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Alcohol and Aging: Here’s What You Need To Know

Medically reviewed by Dr. Po-Chang HsuNovember 2, 2024
Written by
On November 2, 2024

Table of Contents

Key Points

  • Aging lowers one’s alcohol tolerance and increases health risks.
  • Alcohol and medication interactions can cause significant side effects, including death.
  • Alcohol impacts older adults' coordination, balance, and cognitive performance more than it does in young adults.
  • Before using alcohol, older adults should speak to their healthcare provider, especially if they are on medications.
  • Older adults should weigh the risks and benefits of consuming alcohol and be aware of the potential health risks.
  • Should older adults choose to consume alcohol, it should be done in moderation.

Alcohol impacts older adults more than it does younger adults. This is due to changes in the body as it ages, which lowers one’s tolerance. This increases the older adults’ risk for falls, accidents, and injuries. Many older adults take medications to help with health conditions, and many of these medications can interact negatively with alcohol. Before taking any medications, older adults should verify if it is safe to take with alcohol. Moderate to high levels of alcohol consumption are linked to increased risk for several health conditions, including diabetes, cardiovascular disease, cancer, and cognitive decline.

Alcohol and Older Adults

The older adult population is rapidly growing in the United States. Alcohol use among older adults is also growing. According to the National Survey on Drug Use and Health, approximately 20 percent of adults aged 60-64 and 12 percent (7.0 million people) over age 65 report current binge drinking.[1] 4.6% (2.7 million people) over 65 met the criteria of having alcohol use disorder. 43.7% (25.3 million people) over 65 reported drinking alcohol in the past month.[2]   

There is an increase in alcohol use among the population of adults over the age of 65 when compared to previous generations of older adults. One study found that contributing factors to high alcohol consumption were loneliness, anxiety, and depression.[3]  These are mental health issues that are common among older adults and call attention to the need for social connection across the lifespan.

Aging and Alcohol Tolerance

Older adults are generally more sensitive to alcohol. Aging lowers the body’s tolerance for alcohol, resulting in older adults feeling its effects more quickly compared to when they were younger.

One reason for the change in tolerance is that as people age, the amount of water in their bodies declines with an increase in the proportion of body fat.[4] Reduced body water content results in higher blood alcohol concentrations (BAC) and a higher level of intoxication.

Alcohol impacts older adults’ coordination, balance, and cognition more than it does younger adults.[5] Many older adults already struggle with mobility and/or cognitive difficulties. Adding alcohol into the mix exacerbates these problems if the person is already struggling with them.

The danger with this decreased tolerance is when the person does not realize it has changed, placing them at increased risk for falls, car crashes, and other unintentional injuries.

Health Risks for Older Adults Consuming Alcohol

Consuming alcohol, especially at high levels or over a long period of regular use, increases the health risks anyone can experience. However, older adults are more susceptible to these due to body changes and medications used.  

Medication Interactions

Older adults are at a high risk of dangerous alcohol intake and medication interactions. Many prescription and over-the-counter medications, as well as supplements, can have harmful and even fatal side effects when mixed with alcohol.[6]  Older adults are more likely to take medications, especially medications that have negative interactions with alcohol. Many of them take multiple medications. 

Common medications that have negative interactions when combined with alcohol include[7] 

  • Aspirin: Drinking while taking aspirin increases your risk of stomach and gastrointestinal bleeding.
  • Acetaminophen: Taking acetaminophen at high doses or over a long period while also using alcohol can cause liver damage. 
  • Cold and allergy medicine: mixing alcohol with antihistamines increases drowsiness.
  • Cough syrup: some cough syrups already contain alcohol. Drinking alcohol in addition to the alcohol in the cough syrup will compound the alcohol’s effects. 
  • Sleeping pills: can increase sleepiness and sedative effects, which can be deadly. 
  • Pain medication: increased risk for stomach ulcers, GI bleeding, drowsiness, suicidal thoughts, overdose, and death. 
  • Anxiety or depression medicine: potential higher risk of overdose, drowsiness, dizziness, suicidal thoughts, and decreased effectiveness of the medication. 

 

Before taking any medications or supplements, talk to your healthcare provider or pharmacist to determine if you can safely drink alcohol or if you should avoid it. 

