Declining health or functional impairments, which accompany aging, often lead to a decrease in alcohol intake. Alcohol-related illnesses and injuries prevent many alcoholics from surviving to old age. Physiology Elderly persons develop higher blood alcohol levels per amount consumed because of age-related changes that alter the absorption and distribution of alcohol, the most important of which are increased body fat and decreased lean body mass and total body water. There may be an age-related decrease in the activity of gastric alcohol dehydrogenase. It is unclear whether this age-related decrease occurs in women, but women have a lower level of gastric alcohol dehydrogenase activity than men.
Most alcohol is metabolized in the liver by alcohol dehydrogenase.
The liver's ability to metabolize alcohol declines with age, but this change is not clinically important. Susceptibility to psychomotor effects of alcohol may increase with age. For the elderly, who have higher blood alcohol levels per amount consumed, the National Institute on Alcohol Abuse and Alcoholism recommends a limit of one drink per day. Thiamine deficiency can lead to Wernicke's encephalopathy and Korsakoff's syndrome. Other deficiencies, such as hypomagnesemia, hypocalcemia, and hypokalemia, may be important in acute intoxication or withdrawal.