According to science, there’s a biological reason the effects of alcohol are harder on our bodies as we age.
As we age, our relationship with alcohol should change as well.
When we’re young, our organs are capable of withstanding most bad decisions we make. But, as our bodies slowly start losing their elasticity to take abuse, alcohol can play a different role.
Alcohol, no matter how the advertising industry tries to spin it, is a poison.
Every year, an estimated 88,000 people die of alcohol-related causes, making it the third most preventable form of death in the United States behind tobacco use, poor diet, and lack of exercise, according to the National Institute on Alcohol Abuse and Alcoholism.
While alcohol impacts everyone, it can be particularly rough on the elderly, or those over the age of 65. Some continue to drink as they always have, while others, who may have abstained from alcohol throughout their lives, start drinking in their golden years.
Both can create their own host of problems.
Brad Lander, PhD, psychologist and addiction medicine specialist at The Ohio State University Wexner Medical Center warns that, as we age, alcohol can create problems with balance and decrease reaction time leading to accidents, among other things.
“Drinking among seniors is different than people who are younger,” Lander told Healthline. “Accidents is one of the biggest problems.”
While alcohol is often associated with motor vehicle accidents, for seniors, something as simple as getting up and down the stairs can lead to slips and falls, risks that are compounded with acute and heavy alcohol use.
It seems study after study comes out on a regular basis showing the protective effects of drinking alcohol, typically a glass of wine a day.
Joel Garrison, DO, family medicine physician at Piedmont Physicians Monroe Family Practice in Monroe, Georgia, says that while there is some evidence that small amounts of alcohol can be beneficial in preventing heart attacks, there’s also evidence that small amounts of alcohol can increase your risk for stroke.
“It is certainly a double-edged sword,” Garrison told Healthline. “The benefit may be outweighed by the risk, or at least the benefit negated by the risk.”
But when small amounts become big amounts, Garrison says alcohol abuse in the elderly brings with it a “very real risk” of long-term negative health effects, namely cognitive impairment, amnesia, dementia, vision problems, imbalance and falls, inability to walk, nerve pains and dysfunction, muscle aches, high blood pressure, and others.
“These are findings which are seen outside of the acute alcohol intoxication window, when the patient is sober,” he said.
In other words, the effects remain long after you’ve slept off the booze.
Alcohol also makes it more difficult for a doctor to give an adequate diagnosis.
An elderly person who consumes notable amounts of alcohol on a regular basis could be diagnosed with a mental illness when they’re under the influence. Lander says this is because the outward signs of intoxication and Alzheimer’s could be confused at a doctor’s visit.
“Sometimes people get misdiagnosed with dementia when they’re just drunk,” he said.
Much like their younger counterparts, elderly people may reach for alcohol to kill the boredom and sadness that comes with coping with loss, isolation, impending mortality, and other issues that can compound with aging.
Lander says he sees many patients who use a drink or two to help fall asleep before it becomes a vicious cycle of self-medication.
“We see a lot of increasing in drinking because they’re depressed,” he said.
No matter the reason, the effects on a person — while varying by individual based on a host of factors — can be profoundly real and probably only best understood under a microscope.
The outward signs of elderly alcohol abuse pale in comparison to what is going on inside.
Brooke Sprowl, LCSW, a psychotherapist and clinical director and owner of My LA Therapy, says research shows that telomeres — stretches of DNA that live at the end of our chromosomes and protect our genetic data — shorten as we age, which is one reason why we become more vulnerable to disease and other environmental stressors, such as the effects of alcohol.
“Telomeres shorten every time cells divide and then reach a tipping point wherein they become so short that a cell can no longer divide, depriving the body of the protective and regenerative benefits of cell division,” Sprowl told Healthline.
So, there’s a biological reason you aren’t able to bounce back from hangovers as easily as you did in your 20s. It’s due to the fact that you’re not as springy and spongy as you were when you were first old enough to drink alcohol.
Jagdish Khubchandani, PhD, an associate professor of health science at Ball State University, also says that alcohol has widespread effects on all parts of the brain due to its easy crossing of the blood-brain barrier to reach brain cells.
Additionally, this means a person’s body could be more directly impacted by conditions and diseases they’re already genetically predisposed to, including those associated with older age.
He says that alcohol acts on the receptors in the brain that ultimately affect the neurotransmitters that we take for granted, like coordinating simple and complex skills, from physical balance to emotional balance.
“Because alcohol starts binding to these receptors, the neurotransmitters stop functioning normally,” Khubchandani said.
Because of this, chronic alcohol use is linked with neuropsychiatric illnesses because alcohol is really good at dampening our regulation and response to raw data and, unfortunately, damaging our neurotransmitters.
This, Khubchandani says, can damage the brain in two ways: In the structural — or literal shrinkage of your physical brain — and functional, or the behavioral and psychological ways our brains have developed in the society we’ve built around it.
While alcohol is widely accepted in the United States and other colonialized nations, it doesn’t come without consequences, in both the short and long term.
Besides accidents and potentially being misdiagnosed, alcohol abuse in the elderly can exacerbate other problems.
Lander says this includes intensifying existing health conditions, early onset dementia, certain cancers, depression, and decreased sexual functioning, among other health issues. It can also lead to cancer, digestive problems, and pancreatitis.
The National Institute on Aging warns alcohol use can worsen health problems like osteoporosis, diabetes, high blood pressure, and ulcers. It can also contribute to memory loss and mood disorders, and — because of how it creates changes in the heart and blood vessels — it could also dull the pain of an impending heart attack.
Regular use can lead to decreased alcohol tolerance as well. This is because the elderly typically have more fat on their bodies, which slows how fast the body can metabolize alcohol.
“Having a high tolerance is not a good thing,” he said. “It’s not a badge of honor.”
Along with health-related issues, chronic alcohol use in the elderly can have social and economic issues, as many elderly people live alone on a fixed income.
Overall, Lander says acceptable drinking for the elderly is seven drinks per week, but no more than three drinks in any given day. It could be even less, depending on how it interacts with certain medications, namely those that affect a person’s mood or pain tolerance.
For those who care for an elderly loved one, Lander recommends making alcohol consumption part of the conversation, especially if that person is hiding alcohol or lying about how much he or she is drinking.
He does warn, however, that it might not be an easy or straightforward conversation.
“They don’t want to talk about it because they don’t want to be told what to do,” Lander said.