Hu, Y; (2015) The Role of Alcohol Consumption on Physical Functioning in Middle-aged and Older Adults in Central and Eastern Europe. Doctoral thesis , UCL (University College London).

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Abstract

Background: Among middle-aged and older adults, light-to-moderate drinkers appear to have better physical functioning than non- and heavy drinkers. The cross-sectional association may be confounded by former drinking. Longitudinal evidence on alcohol consumption and future changes in physical functioning is sparse. Objective: To investigate the role of alcohol consumption and physical functioning in Central and Eastern Europe (CEE), a region characterised by relatively poor health status and high alcohol consumption. Study design: Cross-sectional and longitudinal analyses of a study of 28,783 men and women aged 45–69 years randomly selected from population registers in Novosibirsk (Russia), Krakow (Poland) and seven towns of Czech Republic, with approximately 10 years of follow-up. Methods: At baseline, alcohol consumption in the past 12 months was measured by a graduated frequency questionnaire, and problem drinking was assessed by the CAGE questionnaire. In the Russian cohort, past drinking behaviour was also assessed. Physical functioning at baseline and at three subsequent occasions was measured by the PF-10 subscale of the Short-Form-36 (SF-36) instrument. Results: In cross-sectional analyses of the baseline data, the odds of physical limitations (PF-10 score<75% of maximum) were highest among non-drinkers, decreased with increasing drinking frequency, drinking volume and average drinking quantity, and were not associated with problem drinking. In the Russian cohort with data on past drinking, increased odds of physical limitations were found in subjects who stopped or reduced drinking for health reasons. In longitudinal analyses, using 10-year follow-up data, alcohol consumption and problem drinking at baseline was not consistently associated with the rate of decline in physical functioning. Conclusions: The excess risk of physical limitations in non-drinkers at baseline was partly explained by ‘sick quitters’, and the apparently protective effect of heavier drinking was partly due to less healthy former heavy drinkers moving to lower drinking categories. The lack of longitudinal association between alcohol consumption indices and the rate of decline in physical functioning may be due to methodological limitations; however, the possibility cannot be excluded that my findings reflect a genuine absence of an effect.

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