were measured using a validated Food Frequency Questionnaire. The main outcome was the first hospital admission following a fall.

Results: Over a median follow-up period of 11.5 years (299 211 total person years), the cumulative incidence function (95% confidence interval) of hospitalized falls at 121–180 months  or non-users, light (>0 to ≤7 units/week), moderate (>7 to ≤28 units/week) and heavy (>28 units/week) were 11.08 (9.94–12.35), 7.53 (7.02–8.08), 5.91 (5.29–6.59) and 8.20 (6.35–10.56), respectively. Moderate alcohol consumption was independently associated with a reduced risk of falls hospitalization after adjustment for most major confounders (hazard ratio = 0.88; 95% confidence interval 0.79–0.99). The relationship between light alcohol consumption and falls hospitalization was attenuated by gender differences. Alcohol intake higher than the recommended threshold of 28 units/week was associated with an increased risk of falls hospitalization (hazard ratio 1.40 [1.14–1.73]).

Conclusions: Moderate alcohol consumption appears to be associated with a reduced risk of falls hospitalization, and intake above the recommended limit is associated with an increased risk. This provides incentive to limit alcohol consumption within the recommended range and has important implications for public health policies for aging populations.

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