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How Alcohol Affects Us as We Age

Why it matters that older adults are drinking more than ever

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You don't have to go to Margaritaville to see people in their 60s and older having nightly rounds of pungent cocktails. Heavier drinking is on the rise among older Americans.

Surveys of about 40,000 U.S. adults taken in 2001-2002 and again in 2012-2013 revealed that the percentage of adults 65 and over who drank shot up by 22 percent — the biggest jump of any age group. High-risk or “binge” drinking, defined as more than five drinks in a sitting for men and four in a sitting for women at least weekly during the previous 12 months, rose a whopping 65 percent. The 2017 study published in the journal JAMA Psychiatry reported that older adults with diagnosed alcohol use disorders had skyrocketed 107 percent.

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Today more than 10 percent of adults 65 and older are binge drinkers, according to a 2019 study of nearly 11,000 U.S. adults published in the Journal of the American Geriatrics Society.

Retirement can lead to more drinking

Why are so many older adults tossing back a few cold ones? It's in part because there are more older adults, including lifelong drinkers, living longer, and they bring their alcohol use — and sometimes alcohol abuse — with them into their later years, says Marc Agronin, M.D., senior vice president for Behavioral Health at Miami Jewish Health.

"There are more older people in general,” Agronin says. “And because of medicine, people are able to mitigate to some extent the impact of alcohol better than they could in the past."

People also sometimes start drinking more with retirement, which brings more time and opportunity, says Jeffrey Johnson, an addiction medicine specialist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois.

"They used to drink after work or in social settings with friends in the evenings. But now they're retired, and they have more time and they just end up drinking earlier and more,” Johnson notes.

The problem is that alcohol also becomes more toxic with age. So if you're drinking more — or even if you're just drinking the same amount — you can start having problems, says Lawrence Ferber, director of Behavioral Health Central Intake Services for Catholic Health Services of Long Island.

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"One common myth has been that older people can consume more alcohol without any negative effect,” Ferber says. “The truth is that there is no specific age where it's okay for you to be consuming mass amounts of alcohol, and aging actually lowers the body's tolerance for alcohol."

As we age, we lose muscle mass. We also typically have less water in our body. That means an older person who drinks the same as a younger person, or the same as they did in their younger years, will generally have a higher blood alcohol concentration, Ferber says. “That puts more older adults at higher risks for falls, car crashes and other unintentional injuries that may result from drinking.”

Older adults also process alcohol more slowly, says Johnson. “The liver is the primary organ that detoxes alcohol. It's also responsible for processing medications, and performs important jobs like recycling iron from the bloodstream and manufacturing proteins and other important things the body needs. As it ages, it has less capacity for all the work it has to do.” (Women are particularly vulnerable to liver disease and other alcohol-related health problems. For more see “Get the Facts on Women and Alcohol.")

Alcohol can wreak havoc with so many prescription and over-the-counter medications, says Ferber, and “also exacerbates common health problems many older adults are taking medications for, like high blood pressure and heart disease.”

‘Low-risk’ drinking? 

Some studies have claimed that a drink-a-day habit comes with some pretty impressive health benefits, including a lower risk of heart disease and a longer life. But those findings are up for debate. “People who drink one drink a day or one drink every other day, at that level, have a higher socio-economic status,” says Richard Saitz, primary care internist and professor at Boston University Schools of Medicine and Public Health. “They're more likely to get mammograms, more likely to do regular physical activity, have healthier diets and live in better zip codes.” (Put another way: Benefits may be more attributable to the Mediterranean diet that may accompany daily wine drinking.)

And if you think drinking will help you sleep, know this: While you might drift off more easily, alcohol interferes with mentally restorative REM sleep. And deep sleep — which rejuvenates the body and leaves you feeling refreshed in the morning — is likely to be disrupted and your snooze time will be shorter once the alcohol wears off.

The bottom line: An occasional drink is fine, but don't kid yourself that it's medicinal. “As a cardiologist, I don't prescribe a drink a day,” says Nieca Goldberg, senior advisor, Women's Health Strategy at NYU Langone Health. “A better, safer way to improve your heart health is to go to the gym and eat a healthy diet.”

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