Pharmacy and Health Blog from myGenericPharmacy.com

Your tolerance decreases with age due to changes in your body, health conditions, and medications you may take. If you feel like you’re getting more sensitive to alcohol as you get older … well, it’s not your imagination. The way we process alcohol changes with age, says a geriatrician.

Why alcohol hits differently as you get older :

The basic process by which your body metabolizes (processes) alcohol doesn’t change. But as you age, it becomes harder for your body to do. Here’s why:
Your liver enzymes change, which slows your body’s ability to break down booze like it used to.
Your lean muscle mass decreases, causing more alcohol to remain in your bloodstream and magnifying its effects.

Medications can interact with alcohol, which may change the way drinking makes you feel. It can also make your medications less effective. Other health conditions can play a role. Conditions like obesity and diabetes may affect your liver function and make it harder for your body to process alcohol.

You can’t metabolize alcohol as well :

Your liver just isn’t as resilient as you get older. So, it might not process alcohol as efficiently it does it does when you’re younger. Alcohol is mostly processed by enzymes in your liver, which break it down into chemicals that circulate throughout your body. Eventually, they morph into carbon dioxide and water that you pee out. But as you age, those liver enzymes change.

We’re all born with varying levels of enzyme activity to begin with, he continues. Then, as you get older, other factors start to compete for those enzymes’ attention, like health issues that affect your liver function and medications you take that also need to be broken down by your liver. There’s another issue, too: As you age, your circulation slows. With less blood flowing through your liver, the whole metabolizing process slows down, and toxic metabolites from alcohol start to build up.

Your body composition changes :

You lose about 3% to 8% of your lean muscle mass each decade after age 30. That means you have less muscle tissue available to retain water. That plays a role in alcohol does to your body, namely, that drinks start hitting you harder and faster. Because we lose lean muscle mass with age, a higher concentration of alcohol remains in the bloodstream explains. You feel more intense effects from the same amount of alcohol.

These effects may include:
Short-term memory problems and poor judgment
Being off-balance or uncoordinated (which raises your risk of falls)
Extra sleepiness or sluggishness
Decreased attention span
Increased risk of dehydration

Medications can interact with alcohol

When you’re taking certain medications, drinking can affect you in ways that you haven’t experienced before. Combining alcohol with certain drugs can affect how those drugs make you feel. It can also contribute to higher blood alcohol levels than when you weren’t on medication.

Plus, many medications compete with alcohol to be processed by your liver. It’s a competition that alcohol always wins, which means your liver doesn’t have the same bandwidth to process your medications the way it should. This can make them less effective and cause dangerous interactions.

Here are some examples:
Sedatives become more potent.
The effect of blood thinners is amplified, which raises the risk of serious bleeding.
Blood pressure medications don’t work as well, increasing your risk of stroke and other issues.

Aging and alcohol tolerance: What it means for you

Alcohol’s effects become more pronounced as you age. You may experience:

Slower recovery times: All the changes we’ve discussed can mean that hangovers hit harder and take longer to bounce back from than they did in your 20s or even 40s.
More sleep troubles: No matter your age, alcohol disrupts sleep and makes the sleep you do get less restful. In general, alcohol compounds the sleep problems that are common after age 65.
Higher risk of injury: Aging increases your fall risk, and the consequences of alcohol-related falls tend to be more serious after age 65. Alcohol is associated with a significant portion of falls with fractures in older adults, he adds.
Other health effects: Alcohol raises blood sugar, increases blood pressure, and worsens sleep, all of which negatively affect your health. It can also make existing conditions worse (like chronic pain and heart disease).
Heavy drinking comes with even greater risks:
Liver disease: It takes longer for your body to metabolize alcohol than it does to absorb it. So, heavy drinking keeps alcohol in your bloodstream longer. This allows a chemical called acetate to build up in your liver, which causes cirrhosis over time.
Cognitive decline: There’s no other way to put it: Long-term heavy drinking is bad for your brain. It raises your risk of many types of cognitive impairment, including alcohol-related dementia.
Mental health concerns: Studies show that older adults may turn to alcohol as a way to cope with loneliness and isolation. But heavy alcohol use can also contribute to depression and other mental health issues.
Nutritional deficiencies: If you consume more calories than you eat, you risk nutritional deficiencies (which are also more common with age). The consequences range from minor to major. Folate deficiency causes anemia, while thiamine deficiency can trigger delirium.
Cancer: Alcohol is a chemical carcinogen, or a substance known to raise your risk of cancer. The more alcohol you consume, the higher your risk of developing certain types of cancer.

