How Alcohol Can Accelerate the Aging Process and Damage Your Health

Increased impact of imbibing as you get older

As you get older, alcohol’s effects can catch up with you. Decades of heavy drinking may take a toll on the liver and brain and leave telltale signs on the skin.

“We turn to alcohol for a lot of reasons,” says Dr. Jonathan Avery, vice chair for addiction psychiatry at Weill Cornell Medicine in New York City. “It’s certainly to enjoy ourselves, but also to self-medicate at times.”

You may find relief temporarily after a drink, but drinking regularly can have the opposite effect.

“It increases the odds of developing depression and anxiety,” says Avery, who treats people with alcohol use disorder. “It impacts you physically — your cognition, your body — and as a consequence, impacts your sleep.”

Even light and moderate drinkers face emotional consequences and increased health risks from alcohol as they age. If you’re approaching retirement with fewer daily obligations to meet and possibly more time to imbibe, don’t throw caution to the wind.

Pandemic consumption

A 2021 survey shed light on the drinking patterns of older adults since the COVID-19 pandemic began. The University of Michigan National Poll on Healthy Aging asked a national sample of participants ages 50 to 80 about their alcohol use and why they drank.

“A majority of people who drank during the pandemic reported reducing their alcohol use relative to past years,” says Anne Fernandez, a clinical psychologist and an assistant professor in the department of psychiatry at the University of Michigan. A smaller but significant number drank more, says Fernandez, who also serves as the associate director of the U-M addiction treatment service.

Among the two-thirds of older adults who drank at least occasionally, key findings included:

— 42% drank once a month or less. About equal proportions (roughly 20% each) drank two to four times a month, two to three times weekly or at least four times weekly.

— 77% consumed one or two drinks on a typical day of drinking. Another 17% had three to four drinks and 6% had five or more drinks.

— The top reasons for drinking were liking the taste, to be social, to relax or as part of their routine. Other reasons included coping with stress, helping with mood, relief from boredom or to ease pain.

— Men drank more than women.

— 7% of drinkers reported experiencing a blackout at least once.

“People who reported drinking for social reasons were more likely to report reducing alcohol use, not surprisingly, because there’s a lot less opportunity for social contact and all of the things that go along with that,” Fernandez says.

More isn’t merrier.

People often underestimate how much they drink, says Robert Pandina, former director of the Center of Alcohol Studies at Rutgers University. For standard servings, a single drink equals the following:

— One 12-ounce can or bottle of regular beer or wine cooler.

— One 5-ounce glass of wine.

— One 1.5-ounce shot glass of liquor at 80 proof or less.

According to the National Institute on Aging, a healthy person age 65 or older should drink no more than seven alcoholic drinks in a week, with at most one drink for women and two for men on any given day.

Avery emphasizes that medical professionals don’t pick these numbers because they’re “finger waggers” and “don’t like to have fun.” Rather, “those numbers really put you at risk for developing an alcohol addiction.” They also increase the odds of negative physical and emotional side effects of drinking, he says.

See the different ways drinking affects the aging process — and vice versa.

Decreased tolerance

“As you age, you may become more sensitive to the effects of alcohol,” says Sean Marchese, a registered nurse at the Mesothelioma Center in Florida. “This means that even moderate amounts of alcohol can impact your body more than they did when you were younger.”

Tolerance for alcohol can decline over time, possibly due to changes in body composition.

“Your ability to metabolize alcohol declines with age,” Avery says.

Hormonal changes that come with age, like the decrease of some hormones involved in metabolism, appear to increase alcohol sensitivity among women and men alike.

As you age, the proportion of fat to muscle tends to increase, even if your weight remains stable. You develop a higher blood alcohol content even if you drink the same amount you used to because fat absorbs less alcohol from the blood than muscle does.

Reaction times and motor ability tend to slow with age — and drinking reduces these abilities further.

Increased risk of accidents

Intoxication increases the risk of accidents, including falls and fractures at any age. But balance and stability pose more of a challenge as people age. Older adults are more likely to suffer falls, with worse injuries — like hip fractures — and longer recovery periods. Alcohol ramps up the risk even more, as it slows the brain’s activity.

“Alcohol is certainly not pro-cognition,” Avery says. “It can result in negative changes to the brain.”

Alcohol can impact the areas that are responsible for memory, he adds, and with heavy use can lead to issues with coordination and falls. Alertness, coordination, judgment and reaction time all decrease with drinking.

