Document Type



The most rapidly growing segment of the US population is that of older adults (≥65 years). Trends of aging adults (those aged ≥50 years) show that fewer women than men consume alcohol, women consume less alcohol than men, and total alcohol intake decreases after retirement. A U- or J-shaped relationship between alcohol intake and mortality exists among middle-aged (age 45 to 65 years) and older adults. Thus, alcohol can be considered either a tonic or a toxin in dose-dependent fashion. Active areas of research regarding the possible benefits of moderate alcohol consumption among aging individuals include oxidative stress, dementia, psychosocial functioning, dietary contributions, and disease prevention. Yet, due to the rising absolute number of older adults, there may be a silent epidemic of alcohol abuse in this group. Dietary effects of moderate and excessive alcohol consumption are reviewed along with mechanisms by which alcohol or phytochemicals modify physiology, mortality, and disease burden. Alcohol pharmacokinetics is considered alongside age-related sensitivities to alcohol, drug interactions, and disease-related physiological changes. International guidelines for alcohol consumption are reviewed and reveal that many nations lack guidelines specific to older adults. A review of national guidelines for alcohol consumption specific to older adults (eg, those offered by the National Institute on Alcohol Abuse) suggests that they may be too restrictive, given the current literature. There is need for greater quantification and qualification of per capita consumption, consumption patterns (quantity, frequency, and stratified combinations), and types of alcohol consumed by older adults in the United States.


Medicine and Health Sciences


NOTICE IN COMPLIANCE WITH PUBLISHER POLICY: This is the author’s final manuscript version, post-peer-review, of a work accepted for publication in the Journal of the American Dietetic Association. Changes resulting from the publishing process, such as further peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. This version has been formatted for archiving; a definitive version was subsequently published in the Journal of the American Dietetic Association, 108(10). October 2008. pp. 1668-1676. Available online at: