Everyone needs to be careful when it comes to over-imbibing in alcohol, but the issue can be especially problematic for older adults. Research shows that people older than 60 are not only more likely to binge drink, but they are also more apt to suffer negative effects from alcohol due to age-related changes in the body.
“Alcohol metabolism is slower in older people, so whatever alcohol is consumed sticks around, and that can have deleterious effects on everything from wound healing to cognitive function,” says Elizabeth Kovacs, PhD, vice chair of research in the University of Colorado Department of Surgery. “Alcohol causes intestinal barrier leakiness, so bacteria that should be in your intestinal lumen can get into the circulation, which goes to the liver, causing the liver to produce a lot of inflammatory mediators and oxidative stress.”
Kovacs has conducted research that looks at the effects of alcohol and aging on the gut, the liver, and lung infection; she also has collaborated with other researchers on studies that show that people who consume alcohol in excess for many years have a shift in the bacteria in the lumen of the gut.
“There's a lot of literature showing that alcohol-dependent individuals have a reduction in the good bacteria and an increase in the bad bacteria,” Kovacs says. “How alcohol causes leakiness of the intestinal epithelium is not entirely known. We are doing research on an enzyme called myosin light chain kinase, which, when activated by inflammatory mediators, pulls apart the actin filaments that hold adjacent cells together.”
Liver concerns
Another reason older adults need to watch their alcohol intake is that they often take more medications than their younger counterparts, putting a greater strain on their aging livers.
“There's no antidote for liver failure other than a liver transplant, so keeping your liver healthy and happy by not consuming too much alcohol is ideal,” Kovacs says. “Especially for older people who may be taking multiple medications, some of those medicines may be a problem if one consumes a lot of alcohol.”
Muting immune response
Another negative consequence of drinking too much alcohol — especially in older adults — is its effect on innate immune cells. In 2017, Kovacs and colleagues wrote a review article in the Journal of Leukocyte Biology showing that advanced age alters many aspects of the immune system, leading to impaired responses to primary infection and poor development of immunologic memory.
“Innate immune cells are the first responders to an infection,” she says. “In the lung, there's a cell called the alveolar macrophage that's like a Pac-Man — it cruises around the lungs looking for garbage that you've inhaled, or particulate material that’s inhaled by people who smoke, and it eats that garbage. Alcohol decreases their ability to migrate around to find the germs, and it decreases their ability to eat them.”
That effect lasts for a couple of days, Kovacs says, potentially allowing bacteria to grow and reducing the ability to quickly clear an infection quickly.
Genetic implications
The Dietary Guidelines for Americans, put out by the departments of Agriculture and Health and Human Services, recommend no more than two drinks a day or 14 drinks per week for men and no more than one drink per day or seven drinks per week for women. Especially for older Americans, going above that limit can mean a mix of short-term and long-term effects, Kovacs says, including long-term epigenetic changes to genetic make-up.
“Epigenetics is the way the environment, including lifestyle factors, alter the way your genes function without changing their DNA sequence,” she says. “We've been studying aging and epigenetics, including a paper that shows having three days of alcohol in your body alters your liver epigenetics. We are also working on research about lung and brain epigenetics.
“The idea is that there are multiple ways by which alcohol can affect your body,” Kovacs continues. “Some are pretty quick, like inhibiting the ability of immune cells to function and fight germs, and there are some that could have longer term outcomes, including changing how your genes are transcribed.”
