One More for the Road? Maybe Not

Alcohol affects your body differently when you’re older

Baby boomers are working harder and playing longer than previous generations—and toasting life to its fullest at the end of the day. But for many, it may be time to think about holding back a bit as we pour the next cocktail. Even a seemingly temperate drink can become difficult to metabolize as our physical and mental states change with the years.

Most of us are fine to imbibe, in moderation, in midlife and beyond. And many of us happily do so. Ron Genovese, 75, of Warwick, NY, was in the alcohol sales business for decades before he retired, and he says people 50 and older were among his biggest buyers.

“I see it now in my retirement community, where you can hear corks popping around the neighborhood at 4 p.m.,” Genovese says. “I have friends here who say they drink more now than when they were younger because they’re retired and have less responsibilities and more time on their hands. I also see older people who don’t want to take medications for physical ailments such as pain, and so they think having an extra drink or two will help relieve it.”

Indeed, older adults may drink alcohol for a wide variety of reasons. In addition to the pure enjoyment of a nightcap or toasting with friends, boomers may turn to alcohol to take the edge off life transitions such as retirement or an empty nest. They may use it to cope with the stress of caring for aging parents, grief from the loss of a spouse, feelings of depression or anxiety, or pain, insomnia and other health issues, says Joseph Nowinski, PhD, clinical psychologist and author of If You Work It, It Works! The Science Behind 12 Step Recovery (2015).

For many people, hangovers get worse with age, even if the amount they drink remains the same.

The recommended drinking limit for both men and women ages 65 and up is no more than three drinks per occasion.

“But I would recommend sticking closer to one or two—and no more than seven per week,” says Alison Ahern Moore, MD, professor of medicine and psychiatry at the David Geffen School of Medicine at UCLA. “The majority of older adults who regularly drink one glass of alcohol on most days can continue to do so safely, while those having more than that should assess with their doctor whether their alcohol intake is healthy for them. It really depends on the individual, the medications they’re on and the amount they drink.”

Aging Bodies Can’t Handle as Much

As we age, our bodies produce less of the enzymes needed to metabolize alcohol, Nowinski says. We’ll feel the effects of alcohol with fewer drinks at 60 than we did at 40, and those effects will last longer.

In short, if that large goblet of cabernet you were able to drink with dinner at age 40 now results in grogginess the next day at 65, it’s time to use a smaller glass. And be forewarned: for many, hangovers get worse with age, even if the amount we drink remains the same.

“We’re not exactly sure why this is, but it might be due to less elasticity in our cardiovascular systems or that our liver becomes less efficient at processing toxins,” says George Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism.

In addition, people tend to lose muscle mass and gain body fat as they grow older. This lessens the body’s ability to absorb alcohol and means the effects of even small amounts of drink will be felt more strongly.

Drinking also affects motor coordination for people of all ages, and this leads to accidents—not just vehicular. For older drinkers, falling after drinking is particularly dangerous, especially for those who live alone.

Age-related loss of bone density and an increased risk of osteoporosis cause the risk of fracture to skyrocket as we grow older. Half of arm breaks treated in the ER are for injuries near the top of the bone that are often linked to falls, and the highest number of these breaks have been seen in men and women age 45 and older, according to a 2012 study in Arthritis Care & Research.

And think about this—older women are as likely to die from a hip fracture as from breast cancer, according to 2009 research from New York’s Columbia College of Physicians and Surgeons.

At any age, alcohol can interfere with a number of drugs or make them less effective.

Drinking too much may also have a dramatic effect on memory, which is already susceptible to decline as people age. A study of more than 5,000 adults age 50 and older found that those who binge-drank (exceeded the recommended limit of three per occasion) twice a month or more were a whopping 149 percent more likely to suffer from memory loss compared to those who drank less, according to British researchers who presented their findings at the Alzheimer’s Association International Conference 2012 in Vancouver, Canada.

If all of that isn’t enough, studies find that drinking more than the recommended limit increases the risk of cancers that are more common with advancing age, such as breast and throat cancer. And even moderate drinking may have a negative impact on aging-related conditions, such as gout, hypertension and ulcers, Moore says.

Such is the case for Michael Gennone, 67, of Hillsdale, NJ.

“Illness has caused me to change my drinking habits. When I was younger, I would go out regularly for beers with the guys after work, but that’s gone forever because I started suffering from gout in my 50s,” Gennone says. “I had to cut back on drinking because it aggravates my condition, and alcohol also interferes with my medications—I take drugs for blood pressure too.”