Drug interactions :

Medicines taken by older adults are more likely to have serious interactions with alcohol and drugs, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Many prescribed and over-the-counter medicines and herbal products can interact negatively with alcohol. Medicines and alcohol can interact even if they’re not taken at the same time. That’s because the drug may still be in your blood when you have a drink.

Reference:
https://health.clevelandclinic.org/why-youll-feel-alcohols-effects-more-after-age-65
https://www.nia.nih.gov/health/alcohol-misuse-or-alcohol-use-disorder/facts-about-aging-and-alcohol
https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-older-adults
https://www.webmd.com/mental-health/addiction/ss/slideshow-alcohol-aging

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According to a study, drinking less or giving it up altogether can benefit your brain. Reduced drinking to a low-risk level resulted in decreased shrinking of the brain. The authors contend that for those having AUD, reducing spending might be a more realistic objective. Some people may be able to reduce their drinking by using techniques like mindfulness. Others, however, might profit from expert assistance.

According to a recent study that was published in the journal Alcohol: Clinical and Experimental Research, even limiting alcohol use can benefit the brain health of those who suffer from alcohol use disorder. Alcohol use disorder (AUD), according to the National Institute on Alcohol Abuse and Alcoholisme, is a brain illness marked by an inability to stop or regulate alcohol consumption despite how damaging it is to your relationships, health, or career. According to the study, those with alcohol use disorders had larger volume in specific brain regions than those who drank more heavily when they either cut back on their alcohol consumption or stopped drinking altogether.

The volume of these brain regions also more closely resembled that of non-drinkers when they reduced their drinking to a low-risk level, which was no more than three drinks per day for males and 1.5 drinks for women. Given the difficulty of stopping completely, the authors propose that reducing alcohol intake might be a more realistic objective for some people than complete abstinence. 68 individuals with alcohol use disorders, ranging in age from 28 to 70, provided data for the study’s data collection. The participants were paired with a control group of 34 individuals, who were either non-drinkers or light drinkers, and were of a comparable age.

The team compared the cortex volume in different parts of their brains using magnetic resonance imaging (MRI) to assess the health of their brains. They studied patients who started treatment and either quit drinking, started drinking again but at a lower risk, or started drinking again at a higher risk. The higher-risk drinkers had considerably decreased volume in 12 out of 13 locations compared to the controls eight months after starting treatment. In nine of the 13 regions, the volume of low-risk drinkers was lower. In six of the 13 locations, there was less volume among nondrinkers.

Further analysis revealed lower volume in four distinct frontal regions, as well as the fusiform and precentral cortical regions, in higher-risk drinkers compared to non-drinkers. On the other hand, the precentral and rostral middle frontal cortex of low risk drinkers were significantly different from those of non-drinkers. The authors point out that the frontal lobes of the brain are crucial for making decisions, regulating emotions, and maintaining working memory. People may be less able to carry out these tasks if there is less volume in these areas.

Although studies have not shown that drinking can kill brain cells, they have shown that it can cause shrinkage, according to Dr. Daniel Atkinson, GP Clinical Lead at Treated. According to this study, he said, even moderate alcohol consumption can lead to a long-term shrinkage of the hippocampus, which is connected to learning and memory. The hippocampus is a portion of the brain with a special and delicate structure, where new neurons are constantly being formed through neurogenesis, he suggested.

Atkinson claims that earlier research has demonstrated that heavy alcohol use can obstruct this process. Atkinson went on to say that because alcohol is a diuretic and causes your body to lose water, it is possible that long-term alcohol consumption will also induce shrinkage. He warned that dehydration could result if this water wasn’t sufficiently supplied. “This effect would be mostly seen across the whole brain though,” he continued, “whereas the recent study shows hippocampus shrinkage most predominantly, suggesting that neurogenesis inhibition plays a bigger role in the reduction of brain size.”

REFERENCES:

https://penntoday.upenn.edu/news/one-alcoholic-drink-day-linked-reduced-brain-size
https://www.nytimes.com/2023/01/13/well/mind/alcohol-health-effects.html
https://www.healthline.com/health-news/drinking-alcohol-can-shrink-your-brain-cutting-back-or-quitting-can-help-it-regrow

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