Is there a relationship between excessive drinking and functional impairment in older persons?

OBJECTIVES: To investigate the relationship between (1) two thresholds of excessive alcohol drinking, (2) binge drinking, and (3) impairments in functional status in older drinkers.
DESIGN: Cross-sectional study.
SETTING: Ten internal medicine practices affiliated with an academic medical center. PARTICIPANTS: One hundred sixty-one persons aged 60 and older who reported drinking one or more drinks in the previous 3 months. MEASUREMENTS: Two commonly used thresholds of excessive drinking: (1) eight to 14 drinks per week for women and men (lower threshold) and (2) more than 14 drinks per week for women and men (higher threshold); a measure of binge drinking (> or =3 drinks per occasion for women or > or =4 drinks per occasion for men); and self-reported instrumental activities of daily living (IADLs) and advanced activities of daily living (AADLs).
RESULTS: Compared with older persons consuming seven or fewer drinks per week, those exceeding the higher threshold of excessive drinking were more likely to have impairments in IADLs (adjusted odds ratio (AOR) = 8.4) and, to a lesser extent, AADLs (AOR = 3.7); those exceeding the lower threshold were more likely to have impairments in IADLs (AOR 5 6.0) but not in AADLs (AOR = 1.7). Binge drinkers were also more likely to have impairments in IADLs (AOR = 3.0) but not in AADLs (AOR = 1.5).
CONCLUSIONS: In this group of older men and women, drinking more than seven drinks per week was associated with impairments in IADLs and, to a lesser extent, AADLs. Drinking more than three drinks per occasion was associated with impairments in IADLs.