A longitudinal study of alcohol consumption and functional disability in a community sample of older people

Objective: To examine the association between alcohol consumption and incident functional disability in community-living older people after adjustment for other risk factors. Method: Randomly sampled community-living people aged 75 years and older from the inner western suburbs of Sydney underwent a clinical interview and medical examination by a physician experienced in geriatric medicine. This was repeated three years later. The examination included an assessment of functional disability and chronic systemic and neurodegenerative illnesses and impairments. Self-reported alcohol consumption was recorded. The relationship between alcohol consumption and incident disability was examined by logistic regression analysis. Results: Cross-sectional analysis at the first wave showed that those who did not drink were more likely to be disabled than drinkers (39.3% and 30.4% respectively, p = 0.032). Although 11.3% were drinking at hazardous or harmful levels there was no concurrent association between disability and hazardouslharmful drinking. Incident disability between waves did not differ between non-drinkers at the first wave and those who drank at nonhazardouslharmful levels (35.3 % and 29.3 % disabled respectively, p=0.306). However 80% of those who drank at hazardouslharmful levels experienced incident disability as compared with 32.5% among non-drinkers and non-hazardouslharmful drinkers combined (p<O.OOl). Logistic regression showed that, among the risk factors examined, hazardouslharrnful consumption had by far the strongest effect with an adjusted odds ratio of 12.9 (9S% CI 3.1-53.9). Conclusion: Alcohol consumption at defined hazardouslharrnful levels is a major independent risk factor for incident functional disability in older people.