How the risks of drinking increase in older age
Alcohol can present new problems in older age — particularly at 65 and older — for even light or occasional drinkers. Older adults tend to have less muscle mass and retain less water in their tissues compared with younger people, which can increase blood alcohol concentration, said Aaron White, a senior adviser at the National Institute on Alcohol Abuse and Alcoholism. This means it takes fewer drinks for older people to feel intoxicated, and heightens the risk of severe injury from falls.
According to Nixon's research, older people also show deficits in working memory at lower blood alcohol concentrations than younger drinkers. In another study Nixon worked on, some older adults in driving simulations showed signs of impairment after less than one drink.
Drinking alcohol can increase the risk of developing chronic conditions such as dementia, diabetes, cancer, hypertension and heart disease. But it can also worsen outcomes for the majority of older adults already living with chronic disease, said Aryn Phillips, an assistant professor of health policy and administration at the University of Illinois Chicago who studies alcohol and aging.
Advertisement
Drug interactions also come into play. Mixing alcohol with prescription medicines that older adults commonly take, such as those for treating diabetes or hypertension, can make the medications less effective or cause harmful side effects, like ulcers or an irregular heart beat. Benzodiazepines, when combined with alcohol, can slow breathing and act as a powerful sedative. Even over-the-counter medication can be dangerous. Aspirin, which some older people take to reduce cardiovascular disease risk (despite the potential side effects), can lead to severe gastrointestinal bleeding, which older people are already at higher risk for, said Michael Wheeler, a professor of nutrition science at East Carolina University who researches alcohol-induced liver disease.
Some older adults also contend that hangovers worsen with age. While there's no strong scientific evidence supporting this, the hangovers may seem worse because alcohol can exacerbate other symptoms of aging, like poor sleep, White said.
How to Reduce Your Risk
Experts said alcohol use among older adults appears to have risen in recent years, though national trends are difficult to track outside of self-reported surveys. A federal survey from 2023 found that 12% of adults 65 and older — about 7 million people — reported drinking at least four or five drinks in a sitting in the previous month.
After decades of mixed messaging around alcohol's health harms and benefits, recent studies have made it clear that no amount of alcohol is good for you. Still, Sacco acknowledged that 'drinking has meaning for people,' and whether to moderate or quit altogether 'is a call that you have to make in consultation with your doctor and your loved ones.'
Advertisement
But what is a 'safe' amount of drinking for the older set? That's difficult to say. The available studies attempting to establish exactly how much alcohol it takes to drive up health risks in older populations use different benchmarks for moderate drinking, making it tricky to draw a consensus. 'Even as an expert in this field, I understand the confusion,' Wheeler said.
Nixon advised that adults 65 and older should consume no more than one drink per day and no more than seven per week. (The NIAAA does not establish guidelines around alcohol consumption, but the Centers for Disease Control and Prevention defines moderate drinking for adults of all ages as two drinks or less per day for men, and one drink or less per day for women.)
All the experts emphasized that older people should pay close attention to their bodies' response to alcohol, and to stop drinking or cut back if they feel like it's affecting them more physically or cognitively.
'If you're not currently drinking, don't start,' Phillips said. And if you do drink, be honest with your doctor about your consumption, and do it in a safe environment, knowing that your tolerance may not be what it used to be, she added.
'The answer doesn't have to be abstinence,' Nixon said. But healthy aging 'probably does not include multiple drinks a day for most people.'