Health Problems

Certain health problems are common among older adults, and consuming alcohol can make them worse. Some of these health problems that are worsened by alcohol include[8] 

Diabetes: Alcohol can cause blood sugar levels to be too high or too low. It can reduce the effectiveness of some diabetes medications. Alcoholic drinks tend to be high in calories and contribute to weight gain. 

Cardiovascular disease: Among adults over the age of 65, cardiovascular disease is one of the leading causes of death, and alcohol is one of the biggest contributing factors to cardiovascular disease. Alcohol use is linked to multiple cardiovascular health problems, including high blood pressure, stroke, heart attack, cardiomyopathy, and atrial fibrillation. Many of these health conditions can be eliminated with avoidance of alcohol. 

Cognitive decline: Drinking more than two servings of alcohol a day has been linked to cognitive decline. Alcohol use disorder is linked to a decrease in grey matter impacting multiple areas of the brain. This decline increases if alcohol has been combined with other substance use.  Alcohol use dementia, Alzheimer’s disease, and Wernicke-Korsakoff (WK) syndrome are serious brain conditions that can impact memory, movement, language, sleep, and vision. Long-term complications can lead to death. 

Increased risk of cancer: Consuming alcohol increases one’s risk of cancer. Alcohol is linked to cancers of the mouth, oropharyngeal, laryngeal, esophageal, female breast, colorectal, and liver. The more alcohol one consumes, or the longtime alcohol consumption, appears to increase one’s risk of developing cancer substantially.

Support for Older Adults with Alcohol Use Disorder

If you believe you or a loved one is struggling with moderating their alcohol use, talk to your healthcare provider or seek alcohol rehab. There are numerous treatment programs available that can support your recovery process. With proper treatment and support, many health problems can be reversed, or their progression can be halted or slowed. Many programs are free, such as AA support groups. Many treatment programs accept insurance and will be free of charge to you.

Medical Content Writer

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

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Frequently Asked Questions About Alcohol and Aging

The Department of Health and Human Services and the Department of Agriculture developed dietary guidelines recommending what a person should eat and drink to promote health and prevent chronic disease. To help older adults minimize risks associated with drinking, the dietary guidelines state that older adults can choose not to drink or limit intakes to two drinks or less in a day for men and one drink or less in a day for women.[9]

When should older adults avoid alcohol completely?
Older adults should avoid drinking alcohol completely when they:

  • Participate in activities that require skill, coordination, and alertness. Including driving or operating machinery.
  • Take certain over-the-counter or prescription medications or supplements that interact with alcohol.
  • Have a medical condition that is worsened by alcohol.
  • They are unable to control the amount of alcohol they drink.
  • Are recovering from alcohol use disorder.

There is conflicting research in this area. Some research supports that limited amounts of alcohol may be beneficial for heart health. However, the tipping point for each individual, which shifts from beneficial to increasing one’s risk of cardiovascular disease, is unclear. All research does support that anything over the dietary guidelines increases one’s risk of health problems.

Some steps to reduce or eliminate alcohol use include:

  • Be aware of how much you are currently drinking and cutting back slowly (ex., If you are having four drinks a day now, try and make it three over the next week).
  • If you are drinking every day, pick a day where you will skip drinking that week.
  • Instead of alcohol, try non-alcoholic drinks such as non-alcoholic beer or mocktails, juice, soda, or sparkling water.
  • Remove alcohol from your home so you won’t be tempted to have a drink.
  • Know your triggers. Are they specific people or places? Do you need to avoid them while you work on cutting back?
  • Get support from your friends and family, from your healthcare provider, and find a support group such as AA.

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[1,9] National Institute on Alcohol Abuse and Alcoholism. (n.d.-b). Older adults and drinking. U.S. Department of Health and Human Services. Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/older-adults on 2024, Oct 18.

[2] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol and older adults ages 65+. U.S. Department of Health and Human Services. Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-and-older-adults-ages-65 on 2024, Oct 18.

[3,4,5,8] White, A. M., Orosz, A., Powell, P. A., & Koob, G. F. (2023). Alcohol and aging – An area of increasing concern. Alcohol, 107, 19-27. Retrieved from https://www.sciencedirect.com/science/article/pii/S0741832922000660 on 2024, Oct 18.

[6,7] National Institute on Aging. (n.d.). Facts about aging and alcohol. Retrieved from https://www.nia.nih.gov/health/alcohol-misuse-or-alcohol-use-disorder/facts-about-aging-and-alcohol on 2024, Oct 18.

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