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Age, alcohol metabolism and liver disease

Meier, Patrick; Seitz, Helmut K

Current Opinion in Clinical Nutrition and Metabolic Care: January 2008 - Volume 11 - Issue 1 - p 21–26
doi: 10.1097/MCO.0b013e3282f30564
Ageing: biology and nutrition: Edited by Ronni Chernoff and Paolo M. Suter

Purpose of review Alcohol consumption among the elderly has increased. Alcohol metabolism changes with age and the elderly are more sensitive to the toxic effects; this increased consumption is therefore of great clinical relevance.

Recent findings Metabolism of ethanol changes with advancing age because activity of the enzymes involved, such as alcohol and acetaldehyde dehydrogenase and cytochrome P-4502E1, diminish with age. The water distribution volume also decreases with age. Both lead to increased blood concentrations of ethanol. Also, elderly people take more drugs, and ethanol and these drugs may interact; therefore, alcohol consumption can modify serum drug concentrations and their toxicity. Finally, elderly people may suffer more frequently from other types of liver disease, and alcohol may exacerbate these.

Summary Over recent decades alcohol consumption has increased among those who are older than 65 years. Alcohol is more toxic in the ageing organism because of changes in its metabolism, distribution and elimination, which lead to central nervous system effects at lower levels of intake; also, ageing organs such as brain and liver are more sensitive to the toxicity of alcohol. For these reasons, alcohol should be used in moderation, especially among those of older age.

Department of Medicine and Laboratory of Alcohol Research, Liver Disease and Nutrition, Salem Medical Centre, Heidelberg, Germany

Correspondence to Helmut K. Seitz, MD, Salem Medical Centre, Zeppelinstrasse 11-33, D-69121 Heidelberg, Germany Tel: +49 6221 483 200; fax: +49 6221 483 494; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.