Alcohol and Older People Families and Caregivers Often Overlook the Signs of a Problem

Anyone at any age can have a drinking problem. Uncle George always liked his liquor, so his family may not see that his drinking is getting worse as he gets older. Grandma Betty was a teetotaler all her life. She started having a drink each night to help her get to sleep after her husband died. Now, no one realizes that she needs a couple of drinks to get through each day.

These are common stories. The fact is that families, friends, and health care workers often overlook their concerns about older people drinking. Sometimes trouble with alcohol in older people is mistaken for other conditions related to aging. But how the body handles alcohol can change with age. You may have the same drinking habits, but your body has changed.

Alcohol may act differently in older people than in younger people. Some older people can feel ’high’ without increasing the amount of alcohol they drink. This high can make them more likely to have accidents, including falls and fractures and car crashes.

Drinking too much alcohol over a long time can:

• Lead to some kinds of cancer, liver damage, immune-system disorders, and brain damage;
• Worsen some health conditions like osteoporosis, diabetes, high blood pressure, and ulcers;
• Cause some older people to be forgetful and confused, symptoms that could be mistaken for signs of Alzheimer’s disease; and
• Make some medical problems hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack.

Alcohol and Medicines

Many medicines — prescription, over-the-counter, or herbal remedies — can be dangerous or even deadly when mixed with alcohol. Many older people take medications every day, making this a special worry. Before taking any medicine, ask your doctor or pharmacist if you can safely drink alcohol. Here are some examples of problems caused by mixing alcohol with some medicines:

• If you take aspirin and drink, your risk of stomach or intestinal bleeding is increased;
• When combined with alcohol, cold and allergy medicines (the label will say antihistamines) may make you feel very sleepy;
• Alcohol used with large doses of acetaminophen, a common painkiller, may cause liver damage;
• Some medicines, such as cough syrups and laxatives, have high alcohol content. If you drink at the same time, your alcohol level will go up; and
• Alcohol used with some sleeping pills, pain pills, or anxiety or anti-depression medicine can be deadly.

How Much Alcohol Is Too Much?

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, recommends that people who are healthy and over age 65 should have no more than 7 drinks a week and no more than 3 drinks on any one day. One drink is equal to one of the following:

• One 12-ounce can or bottle of regular beer, ale, or wine cooler;
• One 8- or 9-ounce can or bottle of malt liquor;
• One 5-ounce glass of red or white wine; or
• One 1.5-ounce shot glass of hard liquor (spirits) like gin, vodka, or whiskey. The label on the bottle will say 80 proof or less.

When Does Drinking Become a Problem?

Some people have been heavy drinkers for many years. But, just as with Uncle George, over time the same amount of alcohol packs a more powerful punch. Other people, like Grandma Betty, develop a drinking problem later in life. Sometimes this is a result of major life changes like death of dear friends or a loved one, moving to a new home, or failing health. These kinds of changes can cause loneliness, boredom, anxiety, or depression. In fact, depression in older adults often goes along with drinking too much.

Not everyone who drinks daily has a drinking problem. And not all problem drinkers have to drink every day. You might want to get help if you, or a loved one, hide or lie about drinking, have more than seven drinks a week, or get hurt or hurts others when drinking.

Getting Help

If you want to stop drinking, there is help. Start by talking to your doctor. He or she may be able to give you advice about treatment. Your local health department or social services agencies may also be helpful.

No one wants to get hurt or to hurt others as the result of too much alcohol. Yet, it can happen if you drink more than you should. Be aware of how your body changes as you age. Be alert to these changes, adjust how much alcohol you can safely drink, and continue to enjoy life to the fullest.

This article was prepared by the National Institute on Aging, a division of the U.S. National Institutes of Health.