Smoking, alcohol consumption, and risk of recurrent falls in community-dwelling Japanese people aged 40-74 years: The Murakami cohort study.

Aim: Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people.

Methods: Participants of this cohort study were 7542 community-dwelling Japanese people aged 40-74 years. The baseline self-administered questionnaire survey was conducted in 2011-2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history.

Results: The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted P for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20-3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57-4.81), suggesting a potential interaction (P for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150-299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33-0.98) compared with no consumption in men.

Conclusions: Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. Geriatr Gerontol Int 2025; 25: 67-74.