Heavy drinking rose to 7.5% among Americans 50 to 64, federal survey data shows

A new study of federal survey data found that alcohol use in the United States is declining among younger adults after the broad increase seen during the pandemic, but the trend is moving in the opposite direction for many older Americans, especially people ages 50 to 64.

The study, published in late September, analyzed data from the Centers for Disease Control and Prevention’s annual National Health Interview Survey. Researchers found that both overall drinking and heavy drinking have continued to rise in the 50-to-64 age group, even as drinking rates have fallen elsewhere. Medical specialists said that pattern is especially concerning because alcohol can worsen chronic disease risk and create immediate dangers for older adults, including falls and harmful interactions with medications.

Kenneth Mukamal, a professor of medicine at Beth Israel Deaconess Medical Center whose research has examined alcohol use in older adults, said heavy drinking compounds many of the health problems that come with aging. He pointed to higher risks of cirrhosis, cancer and heart disorders, along with acute risks such as tripping and falling.

According to the study, the share of adults ages 50 to 64 who reported regular drinking during the previous year increased by about 5% over the past decade. Over the same period, the share classified as heavy drinkers rose from just over 5% to about 7.5%. In the survey, heavy drinking was defined for men as five or more drinks in a day or an average of 15 or more drinks a week, and for women as four or more drinks in a day or an average of eight or more drinks a week during the 12 months before they were surveyed.

CDC data had long shown that Americans at retirement age drank the least, followed by adults in the 50-to-64 group. But that pattern began to change about 10 years ago, when members of Generation X started reporting higher drinking rates than teenagers and young adults. That gap has continued to widen. People born between 1965 and 1980 now fall largely within the older end of the working-age population, and the data suggests that this cohort has carried higher drinking levels into later adulthood.

The increase is not limited to people in their 50s and early 60s. Among adults older than 65, regular drinking has also risen at roughly the same pace as it has for Generation X, while heavy drinking has increased by just over 1%, according to the figures cited in the study.

Jagpreet Chhatwal, director of the Center for Health Technology Assessment at Mass General Brigham, said the numbers may signal more alcohol-related illness in the years ahead. He said many people in older age groups who drink heavily are not new drinkers, which means their bodies may already have absorbed years or decades of exposure. Long-term heavy drinking, he said, can cause severe liver damage, including cirrhosis, liver cancer and end-stage liver disease.

Mukamal said alcohol can also trigger heart rhythm problems such as atrial fibrillation, a condition that is much more common in older adults. He said even one drink may sharply increase that risk. He also said aging changes the way the body processes alcohol. Metabolism slows, muscle mass declines and the tissues that absorb alcohol decrease, meaning the same amount of alcohol can produce a stronger effect in an older person than it would in a younger adult.

Those changes can make balance and judgment worse at a time when the body is already less able to recover from a misstep. Mukamal said that raises the risk of falls and serious injuries such as hip fractures. He also noted that older adults are more likely to take prescription drugs whose side effects, including sedation, can be intensified by alcohol.

The diverging trends could also have implications beyond medicine. If they continue, they may reshape the customer base for beer, wine and spirits makers as younger adults drink less and older consumers account for a larger share of sales. That shift could increase pressure on the beverage industry, health officials and retailers to focus more closely on responsible drinking messages and age-related risks, particularly for middle-aged and older customers.

Researchers said it is still too early to know whether the drop in alcohol use among younger generations will prove lasting or turn out to be a short-term fluctuation. Chhatwal said it may be harder to change behavior among older adults who have been drinking consistently for decades, though he added that the liver can begin to improve when a person stops drinking before the damage reaches its final stages.