Alcohol consumption and frailty risk: a dose-response meta-analysis of cohort studies

Abstract Background/aims While previous studies suggest that light-to-moderate alcohol consumption may reduce the frailty risk, the dose–response relationship is still under question. To address the knowledge gap, we conducted a systematic review and dose–response meta-analysis of cohort studies to examine the association of alcohol consumption with the risk of both prefrailty and frailty in adults. Methods We searched MEDLINE (Ovid), PubMed and Scopus to identify relevant cohort studies published before 8 May 2024. The dose–response meta-analysis was performed to investigate the associations between alcohol drinking and the risk of developing pre-frailty and frailty. We used random-effects models to calculate pooled relative risks (RR) with 95% CIs. Results We included nine cohort studies with 64 769 participants and 15 075 cases, of which eight studies were rated to have a serious risk of bias as assessed by the ROBINS tool. Based on our analysis, each 12 g increase in alcohol intake did not appear to be associated with risks of prefrailty (RR: 1.08, 95% CI 0.89, 1.31; I2 = 91%, n = 3; GRADE = very low) and frailty (RR: 0.94, 95% CI 0.88, 1.00; I2 = 63%, n = 9; GRADE = low). The nonlinear dose–response meta-analysis indicates a slight inverse association with frailty risk up to an alcohol intake of 20 grams per day, beyond which an upward trend is observed. Conclusion The inverse association found between moderate alcohol consumption and frailty risk appears to be stronger among older adults, which might be due to the lower and less popular alcohol consumption among older people than the general population. However, because this finding is based on low-quality evidence, more research is needed to develop specific dietary recommendations for alcohol consumption, particularly among young people.