What to Know About Alcohol as You Get Older

Reviewed by Dan Brennan, MD on October 25, 2021

As you get older, alcohol starts to affect you more than usual. Your body can’t process alcohol like it may have before. This can lead to immediate risks, worsening health conditions, adverse reactions with medications, and much more.

Alcohol abuse in older adults is a quiet but serious problem. It may not be as easy to recognize, but alcoholism in older adults is common. If you believe that you or a loved one has problems with alcohol, you can contact your family doctor and they can perform a substance abuse screening.

Your Body and Alcohol

When you drink alcohol, it’s absorbed through the small intestine, processed by the liver, and circulated through your major organs. As you get older, you have less muscle mass and your liver isn’t as strong. This leaves a larger amount of alcohol in your bloodstream. This causes the effects of alcohol to be stronger, even if you’re drinking the same amount you always have.

You might have increased sensitivity to alcohol. Since alcohol has a more potent effect, this can lead to several risks: 

  • Increased chance of alcohol poisoning
  • Impaired vision
  • Greatly slowed reaction time
  • Increased chances of falling

Alcohol affects you more quickly when you’re older. This can be dangerous for people who already have slower reaction times and poor balance without alcohol.

There are increased health risks. Alcohol can cause serious health complications in older adults, and can make existing conditions worse. These risks include:

  • Orthostasis - blood pressure that rises when you sit or stand up
  • Myopathy (muscle weakness)
  • Peripheral neuropathy
  • Higher risk of hip fracture in adults with osteoporosis
  • Delirium
  • Wernicke-Korsakoff syndrome
  • Alcohol-induced dementia
  • Gastrointestinal disease
  • Alcoholic hepatitis
  • Fatty liver
  • Cirrhosis
  • Worsening hypertension
  • Higher risk of stroke
  • Higher risk of infection
  • Disturbed sleep
  • Depression

As you get older, the effects of alcohol can become dangerous. People over 65 need to be careful when they drink alcohol. 

Alcohol and medications don't mix well. Most medications and alcohol don’t interact well with each other. Not only will alcohol make conditions like hypertension and diabetes worse, but it also mixes poorly with the medications typically used to treat those conditions. 

Ask your doctor if your medications shouldn’t be taken with alcohol. Below are some of the common medications that can be dangerous to mix with alcohol:

  • Sleeping medications, such as zolpidem
  • Pain medications, such as hydrocodone or oxycodone
  • Anti-seizure medications
  • Anti-psychotic medications
  • Antihistamines
  • Benzodiazepines

Can You Drink?

Doctors recommend that most adults over 60 not drink alcohol. Consider your current health conditions and medications before you drink.

If you do decide to drink, professionals recommend that people over 65 shouldn’t take more than one standard drink each day and no more than 7 each week. Of course, this amount may vary depending on your own health and body type. 

Alcohol Abuse

Alcohol abuse in older people has become more common in the past few decades. Alcohol is now the most abused substance among people over 65. Alcoholism is often overlooked or misdiagnosed in older people. Depressive symptoms like insomnia, mood swings, and anxiety can mimic those of alcoholism.

Common signs of alcohol abuse in older adults include:

  • Drinking to manage negative experiences
  • Mixing alcohol and medications
  • Being irritable while sober
  • Not telling the truth about the number of drinks they’ve had
  • Endangering themselves or others because of their drinking

Older adults with mental health conditions such as depression, dementia, cognitive impairments, or anxiety are at a greater risk for developing problems with alcohol. Alcohol abuse can then worsen the symptoms of those conditions. 

There are treatment options for older adults. Your doctor can give you abuse screenings to see how your drinking has affected your health. They can also recommend alcohol abuse programs specifically for older adults. 

Alternatives to Alcohol

If you go out to places that serve alcohol, you may be conditioned to get an alcoholic drink. Mimosas at brunch and beer at the sports bar are social staples. Consider some of these nonalcoholic substitutes the next time you reach for the wine menu:

  • Virgin cocktails
  • Sparkling water with lime or lemon
  • Juice and tonic water
  • Root beer, diet cola, or other typical mixers

Along with these, ask about various nonalcoholic brands of spirits, beers, and wines. 

Choose mental health habits as coping mechanisms. Popular methods such as meditation, yoga, therapy, and exercise may help if you drink to manage mental health conditions. But these alone may not be enough, so ask your doctor about additional treatment options. 

Show Sources


Alcohol Rehab Guide: “Alcoholism in Seniors.”

AlcoRehab: “Alternatives to Alcohol: Methods to Help Alcohol Recovery.”

American Addiction Centers: “The Effect of Alcohol On Older People,” “The Invisible Epidemic: Senior Citizens and Alcoholism.”

American Family Physician: “Alcoholism in the Elderly.”

Cleveland Clinic: “Are Your Drinks Getting Stronger, or Are You Just Getting Older?”

Geriatric Mental Health Foundation: “Alcohol/Drug Abuse/Misuse.”

Hello Sunday Morning: “Alcohol-Free Alternatives.”

Journal of Geriatric Mental Health: “Alcohol use among the elderly: Issues and considerations.”

American Academy of Physical Medicine and Rehabilitation: “Orthostasis.”

Cedars-Sinai: “Myopathy.”

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