Alcohol Use Among Older Adults: Risks and Realities

Research consistently shows that alcohol use is widespread among older adults. Over the past two decades, drinking has trended upward in this age group, with a particularly sharp rise among women. One survey revealed a 107% increase in alcohol use disorder among adults 65 and older between 2001 and 2013. Recent data from the National Survey on Drug Use and Health indicates that about 20% of adults aged 60–64 and 11% of those over 65 report binge drinking. A 2021 analysis found that 1 in 20 adults aged 65 or older had an alcohol use disorder in the past year.

This prevalence of alcohol use among older adults is concerning. While excessive drinking is harmful at any age, it poses unique dangers for older individuals due to age-related physical and mental changes. Let’s explore how alcohol sensitivity changes with age, how to recognize alcohol abuse in older adults, and how to support an elderly parent struggling with alcohol.

Increased Alcohol Sensitivity in Older Adults

Age significantly influences how our bodies respond to alcohol. Older adults often experience heightened sensitivity because they metabolize alcohol more slowly. With age, the activity of dehydrogenase—an enzyme that breaks down alcohol—declines, leading to elevated blood alcohol levels for longer periods.

Lean body mass also decreases with age, meaning there is less muscle to absorb alcohol. As a result, older adults may feel the effects of alcohol more quickly, even after consuming smaller amounts than they did when younger. For example, an older person drinking one glass of wine may be unfit to drive even if their blood alcohol level is below the legal limit. Older women are at even greater risk, as they generally process alcohol more slowly than men.

Since older adults are already more prone to falls, alcohol’s impact on balance and coordination makes drinking especially hazardous. The National Institute on Alcohol Abuse and Alcoholism reports that alcohol-related ER visits among older adults rose by 50% from 2006 to 2016. Even small amounts of alcohol can impair motor skills, vision, and hearing, making tasks like walking or following conversations more difficult.

Greater Dehydration

Alcohol acts as a diuretic, increasing urine production and fluid loss, which leads to dehydration. Older adults are already at higher risk for dehydration due to a diminished sense of thirst, changes in water and sodium balance, and reduced kidney function. One study found that nearly 38% of elderly participants were dehydrated, and another noted that about 40% of older adults admitted to hospitals showed signs of dehydration.

Worsening Health Issues

Even in healthy individuals, alcohol can harm physical and mental health—raising blood pressure and increasing the risk of depression and anxiety. Older adults often manage multiple health conditions, such as osteoporosis, diabetes, high blood pressure, ulcers, heart failure, memory problems, and mood disorders. Alcohol can worsen all of these conditions.

Heart problems are a special concern, as alcohol slows the nervous system and can dangerously reduce heart rate. Studies show that gastrointestinal disease and bleeding are common reasons for ER visits among older alcoholics. Elevated liver enzymes, found in 18% of older alcoholics, may indicate alcoholic hepatitis or fatty liver disease.

Excessive drinking can also increase psychological stress and contribute to anger or mental health issues. Loneliness is common among older adults, and some may turn to alcohol for relief, but it often deepens depressive symptoms.

Harmful Medication Interactions

More than 90% of older adults take at least one medication, making alcohol and drug interactions a major health risk. One study found that 1 in 5 older drinkers used medications that could interact negatively with alcohol.

Mixing alcohol with certain drugs can be deadly. For example, combining alcohol with prescription painkillers like OxyContin can stop the heart. Over-the-counter medications also pose risks: aspirin and alcohol increase the risk of stomach bleeding, while Tylenol and alcohol can cause severe liver damage. Cough syrups, cold and allergy medicines, antidepressants, antipsychotics, mood stabilizers, and anti-anxiety drugs can all have dangerous interactions with alcohol.

Signs of Alcohol Abuse in Older Adults

Recognizing alcohol misuse in older adults can be challenging, as symptoms like confusion, forgetfulness, or poor self-care may be mistaken for normal aging or medication side effects. Warning signs include:

• Cognitive decline
• Neglecting self-care
• Missing medical appointments
• Recurring falls or accidents
• Frequent ER visits
• Gastrointestinal problems
• Uncontrolled high blood pressure

If you suspect an older loved one is misusing alcohol, seek a medical assessment. Lab tests can help determine whether symptoms are due to alcohol use, medication side effects, or another health condition.

Conclusion

Alcohol use is common among older adults, and alcohol sensitivity increases with age. Unfortunately, signs of alcohol misuse are often overlooked. Alcohol’s effects are magnified in older people due to age-related physical and mental changes, and it can worsen dehydration and chronic health conditions. Mixing alcohol with medications is especially dangerous.

If you’re looking to reduce your alcohol consumption, Quitemate can help. It’s never too late to change your relationship with alcohol and embrace a healthier lifestyle.