Moderate drinking has been consistently linked with higher bone mineral density but not the risk of hip fracture. Researchers in this study analyzed the effect of alcohol consumption on this risk. They used data from a study of 5865 older adults from 4 U.S. communities, 1567 of whom underwent a scan to assess bone mineral density.

• During about 12 years of follow-up, 412 hip fractures occurred.
• Light-to-moderate drinkers had a lower risk of hip fracture than abstainers while heavy drinkers had a higher risk. Results for men and women were similar.
• Bone mineral density (in the older adults who underwent scans) of both the total hip and femoral neck increased as alcohol use increased.

Comments by James Harrison, MHS, CADC:
When individuals aged 65 and older enter treatment for substance use disorders, they should be evaluated medically for risk factors, including heavy alcohol use, associated with hip fracture. Further, during annual physical examinations, ways to help these patients reduce hip fractures, including preventing falls, should be addressed.

Comments by Julia H. Arnsten, MD, MPH, Associate Editor of Alcohol, Other Drugs, and Health: Current Evidence:
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.