Alcohol and Older Adults by Joyce Remy, Caresource Healthcare Communications

Seattle-King County Edition

December 1, 2007

Alcohol and Older Adults

Joyce Remy, Caresource Healthcare Communications

How Alcohol Affects Your Body

Alcohol can become a problem for a person of any age. Older adults are no exception. Alcohol affects the body in several negative ways. For example:

Moderate alcohol consumption is generally not harmful. But as we grow older, alcohol affects our bodies differently in several important ways.

Digestion. From the time it enters your mouth, alcohol is hard on your body. It tends to harden the lining of your mouth, tongue, and throat. Over time, especially in combination with aspirin and certain other drugs, alcohol damages the wall of the stomach.

Circulation. From your stomach, alcohol enters your blood stream. Blood vessels are affected by alcohol as they carry it throughout your body. At first, alcohol causes an increase in blood pressure, along with a faster heartbeat. But soon, the heart slows down. A gradual or sudden dilation of the heart muscle occurs, with the result that less blood is being pumped to the rest of the body. Blood vessels can also become congested, which will slow circulation even more.
Thinking. Alcohol reaches the brain and spinal cord through the blood. It first goes to the more complex, higher brain centers, where it slows down mental activity such as behavior, speech, memory, and reasoning.
Coordination. Next, alcohol moves to the motor centers of the brain. When activity in these areas is depressed by alcohol, movements are less coordinated and reflexes are slower.
Muscle tone. Alcohol affects the muscles of the body through the central nervous system. Muscles become over-relaxed and, thus, less able to perform. The heart, the body's most important muscle, can also be damaged by too much alcohol.
Liver function. The liver is the organ that is mainly responsible for removing alcohol from the body. Growing older may mean less blood flowing to the liver. So, the rate at which alcohol is removed is also reduced.

Alcohol and Health Problems

Alcohol affects chronic health problems in important ways. Here are some examples:

Hypertension/heart disease. Alcohol can contribute to the onset and worsening of high blood pressure (hypertension) by increasing the pressure in the blood vessels. In high quantities, alcohol may actually be toxic to the heart muscle, weakening it and causing it to become enlarged. Alcohol may also cause changes in heart rate and rhythm.
Diabetes. Alcohol makes diabetes more difficult to control. It has also been identified as contributing to other complications of diabetes.
Peptic ulcer disease/esophageal reflux. Alcohol frequently makes the symptoms of these conditions worse by irritating the digestive tract and damaging the lining of the stomach.
Lung disease. Persons who consume a lot of alcohol increase their risk of lung disease, lung infections, and lung damage. Alcohol reduces the ability of the respiratory system to defend itself against disease, in part by decreasing the cough and gag reflexes that help keep the respiratory tract clear.
Sleep. Some people have a “nightcap” to help them relax before bed. But the result can be poor quality sleep. In addition, many people find that they wake up after only a few hours if they've consumed alcohol too close to bedtime.

Alcohol and Medications

You probably remember times when your doctor or pharmacist has warned you about using alcohol while taking a particular drug. There are good reasons for caution. Since alcohol affects almost every part of the body, it can interfere with, or even block, the effects of certain medications. In other situations, it can exaggerate the effect of a drug you are taking. For example, combining alcohol and barbiturates can be dangerous, and may even result in death.

Suggestions for Reducing Your Use of Alcohol

Many older adults wisely decide that their body can't handle alcohol they way it used to. If you are among them, here is a five-step approach you may wish to use to help you reduce the amount of alcohol you consume…or, help you eliminate it altogether, if that's your decision.

Step 1: Keep an accurate record of your drinking for one week. During this week, don't try to control or change your usual drinking style. Try to pinpoint the changes you want to make in your drinking, and anticipate any difficulties you might have when you begin to change your drinking.

Step 2: Set a specific goal for yourself, one you have carefully considered and feel you can live with. For example: no more than three drinks a week; or, no more than one drink on any one day.

Step 3: Don’t drink at all for the next two weeks. You may find, when you abstain for the two weeks, that other people may pressure you to drink or that you are tempted to ignore your goal. Finding out how you cope with these pressures or temptations will provide the key to changing your drinking style and staying with the long-term changes you decide to make. Based on what you learn, reaffirm (or, if necessary, modify) your personal plan.

Step 4: If you decide to resume drinking at the end of the trial period, do so at a pace consistent with your plan and personal commitment. For example, try having a single glass of wine with a meal, instead of two or more beers or cocktails before dinner. As you do this, it may also help to change the setting in which you consume alcohol.

Step 5: Finally, work “behind the scenes” to reduce your drinking even further. For example:

Start using more mixer and less alcohol.
Try substituting non-alcoholic beverages, such as club soda and lime or non-alcoholic beer or wine…or alternate between these and ones that contain alcohol.
Sip your drink more slowly. If you usually finish a drink in half an hour, space out your sips so the drink lasts an hour.
Count your drinks carefully. Continue keeping a written record of exactly how much alcohol you are consuming.

Getting Help for Alcohol Abuse

These five steps can help a person who wants to reduce the influence of alcohol in the interests of better health. However, many older adults struggle with their drinking as a dependency and serious health concern. In a person’s older years, personal losses and depression can occur. A person may begin drinking (or begin drinking more heavily) for company and comfort.

If you suspect that you or someone you love is dealing with alcohol abuse, the first rule is to get help. Normally, this is not something you can fix on your own. A good starting point is Alcoholics Anonymous (www.alcoholics-anonymous.org), which offers programs specifically geared to older adults. Or contact your local Senior Information and Referral or your health care provider for help in finding a treatment program in your community.

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