This article originally appeared in
Advertisement
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Los Angeles Times
2 days ago
- Los Angeles Times
Serious liver disease is up among heavy drinkers, even without more drinking
Serious liver disease is becoming more common among Americans who drink heavily, according to a new study from Keck Medicine of USC. It's not that more people are partying with alcohol. And it's not that the drinkers are having more drinks. It's that more of the people who drink regularly are becoming sick. Over the last two decades, the share of heavy drinkers who have advanced liver scarring jumped from 1.8% to 4.3%. For women, more than 1.5 drinks per night, on average, is considered heavy drinking. For men, it's 2 drinks. 'The fact that the risk not only increased but that it more than doubled — almost tripled — is really astonishing,' said Dr. Brian P. Lee, a liver transplant specialist at Keck Medicine of USC and lead author on the study. It was published in the journal Clinical Gastroenterology and Hepatology on Wednesday. Lee said he thinks patients might dramatically change their thinking and behavior if they had this information. The increase in illness was seen especially in women, older people and those with conditions like obesity or diabetes. Three USC researchers analyzed national health data from more than 44,000 adults surveyed between 1999 and 2020 in a well-known national heath study known as NHANES. Of those, 2,474 were heavy drinkers according to the definition of the National Institute on Alcohol Abuse and Alcoholism — 20 grams of alcohol per day for women and 30 grams for men, roughly the equivalent of 1.5 and 2 drinks. They found a more than twofold increase over the two decades in significant liver fibrosis, a condition where healthy liver tissue is replaced by stiff, fibrous tissue — like a sponge hardening into leather. If left unchecked, this can eventually lead to liver failure or cancer. By comparison, non-heavy drinkers saw a much smaller increase, from 0.8% to 1.4% over the same period. This rise in liver damage is especially troubling because many people don't realize anything is wrong until the disease is advanced. 'Liver disease is silent,' Lee said. 'Most people won't, even if they have [advanced liver scarring], have any symptoms at all.' Drinking patterns did not change much over the study period. But the health profiles of heavy drinkers did. Rates of metabolic syndrome — a cluster of conditions including obesity, diabetes, and high blood pressure — increased from 26% of people, to nearly 38%. Demographics shifted too: heavy drinkers became more likely to be women, people over the age of 45, and those living in poverty. 'We're showing with this study that the picture of the American drinker is changing dramatically,' Lee said. 'You have more women who are drinking heavily, more ethnic minorities who are drinking heavily, and these are groups that are known to have a higher sensitivity to alcohol in causing liver damage.' Other factors may also be at play, said Dr. Sammy Saab, medical director of the Pfleger Liver Institute at UCLA, who was not involved in the study. People could be consuming different types of drinks, or at different times. 'Have we moved away from beer, wine, to hard cocktails? Have we moved away from drinking with food, where the food absorbs some of the alcohol you consume, versus drinking without food where alcohol is better absorbed?' Saab asked. Then there are cultural changes, he said. 'In the old days, if you drank, you'd still have to drive home, but now we've got Uber, we have Lyft,' he said, which may remove some deterrents to heavy drinking. The current definition of heavy drinking in the U.S. may actually be too lenient, Lee said, especially compared to evolving global standards. Canada, for example, now advises no more than two drinks per week to minimize health risks. 'In the U.S. right now, we consider heavy drinking to be eight drinks or more per week for women and 15 or more for men — but that's quite high,' he said. 'We've shown in prior studies that you can develop liver disease at lower quantities than the U.S. threshold.' The study's findings highlight the need to rethink long-held assumptions about alcohol-related liver disease, and Lee hopes it can be used to develop more effective screening methods for early detection. The paper raises a lot of good questions, Saab said, serving as a call to action for researchers and clinicians to better understand this increase in alcohol-associated liver disease — and how to stop it.
CNN
3 days ago
- CNN
States, cities face loss of vaccination programs and staff after ‘baffling' cuts to federal funding
Millions of dollars have been pulled from state and local vaccination programs with no explanation, after a review of the funding agreements by the US Department of Health and Human Services. Affected programs say they will probably have to cut staffers and services because of the shortfall, and they worry that vaccination rates will also drop as they lose the ability to assist people who are low-income or uninsured. Immunization programs across the country are already struggling to address an increase in vaccine-preventable diseases. These include pertussis – also known as whooping cough – which has sickened more than 10,000 Americans and killed five children this year, as well as a smoldering outbreak of measles that has killed three people in the US and threatens to end the country's elimination status. 'That's the baffling part,' said one policy expert who spoke to CNN on the condition that they not be named for fear of government retaliation. 