Influences mood

It’s true: A drink or two can help you relax. Alcohol has anti-anxiety and anti-stress properties. However, alcohol acts as a central nervous system depressant, so too much drinking darkens your mood.

“It does hijack (our) neurocircuitry and our reward pathway,” Avery says. “Speaking in terms of mood and reward, your brain prioritizes the alcohol with time. You get the biggest dopamine spike (from) drinking.”

As a result, your brain loses interest in other rewarding activities that make you feel happy or relaxed.

Can aggravate anxiety

In the previously mentioned University of Michigan survey, older adults who said they were drinking to cope with emotions like anxiety during the pandemic were more likely to report increasing their alcohol consumption.

Using alcohol as a coping mechanism can backfire, particularly over time.

“It’s undeniable that alcohol use can reduce some negative emotions on a short-term basis,” Fernandez says. “If you’re feeling really anxious and you have a few drinks, you may feel calmer because alcohol is a depressant and is going to lower your physiological state.”

Although you may feel better for a short period, you will feel worse in the long run, especially if you do that in a habitual way.

“If you’re using alcohol to cope, you’re not learning to use other tools to cope that are going to be more versatile and helpful,” Fernandez explains.

At any age, the potential for building up tolerance is a concern.

“The more alcohol you have, the more likely you are to develop dependence, which can actually cause more anxiety, more depression and more stress in the long run because of the various changes on the brain,” Fernandez adds.

As people become dependent on alcohol, they can become extremely anxious in drinking downtime.

“They’re drinking so much that their anxiety is completely out of control, essentially, when they’re not drinking, because their body is in withdrawal from alcohol,” Fernandez says. “When the depressant is out of your body, you’re in an overstimulated state. You’re jittery, your thoughts are racing and you’re sweating.”

Complicates withdrawal

The long-term solution for alcohol dependence is to stop drinking. But going cold turkey can be dangerous and, in rare cases, fatal.

“If a person has developed an alcohol use disorder, stopping or significantly reducing alcohol use on your own can be risky because of withdrawal,” Fernandez says. “In its most severe forms, alcohol withdrawal can cause seizures, hallucinations and even death.”

That’s why seeking medical advice and care when trying to stop drinking is critical.

Although some people may be able to reduce or stop drinking on their own, Fernandez says other people will be recommended to go to a facility to do a detox that’s medically managed. In some cases, they can do an outpatient detox, depending on safety and various factors.

Being older can add to withdrawal hazards.

“Age is one of the factors that people are concerned about with alcohol withdrawal,” Fernandez says. “For older adults — especially depending on what medications you’re on, what kind of health conditions you have — stopping alcohol if you have dependence, on your own, is even riskier.”

People with age-related cognitive and physical health issues — such as abnormal liver enzymes, liver disease, dementia and gait or mobility problems — are at an increased risk of severe withdrawal or at increased risk of harm if withdrawal occurs without medical oversight.

As a result, experts agree that it’s increasingly important to talk to a doctor.

Impairs decision-making

It’s no surprise that alcohol can lead to lapses in judgment.

“We all know this, anecdotally, from people who overindulge,” says Dr. Donald Ford, chair of family medicine at Cleveland Clinic in Ohio. “That part of it is no more so in the elderly.”

The issue, he adds, is that the effects of alcohol can be heightened with age and the effects on judgment can be greater.

Why is that important?

“If we think about what alcohol does to people at any age, it makes them less inhibited,” Fernandez says. “Your decision-making is impaired. You take risks that you normally wouldn’t take.”

That can put people into risky situations with driving, for instance. Or, for an older adult with limited mobility and decreased coordination, drinking compounds the risks of falls and resulting fractures, as well as increasing the impact of any health condition.

Intensifies grieving

Older adults often experience profound grief as they lose loved ones in their lives. Drinking in response to sadness can be a temptation. Depression, which is already prevalent among older adults, can be worsened with alcohol.

“There are some phenomena that occur with aging that we have to be careful of,” Ford says. “As people get older, unfortunately, more of their peers are going to be passing away. People lose their spouses, people lose close relatives. And the grieving process can really be significantly worsened by alcohol.”

Impacts your heart health

Drinking — even in moderation — no longer gets a pass from many health experts.

