I will admit, I like good eggnog. Champagne for New Year’s Eve. A beer with good Indian food. A glass of red wine at a dinner party. In our culture, alcohol is entwined with celebration.
And very moderate alcohol consumption does seem to have some health benefits. For instance, red wine contains a compound, resveratrol, touted to decrease heart disease. But that doesn’t mean you should see a bottle of wine as a medicine. All health recommendations specify “moderate” drinking as very limited, no more than one drink per day for women, two for men.
And, as this explainer from the renowned Mayo Clinic points out, we know very little about the risks of moderate drinking. Almost all the studies that have been done about lifestyle—diet, exercise, alcohol consumption—rely upon people honestly reporting their habits over the course of years. And the studies only show that various things are associated with one another. They don’t show causation. For instance, people who drink red wine seem to have less heart disease. But the studies don’t show that drinking red wine causes a drop in heart problems.
I’ll tell you what I’ve observed in decades as a geriatrician: Alcohol should be used with caution. I’m not saying that we should return to the bad old days of Prohibition. A glass of wine with a nice meal is a beautiful accent. But we could all be more aware of our alcohol consumption.
Here are things that I tell my families to consider about alcohol:

  • Alcohol is sugar.
    Think of it as a candy bar in a glass. It has no nutritional value. Regular alcohol consumption adds lots of extra calories. That can lead to weight gain, even diabetes, high blood pressure, and increased cholesterol. These things increase the risk of heart attacks, strokes, and dementia.
  • Alcohol is a toxin.
    That’s what makes us feel tipsy or drunk. Any elder who drinks heavily is much more likely to have brain damage. Thiamine needs to be replaced, and alcohol withdrawal should be made with medical supervision. DTs or Delirium Tremens is a life-threatening complication of unmanaged alcohol withdrawal. At some point, the brain damage leads to a loss of ability to care for medical or financial needs independently. (See the Trump capacity blog)
  • As we age, we tolerate the effects of alcohol less well.
    It takes less alcohol to impair judgment as we get older. I’ve had family friends die from car accidents after parties. Alcohol leads to a loss of balance, leading to falls and fractures or head injuries.
  • Alcohol will worsen sleep.
    If someone is not sleeping well, pause the alcohol in cocktail hour. Try special non-alcoholic drinks. Adding bitters or fruit juice to seltzer makes it feel special, without affecting sleep.
  • Alcohol can profoundly affect judgment and mood.
    No alcoholic can be determined to have a mental illness unless they have been dry for at least six months.

If you or someone you love is struggling with alcohol, there is help. Speak with your doctor. Call the local division on aging, look up AA. AlAnon is also helpful for loved ones of alcoholics who will not get help.
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