Regular drinking in your 50s and beyond can exacerbate age-related health problems like heart disease and dementia. Photo / 123rf
Here’s how to know if your alcohol consumption is affecting your health – and what to do about it
In homes across the country, as dusk strips the light from our day, there is the pervasive sound of glasses clinking. “It’s wine o’clock,” we think to ourselves as we pour a large one; a deserved treat after another 12 hours of slog.
But evidence shows that as the years of drinking notch up, so do the downsides. Research carried out by Drink Wise, Age Well, (a seven-year programme that started in 2014 and ended in 2021) on more than 16,700 participants aged over 50, showed that, for some, alcohol consumption directly contributes to physical and mental health issues.
In turn, age-related factors, such as social isolation and longstanding illness, can drive people to drink more, creating a cyclical process.
A survey from the UK’s NHS shows that adults aged 55 and older are more likely to drink on at least five days a week than younger people, who tend to drink less.
And the Office for National Statistics reports that in 2021 there were 2512 alcohol-specific deaths among people aged 65 and older in the UK, which is more than a quarter of all alcohol-specific deaths in that year. These figures may seem shocking, but it’s all too easy for drinking to become a habitual pastime.
As we move into our latter years, decades of socialising have shaped our drinking behaviour (and health). Momentous milestones like children leaving home, the passing of a loved one, divorce, loneliness, retirement and failing health seem to come thick and fast, and alcohol as an anaesthetist can mask these problems.
The Drink Wise, Age Well programme found that people who did not cope well with the challenges of their life were at least five times more likely to be higher-risk drinkers.
Long-term regular drinking can have negative consequences, including on your sex life. Alcohol depresses the central nervous system and often causes erectile dysfunction. It can also break down relationships and damage careers. Alcohol Change UK states that 40% of employers mention alcohol as a significant cause of low productivity.
And at a period when our long-standing careers might be riddled with stress, burnout or the uncertainty of retirement, reaching for the bottle can hide deeper concerns. Annabel Wright is an executive coach who uses psychodynamic methods, and frequently works with midlife leaders in organisations, helping them to work on their confidence, resilience and stress, and navigate and build strong relationships with their teams and peers.
“I have clients who drink to alleviate work pressures. Invariably they want to address this because regular hangovers affect their performance and make them feel bad about themselves. They’ve perhaps got into a habit of drinking after work socially, and in certain cases a dependency can build up. Blotting out uncomfortable emotions with drink is never a solution, and we need to talk them through and find healthy alternatives to self-soothe.”
The charity Drinkaware says that 80% of adults in this country couldn’t tell you what the government’s low-risk drinking guidelines are. Introduced by the UK Chief Medical Officers in 2016, the recommendation is 14 units of alcohol per week. But we are often deluded with our measures – a small glass (125ml) of 14% wine is actually nearly two units. Matt Lambert, the health information and promotion manager for the World Cancer Research Fund, says: “Adults aged between 45 and 64 are more likely to drink over the weekly recommended units. Reasons for this can be varied, but in this age group, life can get harder – illness, death of a loved one or loneliness. These factors can lead people to engage in unhealthy behaviours, like drinking more alcohol.”
And how you drink is part of the picture. The guidelines suggest spacing your alcohol units over three or four days and having several alcohol-free days, rather than drinking them in one big session. Our bodies are capable of processing about one unit of alcohol an hour; overload it and alcohol poisoning can result. In the long term, drinking excessively can cause health problems like heart and liver damage, high blood pressure, stroke and some cancers, including stomach and bowel. Studies show alcohol causes around one in 17 cases of bowel cancer in the UK.
Matt Lambert adds: “A recent poll shows that two in five people are unaware of the links between cancer and drinking alcohol. The alcohol in drinks is a chemical called ethanol, a cancer-causing compound. When our body breaks down alcohol, it can cause damage to our cells. As we age, there’s more time for this cell damage to build up and increase the risk of cancer. To reduce this risk, we would recommend not drinking alcohol at all.”
