We’ve been told that 1 to 3 alcoholic drinks a day are healthy. Does this advice hold true as we get older? Baby boomers may be in for a rude awakening. Newer information is showing that low to moderate intakes of alcohol have a negative effect on health as we age. Thirty-eight percent of men and 30% of women aged 65 to 84 drink moderately. Nine percent of men and 2% of women in this age group drink heavily. With the rising number of older adults in this country, we may soon face a silent epidemic of alcohol related problems.
First, alcohol is not needed in the body. If you never drink you will not suffer any health effects from the lack of alcohol. It does yield calories, 7 calories in 1 gram of alcohol. An average drink – 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor — has approximately 14 grams of alcohol. Our bodies clear about 15 grams of alcohol an hour or approximately 1 drink per hour. Men clear faster than women. Older adults clear alcohol slower than younger adults which means alcohol stays in the system longer and the effects will be felt quicker and for a greater amount of time.
Often problem drinking occurs as we age because of stressful life events such as illness, loss of a spouse, social isolation and retirement. It is difficult for health care practitioners to accurately measure alcohol intake because the norms set for younger adults may not apply as we age and under-reporting is very commonplace.
Drinking 5 or more drinks at any one time usually results in being drunk. If you are older and clear alcohol more slowly, fewer drinks could make you drunk faster, compromising balance and judgment, resulting in many more accidents and falls. It is estimated that 6% to 24% of all falls in older individuals are associated with alcohol. This has serious consequences for older men and women who already may have thinning bones. Any fall for an older adult is likely to result in broken bones. Fifty percent of all fatal falls, head injuries and falling down stairs are alcohol related in those aged 70 and older.
GI disorders are the third leading cause of doctor visits and hospitalizations among those 65 and older. Many of these problems may have taken decades to occur – indigestion, heartburn, ulcers, problems with the pancreas, and cancers of mouth, throat, liver and colon. All are made worse by continued alcohol consumption. Current drinkers are at four times greater risk for these problems.
Periodontal disease, a major cause of tooth loss in this country, is connected to alcohol. Light drinking can cause gums to bleed. Moderate drinking causes tooth detachment. And, bone thinning of the jaw is more common in older alcohol users.
Older individuals routinely take more prescribed and over-the-counter medications, both of which may interact with alcohol. Most people are not aware of the potential for drug-alcohol interactions or they may not be honest enough with their doctor about how much they drink to receive the correct instructions.
Drugs such as Xanax, Valium, Codeine, and OxyContin should never be taken with alcohol because it will intensify the drug’s effect. Other drugs commonly used by older adults, such as diuretics, anti-inflammatory agents, aspirins and drugs to control type 2 diabetes also increase the risk for a harmful drug reaction when combined with alcohol.
Even over-the-counter medications can cause problems. Heartburn relief medications cause blood alcohol levels to rise. Pain relievers such as Celebrex, Advil, Motrin, Aleve and aspirin increase the risk for GI bleeding and liver problems. And, a number of over-the-counter medications – cough syrups, mouthwashes, and bowel stimulators — can be up to 20% alcohol adding to the overall amount consumed.
Excessive alcohol intake may displace food calories which provide needed nutrients. When vitamin and mineral intake falls, the body loses valuable antioxidants which are one of our first lines of defense against disease. This allows damaging free radicals, made in the body, to function unchecked which increases the risk for heart disease, cancer and diabetes.
The National Institute on Alcohol Abuse and Alcoholism recommends that adults 65 and older have no more than one drink a day, regardless of sex. Some experts feel this is too restrictive. But, we need to realize that older adults do have more health conditions, take more medications, and have a greater risk for falls and dementia, all of which are complicated by alcohol intake. It is predicted that in the baby boomer generation, substance abuse issues will double to 5.7 million by the year 2020.
There is no one size fits all recommendation for alcohol use as we age. But we do need to be aware that in excess alcohol is a toxin. In limited amounts it can be beneficial as part of a healthy diet. Indeed, dose does make the poison.