Alcohol and Aging: The Impact of Alcohol Misuse on the Elderly

Studies make it clear: alcohol use is common among the older population. Alcohol use in older adults has been trending upward over the past couple decades, particularly among women. One survey found that between 2001 and 2013, the rate of alcohol use disorder increased 107 percent among people 65 and older. 

Elsewhere, recent data from the National Survey on Drug Use and Health indicate that approximately 20% of adults aged 60-64 and around 11% over age 65 report current binge drinking. Furthermore, a 2021 analysis found that 1 in 20 adults aged 65 or older had an alcohol use disorder in the past year.

The fact that alcohol use is common among the older adult population raises some concerns.

While drinking excessively at any age can be detrimental to our health, elderly alcohol abuse is especially dangerous given the natural physical and mental changes that occur in our body and mind as we age. What are the changes in alcohol sensitivity with age? And how can we help an elderly alcoholic parent? Let’s take a closer look at the harmful effects of alcohol on the elderly and learn to spot the signs of alcohol abuse in older adults.

Alcohol and the Elderly: Increased Sensitivity

Many factors influence alcohol’s effects on our body. One of these is age. Older adults often have an increased sensitivity to alcohol because they typically metabolize alcohol more slowly. As we age, we experience a decline in the activity of dehydrogenase, an enzyme that breaks down alcohol. This can lead to relatively increased levels of alcohol in the bloodstream for longer periods of time. 

Similarly, lean body mass also declines with age. With less muscle to absorb alcohol, older adults feel the effects of alcohol more quickly, even while consuming lower amounts of alcohol than when they were younger. For instance, an older person who drinks one glass of wine may not be competent to drive a car even though their blood alcohol level is below the legal threshold. And since women tend to process alcohol more slowly than men, older women tend to be at higher risk for these effects compared to older men.

Furthermore, given that older adults are more susceptible to falling, drinking alcohol can be particularly dangerous, as it impairs balance and increases the likelihood of falls, bone fractures, and other accidents or injuries. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol-related medical emergencies resulting in visits to the ER increased by 50% among older adults from 2006 to 2016.

Similarly, older people might have more difficulty walking or tracking conversations after drinking a small amount of alcohol because it naturally impairs our motor skills and ability to see and hear.

Greater Dehydration

Alcohol is a diuretic: it increases urine production and causes our body to lose fluid, which leads to dehydration. This is particularly problematic for older adults, since they are already at a greater risk of dehydration. As we age, our sense of thirst diminishes and the balance of water and sodium in our body shifts. Our kidney function can also decline with age, causing more water to be lost through urination. All of these factors cause us to become dehydrated more easily.

One study that looked at the correlation between dehydration and falls among the elderly found that nearly 38 percent of participants were dehydrated. Another study noted that roughly 4 in 10 older adults admitted into hospitals showed signs of dehydration.

Increased Health Issues

Even when we’re healthy, drinking alcohol can have harmful effects on our physical and mental health, from raising our blood pressure to increasing our risk of depression and anxiety. Older people naturally tend to experience a variety of health issues, such as osteoporosis, diabetes, high blood pressure, ulcers, congestive heart failure, memory problems, and mood disorders. Alcohol can exacerbate all of these issues, making symptoms worse. 

Heart problems are a particular concern among the elderly, given that alcohol slows our nervous system. Too much alcohol can slow our heart to a dangerous extent. 

Some studies have noted that gastrointestinal disease and bleeding are common reasons for emergency department visits by older alcoholics. Elevated liver enzymes are found in 18% of older alcoholics and may indicate alcoholic hepatitis or fatty liver disease.

Excessive drinking when we’re older can also contribute to additional psychological stress, making us more prone to anger and mental health conditions. Sadly, loneliness is a common experience in the elderly community. Older people might turn to drinking to help them feel better, but alcohol can actually worsen depressive symptoms.

Harmful Interactions With Medications

Many medical conditions that older people face require medication. In fact, more than 90% of older adults take at least one medication. As a result, one of the biggest health risks among the elderly is the mixing of medications and alcohol. One study found that 1 in 5 older adult drinkers took medications that could have negative interactions with alcohol. 

Mixing alcohol with some medications can be incredibly dangerous, even deadly. For instance, prescription painkillers such as OxyContin can be fatal when combined with alcohol, as teh combination can cause the heart to stop beating altogether. 

Even over-the-counter medications can be dangerous when combined with alcohol. For instance, drinking while taking aspirin can lead to serious health problems, like increased risk of stomach bleeding. Similarly, drinking while on Tylenol can cause excessive liver damage. 

Drinking alcohol while taking cough syrup or cold and allergy medicines can also be dangerous, as some of these medications already contain alcohol and increase drowsiness. Furthermore, it’s also harmful to mix alcohol with antidepressants, antipsychotics, mood stabilizers, and anti-anxiety medications, which many older people take.

Signs of Alcohol Abuse in Older Adults

It’s not always easy to determine whether an elderly person is misusing alcohol, as some signs — such as confusion, forgetfulness, or poor self-care — can be mistaken for signs of aging or side effects of medications. We might be concerned about an elderly alcoholic parent, but not know quite what to look for. These are some warning signs of alcoholism in elderly people:

• Cognitive decline
• Neglecting self-care
• Missing medical appointments
• Recurring falls or accidents
• Frequent visits to the ER
• GI problems
• Uncontrolled hypertension (high blood pressure) 

If we suspect an elderly loved one is misusing alcohol, it’s best to take them to a medical professional for an assessment. Lab work can also help determine whether they’re misusing alcohol or suffering from medical side effects or a medical condition.

The Bottom Line

As we’ve seen, alcohol use is common among the older population. Elderly alcoholics exist, many of us might have elderly alcoholic parents, and there’s an increase in alcohol sensitivity with age. However, unfortunately, signs of the problem are often under-recognized. Alcohol can have a heightened impact on older people due to the natural changes that occur in the body and mind as we age. It can also worsen dehydration and exacerbate any health issues that develop as a result of aging. Mixing alcohol with medications used to manage chronic health conditions can be particularly dangerous. 

Finally, if you’re looking to cut back on our alcohol consumption, Reframe can help. It’s never too late to change your relationship with alcohol and lead a healthier lifestyle.