Truths (and myths) about alcohol and aging

For some, a cold cocktail or a glass of big-bodied cabernet can bring a tremendous amount of pleasure; for others, perhaps, it can bring too much pleasure. Alcohol can be relaxing at best, addictive and dangerous at worst. And if you are someone who partakes, you’ve likely seen studies on the health risks and benefits of drinking alcohol.

Senior man reaches for glass of whiskey
Photo: iStockphoto.com/gpointstudio.

Fact is, there’s really no amount of alcohol that’s technically considered “healthy.” Depending upon the study, some — like the American Heart Association — say alcohol in moderation can have some health benefits, while others, like the World Health Organization, advise that no level of alcohol consumption is safe for our health. 

And as we age, the risks — to both physical and mental health — may increase as our relationship with alcohol changes. Dr. Kevin B. Costello, an associate professor of medicine and geriatric medicine fellowship director at Albany Medical College, shared with us some insights about alcohol and aging. 

Guidelines for alcohol consumption

Costello emphasizes that the Centers for Disease Control and Prevention’s guidelines for alcohol consumption remain consistent throughout one’s life. “The general guidelines don’t change, and regular screening for unhealthy drinking is recommended at all ages,” he says. “However, alcohol intake at even the recommended levels can be unsafe for older adults in the context of their underlying health conditions and medications.” This underscores the need for tailored recommendations based on individual health status.

“My population skews older and more debilitated because I do home care,” Costello says. “Many of my patients have ceased drinking completely for a variety of reasons, or never drank; for some, problem drinking has been and remains a long-standing problem despite efforts at treatment, and some have developed problem drinking after a traumatic event, such as the death of a spouse.” Additionally, caregivers may turn to alcohol as a coping mechanism, driven by social isolation and the stress of caregiving, according to research.

Myths about alcohol

Alcohol research is difficult because it relies on patient recall and truthful responses, however myths about alcohol persist, says Costello. The first, he says, is that if one has not been a problem drinker earlier in life, they are unlikely to be one later on. In fact, he warns that alcohol dependence and alcohol use disorder can develop at any point in a person’s life.

Another myth is that a drink of alcohol at bedtime can improve sleep. But the opposite is true: Alcohol can interfere with the restorative phases of sleep, leading to poor sleep quality, Costello says, so you may fall asleep more easily, but you’ll sleep less well. 

Many also believe that alcohol is a good way to lift one’s spirits. Costello warns against this misconception, as depression is a strong risk factor for alcohol use disorder and dependency, and alcohol can lower the threshold for suicidal behavior. 

He also notes the myth that it’s easy to spot someone with a drinking problem. In reality, problem drinking goes unnoticed all the time. Without regular screening, primary care providers can easily miss those at risk for problem drinking, which may result in missed opportunities for early diagnosis and intervention. 

The rate at which the body metabolizes and distributes alcohol changes with age, causing the intoxicating effect to be increased, he notes. This effect is particularly pronounced in women.

Alcohol consumption can lead to mental confusion, impaired judgment and poor balance, increasing the risk of falls and other injuries. Prolonged alcohol use can also result in nutritional deficiencies that can damage the nervous system. For folks who are struggling with balance and vision problems, alcohol only compounds the risk of injury. 

Bottles of booze featured in a colorful bar display
Photo: iStockphoto.com/ronstik.

Is there a “healthy” approach to drinking? 

Costello offers practical guidance for safe alcohol consumption by aging adults. He stresses the importance of consulting with a health care provider and a pharmacist to evaluate the safety of alcohol in the context of a person’s health conditions and medications.

For healthy alcohol consumption, he recommends limiting daily intake to no more than two drinks a day for men and one drink a day for women. Regularly exceeding these limits or episodic binge drinking is associated with an increased risk of alcohol use disorder. Less alcohol intake is overall healthier and safer.

Costello advocates for regular screening for unhealthy alcohol use. Feedback provided by medical providers and loved ones can have a positive impact on reducing the risk of alcohol use disorder. 

For those in need of assistance, the Substance Abuse and Mental Health Services Administration National Helpline, 800-662-HELP, is a valuable resource to find online and in-person treatment options for alcohol and other substance use disorders.

Alcohol use in aging adults presents a unique set of challenges and risks, and it’s crucial to address these issues with care and expertise. The good news is that there has been tremendous progress in the market for mocktails (see our story Mocktails to Warm Up to This Winter); we don’t have to give up everything that’s delicious.

Top image by iStockphoto.com/D-Keine.


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