Many people enjoy alcohol as part of meals, celebrations and social connection, although drinking patterns vary considerably. Some people drink regularly, others only occasionally, while some choose not to drink at all. These different approaches can fit within a healthy lifestyle, particularly when decisions are guided by current health, medicines and personal priorities.
Understanding how alcohol affects the body becomes increasingly important with age, particularly as health risks rise with both the amount and frequency of alcohol consumed. Research over the past decade has clarified that while small amounts carry relatively low risk of harm to health, alcohol should not be viewed as something to drink for health. Instead, the focus has shifted towards informed choices that balance enjoyment with long-term wellbeing.
Why alcohol can affect the body differently with age
Ageing commonly brings reductions in lean muscle mass and total body water. This may alter how alcohol is distributed and affects the body, although the effect varies between individuals.
Balance, reaction time and physical resilience often decline with age, which means alcohol can have a more noticeable effect than it did earlier in adulthood. A quantity that once felt manageable may now impair coordination and judgement to a greater extent, even if it feels familiar. This is particularly important when combined with poorer vision, reduced muscle strength or an existing risk of falls.
Medicine use is an additional factor to consider. Alcohol can intensify drowsiness caused by certain medications including sleeping tablets, opioid painkillers, some antidepressants and certain antihistamines. It can worsen dizziness with some cardiovascular medicines, increase the risk of low blood sugar with insulin or some of the diabetes tablets when drinking without food, and affect bleeding risk or anticoagulant control.
Alcohol and medicine combinations involving drugs that act on the brain have been associated with falls and injurious falls in older adults (Holton et al., 2019). This is something that should be reviewed with a GP or pharmacist, who can assess alcohol intake alongside prescribed medicines and over-the-counter products, and advise on any potential risks.
The heart health story has changed
Earlier observational studies on alcohol drinking appeared to show that light drinkers had lower cardiovascular risk than heavy drinkers and non-drinkers. However, moderate drinkers often had healthier diet, higher income and better access to healthcare, while the non-drinking group included some people who had stopped because of ill health. Accounting for these differences weakens much of the apparent benefit (Holmes et al., 2014; Biddinger et al., 2022).
Newer studies use genetic differences associated with drinking behaviour to reduce some of the biases affecting conventional research. These analyses have found little support for a protective effect and suggest that higher alcohol intake increases cardiovascular risk, including the risk of stroke and peripheral artery disease (Holmes et al., 2014; Larsson et al., 2020).
Alcohol can also raise blood pressure and increase the likelihood of atrial fibrillation, an irregular heart rhythm associated with stroke and heart failure. The evidence does not support drinking for cardiovascular protection.
Cancer risk starts lower than many people realise
Alcohol is classified as a Group 1 carcinogen, meaning there is sufficient evidence that it causes cancer in humans. It causes at least seven types of cancer, including cancers of the mouth, throat, voice box, oesophagus, liver, bowel and female breast (International Agency for Research on Cancer, 2025).
Risk rises with the amount consumed. The risk from one drink is much lower than the risk from heavy drinking, but there is no clear level where alcohol is completely free of cancer risk.
Wine, beer and spirits all contain alcohol, which the body breaks down into toxic substances. These can damage DNA and interfere with cell repair, which means the instructions inside the cells are harmed and it is harder for the body to fix that damage. This increases the chance that cells grow in an abnormal way and cause cancer.
Red wine is often highlighted in discussions about health because it contains antioxidants such as resveratrol, which have been suggested to have health benefits. However, these compounds do not offset the harmful effects of alcohol itself, so red wine carries the same cancer risk as other alcoholic drinks.
Brain health and sleep
Heavy and prolonged alcohol use is an established cause of brain injury and cognitive impairment. Recent large-scale research found no evidence that light or moderate drinking protects against dementia, while genetic analyses suggested that risk increased as alcohol exposure rose (Topiwala et al., 2026).
Alcohol may affect the brain through raised blood pressure, stroke risk, disrupted sleep and interactions with medicines. The risk from occasional drinking remains difficult to quantify, but alcohol should not be considered protective for cognition.
Alcohol can make it easier to fall asleep, but the resulting sleep is often more fragmented and contains less rapid eye movement sleep, which is the stage of sleep linked to memory and emotional processing. Disruption can occur even at relatively low doses and becomes greater as intake rises (Gardiner et al., 2025). Poor sleep can then affect concentration, mood and physical recovery the following day.
