Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study.
Stephanie A Ruderman, Lydia N Drumright, Joseph A C Delaney and 24 others
PMID 38150572WHAT IT FOUND
People with HIV who became frail were more likely to quit or reduce drinking than those who were not frail.
This suggests poor health drives reduced alcohol use, meaning past drinking habits may distort studies linking alcohol to frailty risk.
Key findings
01Frailty was associated with a 56% greater probability of quitting drinking and a 35% greater probability of reducing drinking frequency compared to not being frail.
02Frailty was also associated with a 58% greater probability of reducing heavy episodic drinking frequency, though the association with quitting heavy episodic drinking was not statistically significant.
03The association between frailty and reduced drinking was generally null among people who reported only rare drinking at baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used categorical self-report data for alcohol use, lacking granularity on exact drinks per day or frequency. The cohort consisted of PWH who reported drinking, which may not reflect all PWH in care (e.g., those who do not drink at all). The study could not effectively subgroup by sex or race/ethnicity to evaluate interactions. As an observational study, unmeasured confounders such as socioeconomic status may have influenced the results. Frailty status was carried forward from the last assessment if not updated, which may have introduced some misclassification.
Declared interests
H.M. Crane has served as an advisor for ViiV and Gilead. E. Cachay has served on an advisory board for Teratechnologies. All other authors reported no conflicts.
The easy way to misread this
Do not interpret the reduction in alcohol use among frail patients as evidence that quitting alcohol causes frailty, or that alcohol is protective. The study suggests that poor health (frailty) causes people to stop drinking, creating a 'sick quitter' bias that can distort the true relationship between alcohol and health outcomes.