[Column] Why do we get more vulnerable to alcohol as we get older?

The older people get, the more susceptible they become to alcohol.

That is not necessarily due to a decreased ability of the liver to metabolize alcohol.

Laboratory studies have not shown an age-related decline in alcohol metabolism. In 2023, the U.S. National Institute on Alcohol Abuse and Addiction compared alcohol metabolism in younger adults (21-25 years old) and older adults (55-65 years) in 48 participants.

However, this study was limited because it compared different people. They could have compared older, harder-drinking people to younger, weaker drinkers. To get more accurate results, one must look at how the same people's ability to metabolize alcohol changes as they age. However, such a longitudinal study would be time-consuming and expensive. It's also possible that some people's ability to process alcohol declines with age.

Even people who maintain the ability to metabolize alcohol after middle age can become vulnerable to the toxicity of alcohol. As we age, we lose muscle mass and body water and gain body fat.

Alcohol is dissolved in water, not fat, so the less water in the body, the higher the blood alcohol level. A 2023 study analyzing data from nearly 200,000 adults aged 37 to 73 from the U.K. Biobank found that heavy drinkers had less muscle mass. Continuous drinking leads to belly fat and less muscle, which means blood alcohol levels stay higher and longer.

Memory and cognitive abilities deteriorate as the brain ages, making you more vulnerable to hangovers and falls. If you ignore this reality and continue drinking, it won’t be good for you in the long run. That’s because the damage that alcohol causes to brain cells increases the risk of suffering from cognitive impairment in later life.

To make matters worse, in middle age and beyond, there’s a high probability that you already have chronic diseases that can be exacerbated by drinking.

If you have conditions like cardiovascular disease, diabetes, depression, anxiety, or chronic pain, drinking increases the risk of worsening the condition. Even one or two drinks can increase the risk of hypoglycemia, arrhythmia, heart attack, and heart failure.

In addition, people who are taking medications are more vulnerable to the toxicity of alcohol. When alcohol is added to sedating medications, such as antihistamines, antidepressants, anxiolytics, and sleeping pills, the risk increases due to excessive sedation. In middle and old age, the number of medications increases. The potential for drug and alcohol interactions also increases.

If you think that light alcohol consumption is beneficial to your health, forget about it.

Even one or two drinks a day increases the risk of cancer death and does not reduce heart disease deaths. That resulted from the U.K. Biobank’s following 135,000 adults aged 60 and older for 12 years as of 2024.

Getting older is hard on the body and mind. Don't make it worse with alcohol.

Jeong Jae-hoon is a food writer and pharmacist. He covers a variety of subjects, including trends in food, wellness, and medications. This column was originally published in Korean in Joongang Ilbo on Jan. 16, 2025. – Ed.