The debate about drinking alcohol appears to be continuing unabated. On one side, we have evidence that drinking alcohol continues to be a popular activity among older adults. According to a recent analysis of credit card spending by The Bank of America Institute, Baby Boomers’ spending at bars was up 4 % in January over last year, while spending by younger drinkers has been diminishing. In addition, the percentage of adults over 55 who say they drink alcohol has increased from 49% in the early 2000s to 59% today, and the Bureau of Labor Statistics reported that spending on alcoholic beverages is down among most age groups since the mid-1980s, except for people over 65. On the other hand, evidence continues to be discovered that drinking alcohol can cause serious health harms, and that older adults in particular are at special risk of certain cancers, increased risk of dementia, and other health repercussions from drinking even moderate amounts of alcohol. For a general overview of the risks of alcohol consumption for older adults, click here. So, if you’re someone who enjoys your evening nightcap or celebratory champagne, how do you make sense of the risks, and how do you balance out your pleasure from your potential peril?

Let’s look at the growing evidence of health harm from drinking alcohol. As you may remember from a previous agebuzz post, early in January 2025, the previous Surgeon General, Dr. Vivek Murthy, issued a report linking even moderate alcohol consumption with an increased risk of several cancers, including breast cancer in older women. While there has been some debate about that report, and no change yet in the warning labels put on bottles of alcohol, many scientists, researchers, and clinicians consider the evidence and that warning to be a clarion call to drastically limit, if not outright abstain from, alcohol consumption. For example, in a recent post in The Conversation, cancer biologist Dr. Pranoti Mandrekar notes that alcohol is the 3rd leading preventable cause of cancer in our country and that alcohol-related car crashes cause around 13,500 deaths each year. She further explains that when alcohol breaks down in the body, it produces a carcinogenic byproduct, and that alcohol makes it easier for the body to absorb the carcinogens in cigarettes and e-vapes. She makes the case that no level of alcohol consumption is safe. Writing in The Washington Post, another cancer researcher and oncologist underscores that the more exposure you have to alcohol, the higher your risk for certain types of cancers, and that even one drink per day could elevate your risk. While each of us has to decide for ourselves what level of risk we are willing to tolerate for what benefit, the growing body of evidence makes clear that alcohol does cause several different types of cancers. A just-released study announced at a meeting of the American Society of Clinical Oncology noted that alcohol-caused cancer deaths have nearly doubled in the past 3 decades, with cancer cases among men fueling this surge in deaths.

New research connecting alcohol consumption to brain health is equally as worrisome. In a recent study published in Neurology, researchers determined that consuming more than 8 alcoholic drinks a week is associated with brain injuries and lesions that are found in Alzheimer’s patients and those experiencing cognitive decline. That’s essentially one drink per day, with perhaps an extra drink on the weekend. Not a tremendous amount of alcohol, yet significant health hazards as a result. The study involved brain biopsies from about 1800 patients who died at an average age of 75 and whose family members supplied information about the deceased’s drinking habits. While alcohol did not appear to directly harm the brain, what it did do was contribute to hyaline arteriolosclerosis, which thickens the walls of small blood vessels in the brain, impeding blood flow and causing brain damage over time. Depending upon your drinking habits, 8 glasses of alcohol a week might seem like moderate drinking or might seem heavy. But it’s important to note that even 7 or fewer glasses of alcohol each week were also seen to damage the brain. And earlier research substantiated the impact of alcohol on brain volume, suggesting that shrinkage caused by increasing alcohol consumption could become the equivalent of a decade of brain aging.

It’s also important to realize that alcohol can also cause problems with your gut health, affecting your digestion, the production of stomach acid, and harming your gut microbiome. In fact, it’s important to realize that ethanol, the main ingredient in alcoholic beverages, is so potent in killing bacteria that it’s used in high concentrations as the primary ingredient of hand sanitizers. Alcohol is also implicated in such distressing symptoms as acid reflux, gas and bloating, abnormal bowel problems, and “leaky gut.” 

It appears that while a drink of alcohol once in a while poses relatively low risk, it’s not possible to make that same declaration when it comes to regular drinking habits, even if you consider them “moderate,” perhaps just a few drinks per week. Is it possible to indulge but in a less harmful way? According to a recent post in The New York Times, there are strategies you can use to lower your risk of harm, including being thoughtful about the kind of alcohol you drink (beer has less ethanol than wine, and wine has less ethanol than hard liquor). And what about mocktails? The Food Network has just published its list of 34 great zero- alcohol mocktails. So grab your martini glass and take a look here.