July 30, 2018/Primary Care

Are Your Drinks Getting Stronger, or Are You Just Getting Older?

The way we process alcohol changes after age 65

Are Your Drinks Getting Stronger, or Are You Just Getting Older?

Does it seem like you’re getting more sensitive to alcohol as you age?


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You’re not imagining things.

“The basic process by which alcohol is metabolized doesn’t change, but after age 65, several factors can alter the way you process it,” says family medicine specialist Donald Ford, MD.

How alcohol is metabolized

What happens when you drink a beer, glass of wine or cocktail?

  • The alcohol you swallow moves from your stomach into your small intestine without being digested.
  • It is absorbed through your small intestinal walls, then travels to your liver.
  • The liver does the lion’s share of processing alcohol; a series of enzymes breaks it down into chemicals (some harmless, some not).
  • These chemicals move through your circulation to your heart, lungs, brain and other organs, and simultaneously into your lean muscle mass.
  • Unless you drink too much or too fast, most chemicals eventually morph into harmless carbon dioxide and water, which are easily eliminated.

(Because women, Asians, Native Americans and Inuits don’t produce the same — or the same quantity of — enzymes to tackle alcohol in the liver, alcohol’s effects are magnified for them.)

How aging affects this process

After age 65, your circulation starts slowing down. Less blood is flowing through your liver, so the process slows, and more toxic metabolites may accumulate,” says Dr. Ford.

“And because we lose lean muscle mass with age, a higher concentration of alcohol remains in the bloodstream. So you feel more effects from the same amount of alcohol.”

By this time, you’ve probably also developed a few chronic conditions. “Needing lots of medication for different conditions can cause lots of interactions with alcohol,” he says.

Alcohol competes with medicines for processing by your liver — and wins. As a result:

“Alcohol also compounds the sleep difficulties that are common after age 65,” notes Dr. Ford.

Many people use alcohol to fall asleep, he says, not realizing that it interrupts sleep, makes sleep less restful and causes earlier awakenings.

As we age, we’re also more prone to falling. “The consequences of alcohol-related falls tend to be more serious after age 65,” he says.

“Tripping on a stair and hitting your head is far more likely to cause significant injury when you are older.”


The toxic effects of drinking too much

It takes longer for your body to metabolize alcohol than to absorb it. So excessive drinking keeps alcohol in your bloodstream longer.

This allows a toxic chemical into which alcohol is processed, called acetate, to build up in your liver. Over time, acetate damages your liver tissues, causing cirrhosis.

In addition, if you “drink” more calories than you eat, that puts you at risk for nutritional deficiencies, which are also more common among the elderly.

“The consequences of nutritional deficiencies range from minor to major,” says Dr. Ford. “Folate deficiency causes anemia in adults, but thiamine deficiencies can trigger delirium.”

Drink moderately (if at all)

It’s best to follow the guidelines for moderate drinking — but, unfortunately, says Dr. Ford, few people do.

“Currently, the recommendation is that after age 65, men and women should have no more than seven alcoholic drinks per week,” he says.

“If you’re otherwise healthy and follow these guidelines, drinking shouldn’t be an issue. It’s overuse that’s the problem.”

Nevertheless, as you’re given more prescription medications in your late 50s and 60s, be aware of how they interact with alcohol.

And to enjoy good health over time, maintain your cardiovascular health, control your blood pressure and cholesterol, and exercise to preserve your lean muscle mass, advises Dr. Ford.


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