Alcohol, Aging,and Brain Health: How Drinking Can Undermine Dementia Prevention

This is Part 2 of our blog series on alcohol and aging. Read the first blog here. 

Alcohol isn’t a benign drink.

As our last blog post noted, even moderate consumption is associated with increased risks of dementia and cancer. And even red wine doesn’t protect our hearts. 

Alcohol consumption can also interfere with the modifiable behaviors that researchers say lower dementia risk by upwards by 45%. Just like excess weight can trigger negative consequences for other modifiable risks (high blood pressure, blood sugar, and cholesterol), alcohol can interfere with exercise, balance, and sleep –  behaviors increasingly tied to brain health. 

Even if you don’t drink alcohol to the point associated with elevated dementia risk, it can negatively impact other health factors. 

This article from the National Institutes of Health does a great job of framing the issues around aging and alcohol – pointing out medicine/alcohol interactions, increased sensitivity to alcohol’s effects, and the issue of alcohol use in conjunction with medications. 

But alcohol use isn’t something you just need to be careful about once you hit retirement age. We know that behaviors that increase our risk of developing dementia begin in midlife. And those behaviors can be negatively influenced by alcohol consumption.

How Alcohol Impacts Our Sleep

Sleep is critical for keeping our brains healthy. And the problems of poor sleep start early. “Insufficient REM sleep appears to be associated with a higher risk of death among middle-aged and older adults,“ this study notes. It also elevates dementia risk. 

While a drink might help you fall asleep initially, it will make it harder to get a good night’s sleep. 

The review of 27 controlled sleep studies determined that alcohol delays the onset of restorative REM sleep and reduces total REM sleep. 

Sleep disruption occurs even at relatively low doses (about two standard drinks). Higher doses caused progressively greater REM suppression. 

Fall Risks and Alcohol Use

By age 30, we begin to lose muscle mass, and our balance begins to decline around age 50. We often make adjustments to counteract the loss or avoid the scenarios that lead to injuries and falls.

But alcohol impairs our ability to make those adjustments and plays a role in injuries, and not just situations like drunk driving car accidents. 

“Recent research has also shown that adults over the age of 50 or 60 show signs of impairment at lower blood alcohol concentrations than younger people,’’ notes an article in the Stanford University Medicine news center. 

“Because women metabolize alcohol differently than men and tend to have smaller bodies, the same amount of alcohol can have a stronger effect on women.”

And when alcohol is combined with the drugs people often take as they age, for conditions like depression, sleep disorders, Parkinson’s disease, nerve pain, even a stroll to the bathroom can lead to an injury.

This prospective cohort study of 1,457 adults aged 65+ found that alcohol combined with certain medications increased the risk of falls by about 50% and injurious falls by about 62%.

Research shows that a higher incidence of injurious falls precedes a dementia diagnosis by about 4 years. 

What the research doesn’t address: Do those falls drive the inactivity and social isolation that accelerate dementia risk?

Falls that impact the head have an even closer association with future onset of dementia. Research suggests that even a single head injury as long as 25 years prior may increase the risk of dementia later in life, and the risk rises substantially with repeated injuries.

This underscores the need to think about how alcohol use as a behavior that can be modified to lower dementia risk. 

Assessing Risks and Making Changes

Alcohol use is one of many behaviors that can impact the onset of dementia. Alcohol isn't just a standalone risk factor for dementia; it can also negatively impact our ability to consistently engage in the healthy positive behaviors we need to adopt to reduce our risk." 

Alcohol consumption can even have a positive effect on one of the key behaviors that lower dementia risk: socialization. In our next blog, we’ll look at the alcohol + socialization connection and how to stay social if you would prefer to do it without alcohol.