Beyond the direct impact on wellness, drinking can be dangerous for older adults who are on medications because our bodies become less efficient at metabolizing both medications and alcohol. People 65 and older use more prescriptions than any other age group—for example, 41 percent take cholesterol-lowering medications, according to a 2013 study in the journal Mayo Clinic Proceedings.

At any age, alcohol can interfere with a number of drugs or render them less effective, from sleeping pills to sedatives, blood thinners and antihistamines. Moore strongly advises talking to your doctors and pharmacist about possible drug and alcohol interactions—especially if you take multiple medications.

Drinking and Depression

Depression can make people more likely to reach for the bottle in an effort to escape the blues. Yet alcohol is a depressant in itself—it not only compounds symptoms, but also renders antidepressant medications less effective. This could be a particular problem for women as they grow older: nearly one in four women 50 and older takes antidepressant medication, according to America’s State of Mind, a report by Medco Health Solutions.

While many people do—and should—turn to antidepressants for their conditions, reducing or eliminating drinking first may significantly help depression, says David Oslin, MD, professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania. Continued drinking while on antidepressants can actually worsen mental health issues and put a person at greater risk of suicide.

Moderate amounts of alcohol have been shown to reduce your odds of heart disease by thinning blood.
— Alison Ahern Moore, MD

A few years back, Oslin had a female patient in her late 60s who was taking a common antidepressant. When he asked about her drinking habits, she said her daily nightcap wasn’t much.

“I told her that even one drink can interfere with her medications, and there are other things she could do to relax, such as stretching or exercise,” Oslin says.

The patient agreed to keep track of exactly how much she was drinking and reported back the following week. It turns out she had grown dependent on alcohol without realizing it. Though she was only having a nightcap, she used a large glass without paying attention to how much she was actually pouring.

“It probably started as one shot 10 years ago, and over time her pours became more generous until it was the equivalent of five or even six shots,” Oslin says. (A serving of alcohol is 1.5 ounces of liquor, 12 ounces of beer or 5 ounces of wine.) The woman stopped drinking altogether. Her symptoms improved so much that she was able to get off antidepressants.

But What about That Healthy Pour of Wine?

Alcohol has its health benefits too. A 2010 study from the University of Texas at Austin found that social drinkers who imbibed moderately lived longer than teetotalers, possibly because of the companionship.

“Drinking in moderation is a marker of social health, and research finds that people who drink with other people tend to be healthier than those who don’t,” Moore says.

Moreover, moderate drinking can prevent some common diseases and improve insulin sensitivity, which helps regulate blood-sugar levels.

“While drinking increases your odds of breast and throat cancers, most people are more likely to die of a heart attack,” Moore says. “Moderate amounts of alcohol have been shown to reduce your odds of heart disease by thinning blood.”

Taking Stock and Taking Steps

Like most things in life, the key to reaping alcohol’s benefits is moderation. While the majority of imbibers in their later years don’t have a problem, other drinkers actually fall into a gray area: people 65 years and older report binge drinking more often than any other age group—overdoing it an average of five to six times a month—according to a report from the Centers for Disease Control and Prevention.

Most people who binge-drink don’t fit the definition of an alcoholic, which is someone who is dependent on alcohol and experiences withdrawal symptoms or who continues to drink despite doing harm to relationships, mental health or job.

But drinking heavily two or more times a month—socially or alone—may be a warning sign that it’s time to take stock. So is drinking to “help” chronic physical pain or anxiety, loneliness or even difficulty sleeping.

“I see many people in their later years drinking to ease physical conditions such as pain or insomnia, so if you suspect you’re doing the same, talk to your doctor about other ways to manage symptoms, such as with acupuncture or yoga,” says clinical psychologist Nowinski. “If you’re drinking because you’re lonely or bored—say, you lack a sense of purpose after retirement or are grieving the loss of a friend or spouse—there are healthier ways to cope.”

Nowinski had a widowed client pushing 70 whose kids lived far away. He started drinking more to deal with boredom and loneliness. The man realized he was overimbibing after getting a DUI for the first time ever.

“He said, ‘I have to do something different.’ In his younger days he made furniture, but it became too physical for him, so he used his woodworking hobby to make birdhouses instead and sell them at local farmer’s markets,” Nowinski says. “He didn’t sell a lot, but his hobby became a healthy way to cope with boredom as opposed to drinking, and going to the market helped him meet new people, which eased his loneliness.”

We don’t all have woodworking to fall back on, of course, and for many of us, that evening cocktail is a much-anticipated reward we’re loathe to lose. Determining how much to drink—and finding alternatives, if need be—will be different for each of us. Still, it’s worthy of some thought before pouring that second glass of wine.