Why Age and Alcohol Don’t Mix

Dehydration is a factor in hangovers

And what about my more severe hangovers? Those are partly from dehydration, a common condition among older people, sober or not. (Our sense of thirst, funnily enough, is dulled with age.) Alcohol pulls water from your body, hence my cotton mouth and headache.

I ask Koob if just drinking more water would dilute the alcohol in my system. Nope. “You’re just going to pee more,” he informs me. Staying hydrated may help limit a blood-alcohol surge, he says, but the physiology of aging will prevail. And the old trick of alternating drinks with something nonalcoholic can help you pace yourself, he adds. But that system may indicate you’re still planning on drinking too much in one session and risking harm to your liver.

How much is too much booze?

The old standby maximum of 14 drinks per week for men and seven for women is still a solid guide, though emerging research finds that really no amount of alcohol is safe for our health. Drinking at levels beyond that “accelerates some of the aging process” in the brain, Koob says. Our brains normally start shrinking in middle age, but older people who drink too much show marked loss of volume in the frontal cortex, a 2018 study found.

The frontal cortex controls our executive function, Koob explains. Impulsive and compulsive behavior can be affected and lead to alcohol misuse. It’s a vicious circle: Alcohol misuse can speed up aging, and that aging process can lead to more alcohol misuse.

Koob estimates there are 200 medical conditions that are worsened by alcohol, including the obvious, such as liver disease, as well as some not so obvious, like cancers, especially oral cancers. Others include high blood pressure, immune system disorders, stroke risk and diabetes.

Alcohol even contributes to wrinkles by impairing your skin’s antioxidant defense system.

And the notion that alcohol helps us sleep is bass-ackward — it may make us drowsy, but it wrecks the quality of our sleep.

When to dial back your drinking

I’ve always been healthy and fit, and I kid myself that a little poison can’t hurt me. But by pushing the 14-a-week limit at my age, I’m also pushing my luck.

I don’t want any of those problems, so I have joined the ranks of the “sober curious,” a newish term that essentially means being both thoughtful and challenging of your drinking impulses. As a guide, Koob suggests abstaining for a certain period to see how it feels. “If you feel better when you’re not drinking, your body is telling you something.”

It’s true that I sleep better and feel better on mornings after abstaining. My drinking — mostly beer in the summer and wine in cooler months — tends to be mindless and habitual. Which is why the “mindful drinking” movement appeals to me. Make it less of a habit and more of an event. Ideally when I drink, I’ll pause and ponder the intriguing viognier in my glass before raising it to my lips. I’ll savor it.

Rosamund Dean, in her book, Mindful Drinking: How to Break Up With Alcohol, suggests carefully counting how many drinks you have — and noting where, when and why the imbibing happens. There is, she suggests, a middle ground.

“So while we don’t want to give up drinking altogether,” she writes, “we do want to wake up clearheaded because we were able to resist that third glass of wine the night before.”

Sounds like a plan.

Editor's note: This story, originally published March 04, 2022, has been updated to reflect new information.