The natural ageing process means our bodies no longer work as they did before. We lose muscle strength, bone density and essential organ health. Our tolerance to alcohol is lowered due to physical changes, like a reduction in the ratio of body water to fat (so alcohol is more concentrated) and decreased hepatic blood flow, which weakens the liver. A nutritious diet, regular weight-bearing exercise, which is recommended for older people as muscle mass diminishes, and – sorry! – less alcohol will up your ability to cope better later in life. But if you do choose to drink, there will be repercussions that escalate as you age.
When we drink alcohol, it first travels into the stomach, then through the bloodstream to the heart, brain and liver. The negative impact on these organs increases with time. Pamela Healy, the chief executive of The British Liver Trust, says: “The liver is your largest internal organ, responsible for processing the alcohol you consume, among its hundreds of other functions. When alcohol is consumed excessively, especially in an aged organ, your liver may struggle to process it efficiently.”
Prof Patrick Kennedy, a consultant hepatologist at Barts and The London School of Medicine and Dentistry, adds: “The capacity of the liver to regenerate (or repair itself) reduces with age, thus recovery from alcohol-related liver injury is slower. This is one of the reasons why people in their 50s are more intolerant of alcohol. If alcohol is consumed continuously or in the context of binge drinking, the potential for liver damage is higher.”
Persistent drinking not only creates a ticking time bomb of health issues, it can also play havoc with our appearance. Aisling Pigott, the dietitian and spokesperson for the British Dietetic Association, says: “A gram of pure alcohol contains around seven calories. Compare that with cooking oil that has nine calories in a gram – there’s not much between them. Most of us will experience weight gain as we age, so it’s no surprise that regular drinkers are more likely to put on weight.”
Weight gain in midlife is very different to gaining a few pounds in your mid-20s. “Gaining fat around our waistline is more common in middle age and carries more health complications,” Pigott adds. “Also, high levels of alcohol can disrupt our gut health, making us more prone to digestive issues like acid reflux or IBS. Alcohol inhibits the absorption of essential nutrients such as magnesium, zinc, potassium and B vitamins, especially B1 (thiamine), which helps the body convert food into energy. And after 50, the body’s ability to absorb some vitamins diminishes (including B9 and B12). Plus, when we drink too much, it’s more difficult to make healthy food choices generally. We’ve all heard of the fat-laden hangover fry-up!”
There are also a number of studies that show alcohol has a detrimental effect on our skin. As a diuretic, it increases dehydration, and drinking substantial amounts over a number of years is shown to cause skin damage. Dr Natalia Spierings is a consultant dermatologist and author of Skintelligent: What You Really Need to Know to Get Great Skin. She adds: “Alcohol consumption – whether within government volume guidelines or beyond that – does indeed have potentially harmful effects on mature skin. There has been a suggested link between alcohol and inflammatory skin disease, like psoriasis and eczema. And the European Prospective Investigation into Cancer and Nutrition showed an association between skin cancer and alcohol intake.
“In men, they found increased alcohol consumption correlated with an increased incidence of both squamous cell carcinoma and melanoma. Both men and women showed an increased lifetime risk of basal cell carcinoma associated with the intake of wine specifically, and also an increased lifetime risk of melanoma with spirit intake.”
Gender also plays a role – because women are usually smaller, weigh less and have less muscle mass, alcohol tends to enter their bloodstream more quickly.
The impact of booze tends to be greater as we get older: less efficient bodies just cannot tolerate it as well. Alcohol affects kidney function by suppressing vasopressin, a hormone that tells the kidneys to hold on to fluid. Dehydration occurs, resulting in headaches and tiredness. There is also a greater risk of contracting a urinary infection.
Booze impairs rapid eye movement, known as REM, the most restorative part of sleep, which results in tiredness and lack of concentration the next day. As we age, good-quality rest is essential to maintain brain function and our ability to manage our lives. Add other factors – the hungover morning after usually means less healthy food choices, irritability and inability to cope well – and the chances of doing any exercise are, frankly, pretty non-existent. Andrew Misell, a director at Alcohol Change UK, adds: “Better care for ourselves in our midlife equates to feeling in good health, more positive and resilient. Drinking too much or too often won’t help us achieve that.”