“The medical view of alcohol consumption has matured within the last few years,” Ford says. “It’s become evident that while in the past we could excuse alcohol use because we thought perhaps there was some beneficial health effect, more and more, the scientific understanding of alcohol is that there is really nothing beneficial about it.”

One potential silver lining has been the possible benefit of drinking a daily glass of red wine on heart health. However, that doesn’t really seem to be the case, Ford says.

“There were certainly published articles that supported the benefit of red wine to cardiac function or cardiac health,” he says. “The closer that’s been looked at over many years, the less that seems to be true.”

Although some research suggests that resveratrol, a chemical in red wine, may have heart-protective properties, a cause-and-effect association between drinking wine and heart health has not been established, the American Heart Association website notes.

Too much alcohol raises the risk of abnormal heart rhythms, heart disease, high blood pressure and stroke. If you don’t drink, experts say it’s not worth starting simply for the sake of potential and unproven benefits.

Contributes to cancer risk

Drinking has been increasingly linked to certain types of cancer, including cancer of the mouth, throat, esophagus, liver, colon and breast.

According to the American Cancer Society, alcohol accounts for about 6% of all cancer cases and 4% of all cancer deaths in the U.S., making it one of the most significant preventable risk factors for cancer.

Heavy alcohol consumers are at the highest risk for developing cancer, but even light to moderate drinkers (about one drink per day for women and about two drinks per day for men) are associated with a minimally increased risk of overall cancer as opposed to non-drinkers, according to researchers.

Shows up in your skin

Heavy drinking can add years to your face. You can develop different skin issues that are indicative of drinking, such as wrinkles, puffiness, dryness, red cheeks and purple capillaries.

That’s because alcohol dehydrates the entire body, including your skin. Jaundice, when the skin and whites of the eyes turn yellow, is one sign of alcoholic liver disease.

“No one ever recommended drinking for their skin quality,” Avery says.

Puts strain on your liver

Heavy drinking is a risk factor for liver diseases such as cirrhosis and liver cancer. Even moderate drinking can affect liver function, and older adults may be at higher risk. The relationship works both ways: Because the aging liver can’t break down, or metabolize, alcohol as quickly, it stays in your system longer.

According to a 2019 systematic review, alcohol is a major risk factor for liver cirrhosis — or permanent scarring of the liver — and women may be at higher risk than men even with low levels of alcohol consumption.

“Each dose of alcohol is increasing your odds of getting into trouble physically and in ways that, certainly depending on the dose and amount of time, may not be reversible,” Avery says.

Makes medical conditions worse

Many health conditions can also be exacerbated by alcohol use, including mental health problems and physical health problems, like liver disease, high blood pressure, heart disease and many cancers.

Drinking can raise blood pressure in the short term, while repeated alcohol binges contribute to hypertension. Heavy drinking is thought to increase the risk of ulcers and keep existing ulcers from healing.

Chronic conditions that tend to develop with age can be complicated by alcohol. According to the American Diabetes Association, alcohol can cause dangerously low blood sugar, or hypoglycemia, up to 24 hours after drinking. Alcohol may interfere with healthy eating for people with diabetes.

“When you change your drinking, you’re often not just changing that — you’re changing a host of other health behaviors,” Avery adds.

Interacts with medications

Older people are likely to take more medicine, so it’s important to know how alcohol interferes with prescription and over-the-counter drugs. Mixing alcohol with medication can either reduce or intensify a drug’s intended effects. Some medications like cough, cold and flu medicines or laxatives already contain alcohol.

Liver function can decrease with age, reducing the body’s ability to break down and get rid of medication. Adding alcohol, which also affects the liver, can increase the risk of drug side effects.

Alcohol can interact with medications commonly taken by older adults in myriad ways, particularly those that cause any sedation.

“There are a lot of medications we use — for instance for blood pressure, depression, pain — that can have their own sedating effect,” Ford says. “When you combine them with alcohol, it’s what we call a synergistic, or multiplying, effect.”

This increased sedation makes older adults more tired and raises their risk of falling and drowsy driving. This can cause a lot of medical problems overall.

May eventually shrink brain volume

A history of hard drinking and alcohol abuse may boost your risk for dementia. Heavy, long-term drinking speeds up shrinkage of the brain, according to the National Institute on Alcohol Abuse and Alcoholism.

