Many of North America’s seniors may have an alcohol problem, but not the kind one would expect. It seems that many seniors may not be drinking enough to reap the research-backed benefits of moderate drinking. Those benefits include heart health, improved memory and cognition, better bone density, and reduced risks for some types of cancer and for developing Type 2 diabetes.
The answer to whether those findings mean that seniors should drink is not that clear. The findings apply only to moderate drinking, and that is defined as one drink a day for women and two for men. For the purposes of moderate drinking, a drink is defined as five ounces of wine, 12 ounces of beer and 1.5 ounces of distilled spirits.
Seniors who drink less than that apparently don’t share the benefits and the benefits seem to unravel and disappear with more than moderate drinking, which for seniors can cause its own set of problems. The findings also apply only to seniors in good health and not to those who take prescription drugs for a variety of ailments and over-the-counter medications for problems such as pain, sleep, and allergies, including such seemingly innocuous drugs as aspirin and ibuprofen. Any of them can interact with or be affected by alcohol.
Just how many seniors drink is not clear, though the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions III showed that 55.2 percent of adults over the age of 65 said they drank alcohol. Most of them did not report having a drinking problem, though some exceeded the “moderate drinking” recommendation.
Seniors tend to be more susceptible to the effects of alcohol than younger people, both because they metabolize it more slowly than younger people do and because they tend to have less water in the body. Consequently, seniors may have a higher concentration of alcohol in the body than younger drinkers, and that concentration stays higher for a longer time -- another reason to stick to moderate drinking.
It is also possible that seniors are more psychologically susceptible to the use of alcohol than their younger counterparts. Many have suffered through multiple losses and/or are themselves facing the possibility of a life-changing disability or a painful, chronic medical problem. While light-to-moderate drinking might be relaxing or sociable, relying on drink as an escape can make depression and a number of health problems worse.
Indeed, the problems associated with too much alcohol are both well-known and well documented, among them poor coordination leading to traffic accidents and falls, liver damage, and increased risk for some kinds of cancer. The combination of alcohol and medications, even those that are prescribed, can magnify those risks and should be sufficient reason to avoid even occasional heavy drinking.
Though dozens of studies show that moderate drinkers seem to be healthier than those who don’t drink at all and, at the opposite end, those who are heavy drinkers, the reasons for this are not clear. Perhaps moderate drinkers are simply healthier than their non-drinking or their heavily imbibing counterparts, or maybe something about the effects of alcohol itself accounts for the documented positive benefits. More than 60 studies suggest that moderate alcohol use can increase the levels of HDL, or good cholesterol, and reduce the incidence of heart attacks.
Also, we learn that alcohol in low doses may help prevent abnormal blood clotting and alcohol seems to have both anti-oxidant and anti-inflammatory properties. These heart-protective benefits do not seem to depend on the type of alcohol consumed, despite the much touted benefits of red wine, suggesting that alcohol itself is the benefactor.
One of the most intriguing findings about the benefits of moderate drinking comes from work done by a team of researchers from the American universities of Maryland, Kentucky and Texas who analyzed data from participants in the original Framingham heart study. Their conclusion: seniors, defined as 60 and older, who were not already suffering any form of dementia, showed improved ability to recall events and memories after light to moderate alcohol use.
Another study from Loyola University showed that moderate drinkers were 23 percent less likely to develop dementia and cognitive impairment. In the case of both heart disease and cognition, the working hypothesis is that moderate drinking improves blood flow, to the heart and heart muscle in one case and to the brain in the other. That improved circulation may account for the benefits.
Other research suggests that alcohol -- again, with the emphasis on “moderate” -- improves bone density, reduces the risk of Type 2 Diabetes by as much as 30 percent, and reduces the risk of developing gallstones. And as an added benefit for older women struggling to control their weight, a study published in the Annals of Internal Medicine in 2010 showed that women who were moderate drinkers were less likely to gain weight than those who did not drink. One suggested explanation was the possibility that moderate drinkers tended to eat less, particularly the kinds of carbohydrates implicated in weight gain.
All things considered, the question of whether seniors should follow the moderate drinking guidance needs to be made by each individual, ideally with input from a physician. Admittedly, this is a tricky question for physicians. While it is easy to advise a senior who exceeds the moderate drinking advice to cut back, a physician may be reluctant to suggest that a non-drinking senior should add a glass of wine to the daily regimen.
Personally, I enjoy a glass of wine as I prepare our evening meals. I also take ibuprofen for arthritic pain on an as-needed basis. My family doctor has never advised me otherwise, of course I have never volunteered the information either. I prefer to consider moderate consumption of the grape as an added tonic in my daily regimen…It works for me!
…But you are on your own dear reader, especially if you are over 65. To drink or not to drink – that is the question!