Alcohol Abuse in Older Women
The cessation of ovarian function at menopause and the accompanying decline in the production of the sex steroid hormones secreted by the ovaries are marked not only by characteristic signs and symptoms but also by a loss of estrogen’s protective effects against osteoporosis and coronary heart disease. Alcohol use affects the health of postmenopausal women in two ways—directly, through its impact on organ systems such as the liver, brain, and gastrointestinal tract, and indirectly, by altering the blood levels of sex steroids that affect the risk for disease. Both the pattern and amount of alcohol that a woman drinks influence whether alcohol has a beneficial or harmful effect on her body.
Coronary heart disease (CHD) is the number one killer of American women. One in every three American women dies of CHD. Several studies suggest that in pre– and postmenopausal women, light–to–moderate alcohol consumption may increase blood concentrations of estrogen and its metabolic byproducts—which may serve to protect against CHD. In fact, the incidence of CHD remains low until after menopause, apparently because abundant estrogen protects women against CHD. After menopause, however, women’s risk of CHD increases, approaching that of men. A large body of epidemiological evidence strongly suggests that light–to–moderate alcohol consumption significantly reduces the risk of CHD in both genders. Although the exact mechanisms remain unclear, alcohol has been found to improve the risk factors and conditions associated with CHD, such as reducing the LDL, or “bad” cholesterol, and increasing the HDL, or “good” cholesterol; and reducing blood clotting and the “stickiness” of platelets, small cells that play an important role in clot formation. It is clear, on the other hand, that heavy drinking can damage the heart.
Osteoporosis is a skeletal disease characterized by low bone mass, increased bone fragility, and susceptibility to fracture. Nearly half of all women over age 50 will have an osteoporosis–related fracture in their lifetime. At about age 35, people reach their “peak bone mass”—the point at which their bones are as strong as they will become. After age 35, women lose 0.5 to 1 percent of their bone mass each year. At menopause, when the ovaries stop producing estrogen, the rate of bone loss increases to about 3 to 7 percent per year.
Some epidemiological studies suggest that light–to–moderate alcohol consumption may be associated with increased bone mineral density and decreased fracture risk in postmenopausal women. This effect has not been found in animal studies in which the amount of alcohol consumed as well as other lifestyle factors could be controlled. On the other hand, heavy alcohol use clearly has been shown to compromise bone health and to increase the risk of osteoporosis by decreasing bone density and weakening the bone’s mechanical properties. These effects are especially striking in young women, whose bones are still developing, but chronic alcohol use in adulthood also can harm bone health. In addition, animal studies suggest that bones do not overcome the damaging effects of early chronic alcohol exposure even when alcohol use is discontinued.
Other lifestyle factors, such as tobacco use, also may increase the risk of osteoporosis and fractures. People who drink are 75 percent more likely to smoke, and smokers are 86 percent more likely to drink. This combination of habits significantly compounds osteoporosis risk.
The greatest risk factor for the development of osteoporosis in women is menopause. Previous research found that postmenopausal HRT protected against the loss of bone density and greatly reduced the risk of osteoporosis–related fractures. However, findings from the Women’s Health Initiative—a large study on the risks and benefits of strategies that may reduce the incidence of heart disease, breast and colon cancer, and fractures in postmenopausal women—found that when weighed against the risk of other types of disease, such as cancer, there was no net benefit for using HRT, even in women who have a high risk of fracture. Other factors, such as weight–bearing exercise and increased body mass, do have beneficial effects on bone health.
Memory and Brain Function
Alzheimer’s disease (AD) is the most common form of dementia among older people. It is characterized by progressive changes in cognitive ability, memory, and mood. Women appear to be at greater risk than men for AD, although women’s longer life spans may contribute to this higher risk. Heavy alcohol consumption is known to result in memory deficits. Heavy alcohol consumption also may increase the risk for AD in both genders and in women in particular, as they appear to be more vulnerable than men to alcohol–induced brain damage. At present there is no evidence to suggest that brain function is negatively affected by moderate alcohol consumption. In fact, some researchers believe that moderate drinking may even protect the blood vessels in the brain, in a way that is similar to how it protects the vessels in the heart against CHD.
Mixing Alcohol with Medications
More than 150 prescription and over–the–counter (OTC) medications interact negatively with alcohol. Older women may be more sensitive to the effects of OTC and prescription medications. Although people over 65 make up 12 percent of the population, they consume 25 to 30 percent of all prescription medications. Careful attention to the occurrence of alcohol/medication interactions is especially important in this population.
If you or a loved one needs help, contact Jeff at (941) 586-0929
This information is from the National Institute on Alcohol Abuse and Alcoholism website.