This loss of brain volume is a key factor in the decline of memory and cognitive ability sometimes seen in aging. A condition known as alcoholic dementia, which can occur after years of excessive drinking, leads to mental confusion, agitation and lack of muscle coordination.

Disrupts sleep

A nightcap can actually keep you up at night. Some seniors may think alcohol helps them sleep, but it may actually harm sleep quality, especially if they have a drink just before bedtime. Alcohol impacts you physically — your cognition, your body — and “as a consequence, impacts your sleep,” Avery says.

Alcohol has been affiliated with insomnia, short sleep and circadian abnormalities, according to a 2019 review. Circadian rhythm sleep disorders are particularly disruptive because they can cause individuals to have trouble falling or staying asleep and impair daytime functioning — which is especially debilitating for older adults, who already may experience a decline in function as they get older.

Many older people already have habits that negatively affect sleep, according to the National Institutes of Health. Napping frequently during the day, exercising less and spending less time outdoors can affect sleep cycles. Drinking alcohol and caffeine worsens insomnia by keeping seniors from falling asleep or staying asleep.

Dehydrates your body

Because alcohol is a diuretic, drinking alcoholic beverages makes you urinate more. That’s why you need to drink more water to replenish your system, but the body’s ability to sense thirst and conserve water decreases over the years, making it easier to become dangerously dehydrated. As you age, your body is less able to respond to changes in the weather, like a heat wave.

In seniors, signs of dehydration include:

— Confusion.

— Incoherence.

— Constipation.

— Falls.

Decreased bone density

Drinking alcohol can decrease bone density, increasing the risk of fractures and osteoporosis, especially in women.

Osteoporosis occurs when your bones become weak and more brittle, and the risk increases with age. A 2022 meta-analysis concluded there is consistent evidence that increased alcohol consumption is associated with a higher risk of osteoporotic fracture — meaning fragility or low-trauma fractures in the bones resulting from osteoporosis. Low-trauma fractures refer to fractures that occur when an individual falls, for example, or in extreme cases when they cough or sneeze, rather than from high-trauma incidents like a motor vehicle accident.

With the complexity of interpreting results on alcohol consumption, researchers also concluded more research is needed to clearly explain the role of behaviors related to alcohol consumption and their relationship with bone health.

Dominates your social life

Retirement brings a lot more time to drink, and social life often centers on alcohol.

“One of the growing problems, which is not often discussed in the United States, is with retirees who move to retirement communities or other locations where cocktail hour begins early and often,” Pandina says. “They drink at a much higher level than even they believe that they’re drinking.”

Outdoor activities, hobbies, book clubs and other interests can provide good alternatives.

Drains your wallet

Don’t underestimate the monetary cost of alcohol when multiplied by days and years of use. Liquor store spending and bar tabs add up for seniors with fixed incomes on a tight budget. By sometimes switching to nonalcoholic drinks like club soda, ginger ale and water, you can save money at the bar, socialize longer and feel better.

There are ways to curb your alcohol intake — for heavy users too.

If you’re considering quitting drinking, especially if you typically consume a high volume of alcohol in any given week, it’s best to start a conversation with your primary care doctor. Other than well-known options like Alcoholics Anonymous and other peer support, self-help groups that are available in person and on Zoom, there are a range of medications and more formal therapies that can really improve outcomes.

Avery, who works in addiction psychiatry, says doctors are able to offer more options now, including Naltrexone, which was approved by the Food and Drug Administration to treat both alcohol use disorder and opioid use disorder.

“Prescribing naltrexone is just one tool for, and approach to, helping individuals who are struggling to reduce their alcohol use,” he stated in an editorial published in the American Journal of Psychiatry. But he emphasizes that it’s an underutilized option that is available to aid in reducing your alcohol intake and reestablishing a healthy relationship with alcohol, and it’s safe in both younger adults and in the elderly.

The regret at the end of life is not that you wish you drank more, “it’s that you didn’t take advantage of some of these resources earlier,” Avery says.

“The most important point is that it’s never too late to get treatment,” Avery says. “Better treatments, more accessible treatments exist now than ever before.”

As you get older, alcohol can affect you in a variety of ways:

— Decreased tolerance.

— Increased risk of accidents.

— Influences mood.

— Can aggravate anxiety.

— Complicates withdrawal.

— Impairs decision-making.

— Intensifies grieving.

— Impacts your heart health.

— Contributes to cancer risk.

— Shows up in your skin.

— Puts strain on your liver.