SMOKING, ALCOHOL, AND NEUROMUSCULAR AND PHYSICAL FUNCTION OF OLDER WOMEN

Objective.-To determine the associations of current and lifetime smoki ng and alcohol use with physical function in an older population. Desi gn.-Survey. Setting.-Four clinic centers in the United States. Partici pants.-A total of 9704 community-dwelling, ambulatory white women 65 y ears or older recruited from four areas of the United States. Main Out come Measures.-Twelve performance tests of muscle strength, agility an d coordination, gait and balance, and self-reported functional status. Results.-Compared with women who never smoked, current smokers had si gnificantly poorer function on all of the performance measures except grip strength after adjusting for age, history of stroke, body mass in dex, clinic site, physical activity, and alcohol use (P<.05). This dec rease in function was 50% to 100% as great as that associated with a 5 -year increase in age, and most measures worsened with increasing numb ers of pack-years. Compared with current moderate drinkers, nondrinker s had significantly poorer function on all of the performance measures except tandem walk (P<.05). Evaluation of a dose effect with alcohol was limited by the small number of heavy drinkers in the study. Conclu sions.-In this population, women who currently smoke are weaker and ha ve poorer balance and poorer performance on measures of integrated phy sical function than nonsmokers. Smoking is associated with a decline i n physical function. Current moderate drinkers have better physical fu nction compared with nondrinkers, but associations of function with he avy drinkers could not be assessed.