How much alcohol is too much alcohol for the aging brain? That’s a common question among older adults, many of whom enjoy an alcoholic beverage from time to time, but worry that drinking might increase their risk for memory decline and other cognitive problems.

Yet despite years of research and an abundance of studies on the topic, conflicting results have failed to produce a general rule of thumb for how much drinking, if any, appears to be safe for the brain in older age.

“We know that, in general, drinking to excess—more than 21 drinks in a week for four or five years—is bad for brain health in most individuals, and that vulnerability to the brain effects of alcohol and to problem drinking seems to increase at middle age and beyond,” says Marlene Oscar Berman, PhD, an award-winning researcher on the brain effects of alcohol who is associated with Massachusetts General Hospital's Martinos Center for Biomedical Imaging. “But it’s impossible to be more specific than that. There are so many factors and conditions that influence alcohol-related brain damage, including the person’s age and level of education, gender, genetic background and family history of alcoholism.

Dr. Berman says the person’s overall physical and mental health are also factors. “Are you overweight? Do you exercise? Do you eat a healthy diet or have a history of stroke? Your tolerance to alcohol may depend on your answers to these and other basic questions. Essentially, for many people it boils down to this: If you want to drink, stay healthy. And consider cutting down or stopping when you reach middle age to reduce the growing risk of harmful effects on your brain.”

Effects Of Age

Many of the negative effects on the brain associated with alcohol intake are magnified with age. Older people become more sensitive to alcohol as age-related changes in absorption and metabolism lower tolerance, and their brains cannot recover as quickly from the effects of alcohol. Older adults have greater health problems and are more likely to use medications that may interact negatively with alcohol. The risk of harmful drug interactions increases among elderly individuals who drink, as does the risk of injury from falls. Too much alcohol can aggravate symptoms of cognitive decline and early dementia in the elderly. Sleep disorders, memory problems, and mood and anxiety disorders become more likely.

Older adults should consider checking periodically with their doctor (who knows their health status and history) to see whether moderate or occasional drinking is okay, or whether reducing alcohol consumption is advisable.

“The bottom line is be sensible. Alcohol consumption is an aspect of brain health that should be carefully considered.”

Marlene Oscar Berman, PhD
Award-winning researcher associated with Mass General's Martinos Center for Biomedical Imaging

Recent Studies

Meanwhile, scientists continue to delve into the relationship between drinking and brain health in older individuals. A large study published in the July 30, 2015 American Journal of Geriatric Psychiatry suggests that participants who reported problem drinking in middle age are more than twice as likely as those who did not report a history of problem drinking to suffer from severe memory impairment in later life.

But while heavy drinking may be harmful, moderate alcohol consumption may be safe for brain health, according to another investigation of alcohol consumption and dementia risk in a large population of older adults. The paper, published in the European Journal of Epidemiology, found that compared to participants who reported consuming alcohol at a rate of five or more times in two weeks, those who reported consuming alcohol at a rate of one to four times in two weeks or abstained from alcohol altogether were significantly less likely to develop dementia over the 27-year study period.

Yet another study suggests that the choice of alcoholic beverage may influence the effect of drinking on brain health. A review of previous studies on the link between alcohol consumption and dementia published in the International Journal of Geriatric Psychiatry  found no evidence that light-to-moderate alcohol drinking was harmful. In fact, the report suggests that—in individuals without the APOE4 gene variant, which increases risk for dementia—the consumption of red wine might even be beneficial.

“The bottom line is be sensible,” says Dr. Berman. “Alcohol consumption is an aspect of brain health that should be carefully considered.”

Managing Alcohol Consumption

If you believe that your drinking is unhealthy or you have become dependent on alcohol, but have difficulty cutting down, seeking help is essential.

Some options:

  1. Consult with your primary care doctor for advice and to arrange for proper medical attention in the event you encounter withdrawal symptoms when you try to quit
  2. Consult a mental health professional trained to deal with addiction
  3. Consult a clinic specializing in alcohol dependence
  4. Join a 12-step program, such as Alcoholics Anonymous, for ongoing support
  5. Ask for support from loved ones