Alcohol Use and Older Adults - If You Drink

05/17/19 ·National Institute on Aging

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, to be at low risk for alcohol use disorder (AUD), 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.

(Watch the video for tips on cutting back on drinking. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)

What Is a "Standard" Drink?

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 distilled spirits 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. "Light” typically refers to less calories, not less alcohol.

Risks and Benefits of Drinking

Many people think that a little drinking can be good for you. Studies have shown that people who drink at light to moderate levels—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 better health in people who drink moderately 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 people who don’t drink start drinking to improve their heart health. 

Signs of Problem Drinking

 It’s not always obvious that someone drinks too much. For older adults, clues to a possible alcohol use disorder 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, or work.

Reasons Older Adults May Drink

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 Use Disorder

 If a person drinks too much or too often he or she may develop an alcohol use disorder (AUD). An AUD can range in severity from mild to severe. On one end of this spectrum, drinking might cause sickness, depression, or sleeping problems. More severe symptoms include drinking more than intended or craving alcohol once you’ve stopped drinking. 

AUD can be a lifelong disease in which people have a strong need to drink, cannot control their drinking once they start, and over time need to drink greater and greater amounts of alcohol to get “high.” Older adults who develop a severe AUD become physically dependent on alcohol. When they stop drinking, they can get nauseated, sweaty, shaky, and restless. These withdrawal symptoms can cause them to start drinking again to feel better, even though doing so can lead to physical or psychological problems. 

Do Problems With Alcohol Run in the Family?

Many factors can influence a person’s risk of an alcohol use disorder. Some people inherit genes from a parent that increase the likelihood of an alcohol use disorder. People who drink heavily for a long time are more likely than people who start drinking later in life to have a family history of alcohol use disorder. High levels of stress, having friends and family members who drink, and ready access to alcoholic drinks also increase the chance of developing a problem with alcohol. But having an alcoholic parent does not always mean that a child will develop alcohol use disorder. Some people develop an alcohol use disorder even though no one in their family has a drinking problem.