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Heavy drinking and smoking lead to visible premature ageing

Biological ageing not linked to light/moderate drinking

Adrian O'Dowd

Thursday, 16 November 2017

People who drink heavily and smoke are more likely to show visible signs of physical ageing and look older than their actual age, suggests research* published online today in the Journal of Epidemiology & Community Health.

Danish researchers based their findings on information from more than 11,500 adults, whose heart health and visible ageing signs were tracked for an average of 11.5 years as part of the Copenhagen City Heart Study.

Looking old for one’s age is associated with poor health, cardiovascular disease and early death, implying that biological age, to some extent, can be observed visually.

Researchers from the University of Southern Denmark in Copenhagen, set out to investigate whether alcohol and smoking were associated with four visible age-related signs.

They used data gathered on 11,613 individuals who took part in the Copenhagen City Heart Study. This study, which started in 1976, has been monitoring a random sample of Danish people over the age of 20 living in the Copenhagen area in 1981-3, 1991-4, and in 2001-03.

Alcohol intake, smoking habits and other lifestyle factors were assessed prospectively and visible age-related signs were inspected during subsequent examinations.

The age-related signs were arcus corneae (a greyish opaque coloured ring or arc around the peripheral cornea of both eyes); xanthelasmata (yellow-orange plaques on the eyelids); earlobe crease; and male pattern baldness.

Average alcohol consumption was 2.6 drinks per week for women and 11.4 for men. Just over half the women (57%) and around two thirds of the men (67%) were current smokers.

Arcus corneae was the most common sign of ageing among both sexes, with a prevalence of 60% among men over 70 and among women over 80. The least common sign was xanthelasmata, with a prevalence of 5% among men and women over 50. A receding hairline was common among men, with 80% of those over the age of 40 affected.

Analysis of drinking and smoking patterns revealed a consistently heightened risk of looking older than one’s true age and developing arcus corneae, earlobe creases, and xanthelasmata among those who smoked and drank heavily.

One example was data showing that compared with a weekly alcohol intake of up to seven drinks, a tally of 28 or more was associated with a 33% heightened risk of arcus corneae among the women, and a 35% heightened risk among men who consumed 35 or more drinks every week.

Similarly, compared with not smoking, smoking one pack of 20 cigarettes daily for between 15 and 30 years was associated with a 41% heightened risk among women and a 12% heightened risk among men.

The occurrence of the visible signs of ageing was no different among light to moderate drinkers than it was among non-drinkers, the analysis showed.

This was an observational study so no firm conclusions can be drawn about cause and effect, particularly as the data on smoking and drinking relied on personal recall, which is subject to bias.

Nevertheless, the researchers concluded: “This is the first prospective study to show that alcohol and smoking are associated with the development of visible age-related signs and thus generally looking older than one’s actual age. This may reflect that heavy drinking and smoking increases general ageing of the body.”


* Schou AL, Mølbak M-L, Schnor P, et al. Alcohol consumption, smoking and development of visible age-related signs: a prospective cohort study. J Epidemiol Community Health 2017;71:1177-1184. DOI:10.1136/jech-2016-208568

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