July 30, 2018

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?


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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.

Related Articles

man sick wants to vomit
April 4, 2022
Vomiting 101: Why You Throw Up and the Best Way To Recover

Drink small amounts of water for a few hours after throwing up

A person sitting on a couch holding a glass of red wine
December 2, 2021
How Long Does Alcohol Stay in Your System?

The speed of alcohol metabolism is different for everyone

Variety of medication pills and tablets and liquids
February 22, 2024
Is It OK To Take Expired Medicine?

Some types of expired meds may not be harmful, but they probably aren’t worth the risk

Shoe storage shelf home, including purses and bike helmets
February 14, 2024
Wearing Shoes in the House: ‘OK’ or ‘No Way’?

Leaving footwear on invites germs, bacteria, toxins and other unwanted guests into your home

Male consults with pharmacist about herbal supplement
February 13, 2024
Herbal Supplements: Why To Check With a Healthcare Provider First

Besides questionable effectiveness, herbal supplements aren’t safe for everyone

Teacup of tea and plate of toast
February 2, 2024
What To Eat, Drink and Avoid When You Have the Stomach Flu

Start slowly with clear fluids, and then move to bland, easy-to-digest foods

Male with eyes closed sitting hunched over, pinching area between their eyes
January 29, 2024
Headache and Fatigue: 11 Possible Causes That Can Trigger Both

Many factors, like dehydration, a cold or even your medication, can result in these common symptoms

various New Year's resolutions written in date planner, with weights and chocolate in foreground
December 28, 2023
8 Common New Year’s Resolutions and How To Keep Them

Whether you’re trying to work out more, drink less or manage stress, we can help set you up for success

Trending Topics

close up of keto gummies
Do Keto Gummies Work for Weight Loss? Are They Safe?

Research is inconclusive whether or not these supplements are helpful

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

Older person postioned sideways showing dowager hump.
Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture