| Aim: Functional limitations are common physical function impairment in older adults,which are associated with numerous adverse health outcomes,such as loss of independence,depression,dementia and even death.According to Eurostat,more than two thirds of Europeans aged 65 or over suffered from physical and sensory functional limitations.Moderate alcohol consumption has been consistently linked to lower risk of functional limitations in older adults.But dose-response analyses of these relationships are insufficient.Additionally,it is now evident that moderate alcohol consumption is associated with greater hand grip strength,and grip strength could predict almost all kinds of functional limitations.If,in fact,moderate alcohol consumption is associated with lower risk of functional limitation,does the protective role of alcohol consumption in muscle strength contribute to this association? Here we conducted a cross-sectional study using a large,population-based sample to evaluate the dose-response relationships between alcohol consumption and functional limitations in older European men,and determine whether muscle strength may mediate these relationships.Method: Data was from the Survey of Health,Ageing and Retirement in Europe(SHARE,2015),Wave 6.SHARE is a biennial longitudinal survey of the aging process in individuals aged 50 and older in most European Union countries and Israel.Considering the gender difference of alcohol consumption,as well as the onset age of functional limitation,we selected the male adults aged 65 years and older in this study.Participants were asked if they had difficulty or inability to complete the listed ten activities in daily life.Three domains of physical function including mobility,arm function and fine motor and total functional limitation were assessed in SHARE.The alcohol consumption was measured by the units' number of alcoholic beverages consumed during last 7 days,ranging from 0 to 70.Grip strength was measured as mediator using a dynamometer.Restricted cubic splines analyses were to explore dose-response relationships between alcohol consumption and each functional limitation domain and grip strength.Binary logistic regression was fitted to test the associations of grip strength with each functional limitation domain.Karlson/Holm/Bree(KHB)methods were conducted to test grip strength as a mediator in the associations of alcohol consumption with each functional limitation domain.All models were adjusted for the potential confounders,including region,age,marriage status,educational level,BMI,physical activity,depression,cigarette smoking,heart attack,hypertension,diabetes,rheumatoid arthritis and osteoporosis.Results: A total of 13,144 men aged 65 years or over were included in this study.Doseresponse analyses revealed that moderate alcohol consumption of ? 32 units/week was related to lower odds of reporting mobility limitation and arm function limitation,with a minimum odds ratio(OR)of 0.75(95%CI:0.64-0.89)occurring at 12 units/week drinks for mobility limitation and 0.68(95%CI: 0.59-0.79)occurring at 10 units/week drinks for arm function limitation.When the alcohol consumption was up to 16 units/week,the odds of fine motor limitation monotonically increased with alcohol consumption.Binary logistic regression models showed that after adjusting for all the potential confounders,the participants with functional limitations had lower grip strength than the normal participants.Compared with no alcohol consumption,the mediation effect of grip strength was not statistically significant for mobility limitation(OR=0.943,95%CI: 0.787-1.129)and arm function limitation(OR=0.937,95%CI: 0.768-1.143),with approximately 23.85% and 19.05% of the total effect being mediated,respectively.Sensitivity analysis results showed that the results of this study were relatively stable and high reliability.Conclusion: our results show that moderate alcohol consumption of ?32 units/week is associated with lower odds of reporting mobility and arm function limitation in older European men.Grip strength is not the main mediator of these associations shows that the protective effect is independent of muscle strength.The odds of reporting fine motor limitation rise with increasing levels of alcohol consumption when the alcohol consumption is up to 16 units/week. |
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