Alcohol Use and Older Adults

If You Drink

Drinking Too Much Can Be Harmful

Millions of older adults drink alcoholic beverages. Some of them drink too much, which can harm their health and lead to safety problems. Sometimes it's hard to tell if someone has a drinking problem. Some signs of drinking, such as falls and depression, can be mistaken for other physical or mental conditions. Some people don't recognize or admit that they have a problem. Drinking problems are serious and should be treated by a doctor or other health care professional.

How Much Is Safe To Drink?

In general, healthy men and women over age 65 should not drink more than three drinks a day or a total of seven drinks a week. Drinking more than these amounts puts people at risk of serious alcohol problems. However, people can still have problems within these limits. Depending on their health and how alcohol affects them, older adults may need to drink less than these limits or not at all. Do not drink if you plan to drive a vehicle or operate machinery, take medicines that interact with alcohol, or have a medical condition that can be made worse by drinking.

How much is one alcoholic drink? A "standard" drink contains about 0.6 fluid ounces of pure alcohol. A single drink can be

  • 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 wine
  • one 1.5-ounce shot glass of hard liquor such as whiskey, gin, vodka, or rum. The label on the bottle will say "80 proof."

Not all drinks are served in standard sizes. For example, a mixed drink can contain as many as three or even more standard drinks, depending on the type of liquor and the recipe. Even popular brands of beer advertised as “light” may have almost as much alcohol as regular beer.

Weighing the Risks and Benefits of Drinking

Many people think that a little drinking can be good for you. Studies have shown that light to moderate drinkers -- men who have one or two drinks a day and women who have one-half or one drink a day-- are less likely to develop or die of heart disease than people who drink more or not at all. But it is not clear that red wine or any other alcoholic drink accounts for moderate drinkers' better health because they may be healthier than others to begin with. The risks of drinking must be considered along with the potential benefits. For example, as little as one drink a day can slightly raise the risk of breast cancer in some women, especially those who are past menopause or who have a family history of breast cancer. Doctors do NOT recommend that nondrinkers start drinking to improve their heart health.

How to Tell if Someone Drinks Too Much

It's not always obvious that someone drinks too much. For older adults, clues to a possible alcohol problem include memory loss, depression, anxiety, poor appetite, unexplained bruises, falls, sleeping problems, and inattention to cleanliness or appearance. Answering "yes" to at least one of the following questions is also a sign of a possible drinking problem.

  • Have you ever felt you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about your drinking?
  • Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

If you answered "yes" to any of these questions, talk with your health care provider. Also seek help if you feel you are having drinking-related problems with your health, relationships, work, or the law.

Older adults drink for different reasons than do younger adults. Some have been drinking for many years and are physically dependent on alcohol. Others start drinking later in life because of health problems, boredom after retirement, or loneliness after the death of a spouse or close friend. This is called "late-onset drinking." Feeling tense or depressed can also trigger drinking.

Alcohol Abuse and Dependence

There are two main kinds of alcohol problems, alcohol abuse and alcohol dependence (also known as alcoholism). Alcohol abuse occurs when a person drinks too much and too often but is not physically dependent on alcohol. In addition to its physical effects, this abuse can lead to dangerous behavior such as driving a car after drinking, or to legal problems such as an arrest for drunk driving. Alcohol abuse can also involve trouble with personal relationships and with taking care of home or work responsibilities. People who abuse alcohol often continue to drink, even though they know it may cause these problems.

Alcohol dependence is a more serious problem than alcohol abuse. It is a lifelong disease in which people have a strong need to drink, cannot control their drinking once they start, and need to drink greater amounts of alcohol to get "high." Many, but not all, older adults with this disease physically depend on alcohol. When they stop drinking, they can get nauseated, sweaty, shaky, and restless. These withdrawal symptoms cause them to start drinking again, even though doing so can lead to physical or mental problems. Because of their increased sensitivity to alcohol, older people with alcohol dependence may not drink as much as younger people who are dependent on alcohol.

Does Alcohol Dependence Run in the Family?

Many factors can influence a person's risk of alcohol dependence. Some people inherit genes from a parent that increase the likelihood of alcohol dependence. Long-time heavy drinkers are more likely than late-onset drinkers to have a family history of alcohol dependence. High levels of stress, having friends and family members who drink, and ready access to alcoholic drinks also increase the chance of developing alcohol dependence. But, having an alcoholic parent does not always mean that a child will develop alcohol dependence. Some people become alcohol dependent even though no one in their family has a drinking problem.