Alcohol and the Older Adult: A Comprehensive Review

Abstract

Alcohol consumption in the older adult is of major concern with the advent of baby boomers coming into the over 65-age bracket. Alcohol consumption has been touted as beneficial for health, and while that may be accurate for moderate consumption in younger persons, there is considerable risk associated with increased alcohol intake in older adults. This increase is partially due to age-related physiological changes, existing diagnoses, number of comorbid conditions, and increased use of prescribed and/or over-the-counter medications, coupled with other concerns. This review addresses the current research regarding ethanol consumption in older adults and all-cause mortality as well as several conditions more frequently seen in the geriatric population. These conditions include vascular diseases, hypertension, type 2 diabetes, gastrointestinal disorders, hepatic disorders, dental and oro-facial problems, bone density decline, and falls and fractures. In addition, drug interactions and recent research into select vitamin and mineral considerations with increased alcohol intake in older persons are addressed. While recommendations for alcohol intake have not been specifically established for age ranges within the 65-year-and-older bracket, and practitioners do not routinely assess alcohol intake or ethanol related adverse events in this population, common sense approaches to monitoring will become increasingly important as the generation of “boomers” who believe that alcohol intake improves health comes of age.

KEYWORDS:

• alcohol drinking
• alcoholism
• comorbidity
• older adults

Notes

∗Age-related changes vary widely depending on genetic predisposition, environmental and lifestyle factors, as well as preexisting disease states and comorbid conditions.

∗Non-comprehensive listing of potential drug–ethanol interactions, mechanistic considerations, and adverse clinical consequences.

∗Distinguishing among healthy adult older than 65 years versus “frail” or older adult with multiple concerns.