'Why anyone would create this disruption in the midst of the worst measles outbreak in 30 years.' Most money spent by states on vaccination comes from the federal government. The grant money, which is appropriated by Congress under Section 317 of the Public Health Services Act, enables states, territories and some large cities to collect data on vaccination, as well as provide shots to underserved children and adults. The funds also help monitor the safety of vaccines and fight misinformation. The money is doled out in five-year grants overseen by US Centers for Disease Control and Prevention, and the most recent awards were due to states on July 1. This year, however, HHS conducted lengthy reviews of the awards, which delayed their arrival in some cases. HHS Director of Communications Andrew Nixon said the reviews were part of agency cost-cutting efforts. 'The Defend the Spend initiative is a department-wide effort to ensure that taxpayer dollars are being used effectively, transparently, and in alignment with this administration,' Nixon said in a statement to CNN. 'As part of this oversight, grant recipients may be asked to provide additional information, which is essential to preventing waste, fraud, and abuse. HHS is committed to working all grantees to resolve outstanding issues as quickly as possible while maintaining the highest standards of accountability.' Public health advocates say the latest funding cuts appear to be part of a larger pattern of efforts by HHS Secretary Robert F. Kennedy Jr. to disrupt and dismantle the America's vaccination infrastructure. 'Millions of children missed their routine vaccinations during the pandemic,' and never caught back up said Dr. Caitlin Rivers, director of the Center for Response Outbreak Innovation at the Johns Hopkins Bloomberg School of Public Health. Vaccine hesitancy has also increased, driven by a deluge of misinformation, some of it now coming from official channels. As a result, vaccination rates have dropped, and some communities are no longer protected by herd immunity, the threshold of vaccination required to prevent certain infectious diseases from easily spreading. If state vaccination programs are not adequately resourced, 'we're just going to continue to fall further and further behind, and that sets the stage for things like measles and pertussis outbreaks, which we're seeing,' Rivers said. Public health programs often become victims of their own success, she said. 'When there is a large public health emergency … there are huge investments made in public health, because we can see very clearly what the consequences are of having inadequate resourcing and inadequate infrastructure. But over time, those investments begin to work, and the threats recede, and we start to forget why it's so important to maintain those defenses,' Rivers said. 'And I think now, five years out of Covid, we're very clearly in the neglect cycle, and we're seeing a lot of the investments we made during the pandemic be pulled back,' she added. Of 66 jurisdictions awarded federal immunization funding this year, about 40 received awards lower than their funding targets. And more than a dozen states and cities received lower awards this year than they did in 2019, just before the Covid-19 pandemic began, the last time these awards were offered through the CDC, according to a CNN analysis of federal data. Massachusetts, New York, Indiana, California and Arizona were among those awarded less this year than in 2019, the year before the Covid-19 pandemic began. 'That's really, really unbelievable to us,' said one public health advocate who asked not to be named for fear of political retaliation for speaking out against the cuts. 'How could we come out of a pandemic with half of states being less prepared?' Other states found that their awards were far lower than they'd been told to expect. In January 2025, the CDC sent out a Notice of Funding Opportunity – essentially an invitation – to states, territories and certain large cities. It came with a funding target: the amount they could expect if their grant proposals were accepted. Washington, for example, was told it could expect about $9.5 million, so the Department of Health planned for that amount for the 2026 fiscal year. When the state got its Notice of Award on July 1, however, it was for $7.8 million, an 18% reduction. Massachusetts was told it could expect $7.7 million for the upcoming fiscal year, already a 20% reduction from its 2025 budget. When the award arrived, it was $1 million under the targeted amount, at $6.7 million, which means the department expects to operate with about 30% less funding next year than it has this year. Colorado received almost $500,000 less than it expected, a decrease of about 5% from the amount it budgeted for, according to federal data California, Illinois, Michigan and New York also received lower-than-expected funding awards, according to a CNN analysis of federal data. Sometimes, the delays and errors in funding caused chaos: At least one state, Idaho, furloughed its immunization program staff with no notice after the money didn't arrive when expected. When the award did come through a day later, they were put back to work, but medical providers who reached out in the interim to submit their regular data updates had no one to help them and didn't know when services would be restored. The cuts didn't just affect state health departments. The city of New Haven, Connecticut, had to lay off immunization positions that were supported by subawards it receives from the state grant. When the grant didn't arrive in time, the state directed the city not to incur any more expenses, and when the federal money did come through, it was 20% less than anticipated. Chicago is also preparing to lay off immunization workers, according to multiple sources with knowledge of the city's plans, who asked not to be named because they feared retaliation by the Trump administration. Not all awardees saw reductions, however. About two dozen jurisdictions, including Alabama, Idaho and Wyoming and Montana, got significant funding increases over their award targets for this year. State officials who spoke to CNN for this story say they were given no explanation for why the awards were reduced or increased this cycle. The cuts come on top of the loss of billions in unspent Covid relief funding that was being used by states, in part, to help staff immunization programs. In late March, HHS directed the CDC to roll back about $11.4 billion in Covid-era funding granted to state and local health departments. Another $1 billion was reclaimed from the Substance Abuse and Mental Health Services Administration. A survey conducted by the Association of Immunization Managers found that the Covid money clawback alone has led to the elimination 579 staff positions in state vaccination programs. After the new grant cuts, some jurisdictions said they would probably need to lay off even more workers but were trying to assess the changes that would be needed. Some programs said they hoped state funding could help fill the gaps. In the past, the funding amounts that jurisdictions were told they could expect have been determined by a relatively simple formula that primarily relied on an area's population. This year, however, federal officials deployed a more complicated formula that took into account population levels as well as how much of a state was rural and how many providers participate in the Vaccines for Children program compared with the overall population, according to a public health advocate familiar with the awards who asked not to be named for fear of political retaliation. Immunization programs were told they could expect about $418 million in funding. All told, what they were awarded totaled roughly $398 million. Changes to the funding formula don't appear to account for the reductions, however. The formula was applied to the target amounts that were distributed in January. Instead, changes to the awards came after the HHS review, which in some cases delayed the release of the money and left programs hanging. Hawaii, for example, received authorization to borrow up to $100,000 from the state government to pay salaries and cover operational expenses until its award came through, about two weeks late. Public health advocates blasted the funding decision. 'Stripping 317 waiver funds combined with other losses is starving state and local public health budgets and is not just short-sighted, it's reckless,' said Dr. Brian Castrucci, president and chief executive officer of the nonprofit deBeaumont Foundation, which advocates for the public health workforce. 'We're watching the deliberate dismantling of the public health safety net in real time,' Castrucci said.
CNN
3 days ago
- CNN
States, cities face loss of vaccination programs and staff after ‘baffling' cuts to federal funding
Vaccines Federal agencies Children's healthFacebookTweetLink Follow Millions of dollars have been pulled from state and local vaccination programs with no explanation, after a review of the funding agreements by the US Department of Health and Human Services. Affected programs say they will probably have to cut staffers and services because of the shortfall, and they worry that vaccination rates will also drop as they lose the ability to assist people who are low-income or uninsured. Immunization programs across the country are already struggling to address an increase in vaccine-preventable diseases. These include pertussis – also known as whooping cough – which has sickened more than 10,000 Americans and killed five children this year, as well as a smoldering outbreak of measles that has killed three people in the US and threatens to end the country's elimination status. 'That's the baffling part,' said one policy expert who spoke to CNN on the condition that they not be named for fear of government retaliation. 'Why anyone would create this disruption in the midst of the worst measles outbreak in 30 years.' Most money spent by states on vaccination comes from the federal government. The grant money, which is appropriated by Congress under Section 317 of the Public Health Services Act, enables states, territories and some large cities to collect data on vaccination, as well as provide shots to underserved children and adults. The funds also help monitor the safety of vaccines and fight misinformation. The money is doled out in five-year grants overseen by US Centers for Disease Control and Prevention, and the most recent awards were due to states on July 1. This year, however, HHS conducted lengthy reviews of the awards, which delayed their arrival in some cases. HHS Director of Communications Andrew Nixon said the reviews were part of agency cost-cutting efforts. 'The Defend the Spend initiative is a department-wide effort to ensure that taxpayer dollars are being used effectively, transparently, and in alignment with this administration,' Nixon said in a statement to CNN. 'As part of this oversight, grant recipients may be asked to provide additional information, which is essential to preventing waste, fraud, and abuse. HHS is committed to working all grantees to resolve outstanding issues as quickly as possible while maintaining the highest standards of accountability.' Public health advocates say the latest funding cuts appear to be part of a larger pattern of efforts by HHS Secretary Robert F. Kennedy Jr. to disrupt and dismantle the America's vaccination infrastructure. 'Millions of children missed their routine vaccinations during the pandemic,' and never caught back up said Dr. Caitlin Rivers, director of the Center for Response Outbreak Innovation at the Johns Hopkins Bloomberg School of Public Health. Vaccine hesitancy has also increased, driven by a deluge of misinformation, some of it now coming from official channels. As a result, vaccination rates have dropped, and some communities are no longer protected by herd immunity, the threshold of vaccination required to prevent certain infectious diseases from easily spreading. If state vaccination programs are not adequately resourced, 'we're just going to continue to fall further and further behind, and that sets the stage for things like measles and pertussis outbreaks, which we're seeing,' Rivers said. Public health programs often become victims of their own success, she said. 'When there is a large public health emergency … there are huge investments made in public health, because we can see very clearly what the consequences are of having inadequate resourcing and inadequate infrastructure. But over time, those investments begin to work, and the threats recede, and we start to forget why it's so important to maintain those defenses,' Rivers said. 