Alcohol may be less harmful for people over 50

Recent analyses have challenged the idea that alcohol’s impact is uniform across ages. In one large study, people aged 65 and older accounted for a far smaller proportion of alcohol-related years of life lost than younger adults, but they accounted for the vast majority of “years saved” (lives spared by moderate drinking) in population data. In practical terms, younger adults (ages 20–49) suffered most alcohol-related deaths, whereas older adults (>65) saw more of the modest protective effects attributed to light drinking. This does not mean drinking is safe for seniors: heavy alcohol use is linked to cancers, liver cirrhosis and heart disease at any age. However, these findings suggest that moderate alcohol intake may be relatively less harmful (and relatively more “beneficial”) in people over 50 compared to younger drinkers, assuming all else equal. Importantly, a global analysis in The Lancet still concluded there is no completely safe level of alcohol – even low amounts increase health risks.

Scientists explain this paradox by selection bias: people who survive to old age while drinking moderately tend to be healthier in other ways. Dr. Timothy Naimi of Boston University and colleagues showed that older moderate drinkers in studies were likely the “survivors” – they already lived long enough to be enrolled – whereas younger heavy drinkers may die before long-term studies even begin. The Naimi team found that at age 65+, moderate drinkers had lower overall death rates than non-drinkers, whereas the opposite was true in middle age. In their analysis, 65+ adults accounted for about 35% of alcohol-related deaths and 80% of alcohol’s “deaths prevented,” reflecting the net balance of harm versus benefit in that age group. In contrast, adults 20–49 made up over one-third of alcohol deaths but only 4–5% of lives saved. The authors caution this means “moderate drinking may benefit people of a certain age group” (older adults), but stress that “heavy drinking is harmful to all”.

Nevertheless, recent evidence urges caution. In 2024, a UK Biobank study of 135,000 people over 60 reported no improvement in longevity for any drinking level – even light drinkers had slightly increased cancer and all-cause mortality compared to abstainers. A health expert in Medical News Today noted that moderate drinkers in that study still had higher cancer death rates than non-drinkers. Others point out that population studies (like the 2018 Lancet global analysis) found that the safest option for health was zero alcohol. At the same time, moderate drinking is associated with lifestyle factors (more exercise, better diets) that could explain some benefits. As Harvard experts advise, “everything in moderation” – any possible heart or longevity benefit of a drink might be due to a generally healthy lifestyle rather than the alcohol itself.

• Heavy drinking: Causes cancers (breast, colon, liver, etc.), liver and heart disease, and many other health problems. The risks apply at any age.
• Moderate drinking: Some studies in older adults report modest benefits (e.g. lower heart attack rates). For example, one analysis attributed over 80% of “lives saved” to moderate drinking in people 65+. However, newer data suggest even low-to-moderate intake raises dementia and cancer risks in seniors.

Current public health guidelines reflect this uncertainty. In the U.S. and Europe, low-risk limits are set at ≤1 drink/day for women and ≤2 for men. The CDC emphasizes that there is no “safe” level of alcohol for cancer prevention, and advises minimal consumption. Doctors generally recommend that anyone over 50 discuss alcohol use with their provider. In practice, physicians often weigh an older person’s overall health and medications: for someone with no heart disease, the slight cognitive risks of one glass of wine may be small, whereas for someone with cancer risk factors it may be wiser to abstain. In summary, alcohol tends to be harmful more than helpful for most people, but the balance of risk vs benefit can shift with age and individual health. Older adults should be especially vigilant, avoiding heavy drinking and talking to their doctor about what level (if any) might be tolerable.