Falls and long-term independence
Alcohol affects balance, coordination and reaction time. These effects can combine with reduced muscle strength, poor vision, nerve damage affecting the feet or legs, or medicine-related dizziness.
A fall after 60 can lead to a fracture, hospital admission and a prolonged loss of confidence or independence. Risk may be particularly important for people taking sedatives, strong painkillers or several medicines that lower blood pressure.
How much is low risk
The UK Chief Medical Officers advise adults who drink regularly to consume no more than 14 units a week and to spread this across at least three days. Fourteen units is approximately six pints of 4% beer or six 175 ml glasses of 13% wine (Department of Health, 2016).
This is a low-risk guideline rather than a guarantee of safety. Some people may need to drink less because of their medicines, falls risk, liver disease, poor sleep, atrial fibrillation or other health conditions.
Checking the units in your usual drinks, including those poured at home, can help you see how much you are really drinking. Adding alcohol-free days and avoiding concentrating the weekly allowance into one or two evenings can also reduce risk.
Anyone who experiences morning shakes, sweating, anxiety, nausea or a need to drink early in the day should seek medical advice before stopping suddenly, because alcohol withdrawal can be dangerous.
Making an informed choice
After 60, it is worth considering whether a familiar drinking pattern still fits current medicines, sleep, balance and overall health. A pattern that caused no obvious problems earlier in adulthood may have greater consequences as these factors change.
Healthy ageing does not require alcohol to be viewed in absolute terms. For people who choose to drink, the aim is to understand the evidence, recognise where individual risks may have changed, and make choices that balance enjoyment with long-term wellbeing.
Drinking less generally reduces risk, but the decision about whether and how much to drink remains a personal one. Staying informed allows that decision to reflect current health and priorities rather than older assumptions about alcohol being beneficial.
References
Biddinger, K.J., Emdin, C.A., Haas, M.E. et al. (2022) ‘Association of habitual alcohol intake with risk of cardiovascular disease’, JAMA Network Open, 5(3), e223849. doi: 10.1001/jamanetworkopen.2022.3849.
Department of Health (2016) UK Chief Medical Officers’ Low Risk Drinking Guidelines. Available at: https://assets.publishing.service.gov.uk/media/5a80b7ed40f0b623026951db/UK_CMOs__report.pdf (Accessed: 13 July 2026).
Gardiner, C., Weakley, J., Burke, L.M., Roach, G.D., Sargent, C., Maniar, N., Huynh, M., Miller, D.J., Townshend, A. and Halson, S.L. (2025) ‘The effect of alcohol on subsequent sleep in healthy adults: a systematic review and meta-analysis’, Sleep Medicine Reviews, 80, 102030. doi: 10.1016/j.smrv.2024.102030.
Holmes, M.V., Dale, C.E., Zuccolo, L. et al. (2014) ‘Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data’, BMJ, 349, g4164. doi: 10.1136/bmj.g4164.
Holton, A., Boland, F., Gallagher, P., Fahey, T., Moriarty, F. and Cousins, G. (2019) ‘Potentially serious alcohol-medication interactions and falls in community-dwelling older adults: a prospective cohort study’, Age and Ageing, 48(6), pp. 824–831. doi: 10.1093/ageing/afz112.
International Agency for Research on Cancer (2025) Alcohol: a major preventable cause of cancer. IARC Evidence Summary Brief No. 6. Available at: https://www.iarc.who.int/wp-content/uploads/2025/10/IARC_Evidence_Summary_Brief_6.pdf (Accessed: 13 July 2026).
Larsson, S.C., Burgess, S. and Mason, A.M. (2020) ‘Alcohol consumption and cardiovascular disease: a Mendelian randomization study’, Circulation: Genomic and Precision Medicine, 13(3), e002814. doi: 10.1161/CIRCGEN.119.002814.
Topiwala, A., Levey, D.F., Zhou, H. et al. (2026) ‘Alcohol use and risk of dementia in diverse populations: evidence from cohort, case-control and Mendelian randomisation approaches’, BMJ Evidence-Based Medicine, 31(1), pp. 13–22. doi: 10.1136/bmjebm-2025-113913.