For women, this time of their lives is synonymous with menopause. Dr Louise Newson, a GP and menopause specialist, says: “Some patients will admit they are drinking more as a way to numb menopause symptoms, but alcohol can make things worse. It impacts your circadian rhythm (our internal body clock that regulates cycles of sleepiness and alertness), leading to more disruption and that horrible foggy feeling in the morning.
“In addition, alcohol can worsen anxiety and lower mood, both of which are common menopause symptoms due to the fluctuation and falling of the hormones oestrogen, progesterone and testosterone during menopause.
“Alcohol, particularly red wine, often triggers hot flushes and night sweats – though it’s worth pointing out that evidence is mixed in this regard. Another thing I find is that women can be unaware of the wider health implications of heavy alcohol consumption, such as an increased risk of mental health problems and osteoporosis.”
The Royal Osteoporosis Society says that “alcohol affects the cells that build and break down bone”.
Experts say our cognitive ability rises sharply, peaking in our mid-30s, before levelling off and declining from our mid-30s onwards. So once we reach midlife, our reflexes, balance and concentration are not as sharp, our eyesight and hearing are affected, and our judgement is already compromised. Alcohol will exacerbate this. Consequently, falls, car accidents and mishaps in the home tend to happen more frequently if drinking is involved.
ASCERT, a Northern Irish charity that aims to reduce alcohol and drug harm, says of the 4,000 fatal accidents that happen in UK homes every year, 400 are alcohol related. And UK Government statistics for 2021 reveal that between 240 and 280 people were killed in vehicle collisions in the UK where at least one driver was over the limit.
And anyone with a chronic illness should be wary of mixing prescription or over-the-counter medication with alcohol. It can increase the person’s sensitivity to the drugs, or cause a surge in the product’s side effects, or even a reduction in its effectiveness. Some anti-depressants can intensify negative feelings when taken alongside alcohol.
It isn’t always easy to know if someone has a drink problem, but Drinkaware suggests looking out for changes in behaviour, physical and mental health, or if someone is being secretive or dishonest about the amounts they are buying or drinking.
Age Concern UK says: “Alcohol consumption is causally linked to over 60 diseases, and older people living with a drink problem are more likely to develop physical and mental health conditions, including dementia, liver disease and brain damage.”
Alcohol is a depressant, affecting the balance of chemical messengers in the brain. Dr David Crepaz-Keay, the head of research at the Mental Health Foundation, says: “Alcohol and mental health are closely linked, and drinking too much can negatively affect your wellbeing. Drinking consistently over a long period of time into older age reduces the number of neurotransmitters, and we need these to ward off feelings of anxiety and depression. This means we might drink more to help relieve these feelings, which can start an unhealthy cycle of dependence.”
Many of us have experienced short-term memory loss after a heavy night, but excessive, long-term alcohol consumption and binge drinking has been linked to dementia. Siân Gregory, the research communications manager at Alzheimer’s Society, says: “We’ve known for some time that drinking too much alcohol over a lengthy period is linked to poor brain health. Alzheimer’s Society part-funded a report led by Professor Gill Livingston at University College London called The Lancet Commission on Dementia Prevention, Intervention and Care. This report suggests that up to 40% of all dementia cases could be potentially preventable, as they are associated with 12 different risk factors that include drinking too much alcohol, excessive smoking and high blood pressure. However, drinking alcohol in moderation has not been conclusively linked to an increased dementia risk.”
Karen Tyrell, the CEO of Drinkaware, says: “No matter how old you are, you will see some positive health benefits if you stop drinking, or even cut back on the amount. Your quality of sleep will improve, giving you more energy in the morning, and as alcohol can act as a depressant, you should start to feel your mood and mental health improve. Cutting back can also lead to improvements in your skin, and as alcohol is high in calories, you should notice some weight loss. It is never too late to reduce your drinking or stop altogether.”
NY Times: Heatwaves impair cognition, increase aggression, and disrupt self-control.