'And I think now, five years out of Covid, we're very clearly in the neglect cycle, and we're seeing a lot of the investments we made during the pandemic be pulled back,' she added. Of 66 jurisdictions awarded federal immunization funding this year, about 40 received awards lower than their funding targets. And more than a dozen states and cities received lower awards this year than they did in 2019, just before the Covid-19 pandemic began, the last time these awards were offered through the CDC, according to a CNN analysis of federal data. Massachusetts, New York, Indiana, California and Arizona were among those awarded less this year than in 2019, the year before the Covid-19 pandemic began. 'That's really, really unbelievable to us,' said one public health advocate who asked not to be named for fear of political retaliation for speaking out against the cuts. 'How could we come out of a pandemic with half of states being less prepared?' Other states found that their awards were far lower than they'd been told to expect. In January 2025, the CDC sent out a Notice of Funding Opportunity – essentially an invitation – to states, territories and certain large cities. It came with a funding target: the amount they could expect if their grant proposals were accepted. Washington, for example, was told it could expect about $9.5 million, so the Department of Health planned for that amount for the 2026 fiscal year. When the state got its Notice of Award on July 1, however, it was for $7.8 million, an 18% reduction. Massachusetts was told it could expect $7.7 million for the upcoming fiscal year, already a 20% reduction from its 2025 budget. When the award arrived, it was $1 million under the targeted amount, at $6.7 million, which means the department expects to operate with about 30% less funding next year than it has this year. Colorado received almost $500,000 less than it expected, a decrease of about 5% from the amount it budgeted for, according to federal data California, Illinois, Michigan and New York also received lower-than-expected funding awards, according to a CNN analysis of federal data. Sometimes, the delays and errors in funding caused chaos: At least one state, Idaho, furloughed its immunization program staff with no notice after the money didn't arrive when expected. When the award did come through a day later, they were put back to work, but medical providers who reached out in the interim to submit their regular data updates had no one to help them and didn't know when services would be restored. The cuts didn't just affect state health departments. The city of New Haven, Connecticut, had to lay off immunization positions that were supported by subawards it receives from the state grant. When the grant didn't arrive in time, the state directed the city not to incur any more expenses, and when the federal money did come through, it was 20% less than anticipated. Chicago is also preparing to lay off immunization workers, according to multiple sources with knowledge of the city's plans, who asked not to be named because they feared retaliation by the Trump administration. Not all awardees saw reductions, however. About two dozen jurisdictions, including Alabama, Idaho and Wyoming and Montana, got significant funding increases over their award targets for this year. State officials who spoke to CNN for this story say they were given no explanation for why the awards were reduced or increased this cycle. The cuts come on top of the loss of billions in unspent Covid relief funding that was being used by states, in part, to help staff immunization programs. In late March, HHS directed the CDC to roll back about $11.4 billion in Covid-era funding granted to state and local health departments. Another $1 billion was reclaimed from the Substance Abuse and Mental Health Services Administration. A survey conducted by the Association of Immunization Managers found that the Covid money clawback alone has led to the elimination 579 staff positions in state vaccination programs. After the new grant cuts, some jurisdictions said they would probably need to lay off even more workers but were trying to assess the changes that would be needed. Some programs said they hoped state funding could help fill the gaps. In the past, the funding amounts that jurisdictions were told they could expect have been determined by a relatively simple formula that primarily relied on an area's population. This year, however, federal officials deployed a more complicated formula that took into account population levels as well as how much of a state was rural and how many providers participate in the Vaccines for Children program compared with the overall population, according to a public health advocate familiar with the awards who asked not to be named for fear of political retaliation. Immunization programs were told they could expect about $418 million in funding. All told, what they were awarded totaled roughly $398 million. Changes to the funding formula don't appear to account for the reductions, however. The formula was applied to the target amounts that were distributed in January. Instead, changes to the awards came after the HHS review, which in some cases delayed the release of the money and left programs hanging. Hawaii, for example, received authorization to borrow up to $100,000 from the state government to pay salaries and cover operational expenses until its award came through, about two weeks late. Public health advocates blasted the funding decision. 'Stripping 317 waiver funds combined with other losses is starving state and local public health budgets and is not just short-sighted, it's reckless,' said Dr. Brian Castrucci, president and chief executive officer of the nonprofit deBeaumont Foundation, which advocates for the public health workforce. 'We're watching the deliberate dismantling of the public health safety net in real time,' Castrucci said.
