Hangovers are a collection of unpleasant symptoms experienced after a night of heavy drinking. Nearly everyone has experienced a hangover at some point. While hangovers are never pleasant, they tend to get progressively worse with age. There are several reasons why hangovers intensify as people get older.
Dehydration
One of the main causes of a hangover is dehydration. Alcohol is a diuretic, meaning it makes you urinate more frequently. This leads to the loss of important electrolytes such as sodium, potassium and magnesium. As people age, the body’s ability to rehydrate declines. Older adults tend to experience greater fluid losses. This exacerbates the dehydration and electrolyte imbalance caused by alcohol consumption.
Studies show that hangover severity is strongly associated with the extent of dehydration. Since older drinkers become more dehydrated than younger drinkers when consuming the same amount of alcohol, their hangovers are typically worse.
Congeners
Congeners are byproducts of alcohol fermentation and they are found in larger amounts in dark liquors like brandy, tequila, and bourbon. Research indicates that congener content contributes to the severity of hangovers. Bourbon has 37 times the amount of congeners as vodka.
As people age, they tend to gravitate toward darker spirits. While a younger drinker may favor vodka, older adults often prefer whiskey, brandy, or red wine. The higher congener content in these beverages may account for more painful hangovers in older drinkers.
Medications
Older adults use prescription medications much more frequently than younger adults. Drinking alcohol while taking certain medications can enhance the hangover effect. Some examples include:
- Diuretics – These will worsen dehydration.
- Blood pressure medications – These lower blood pressure further when combined with alcohol.
- Antidepressants – These interact with alcohol causing nausea, headache, anxiety.
- Statins – These increase the toxicity of alcohol to the liver.
- Sedatives – These amplify the drowsiness caused by alcohol.
Slowed metabolism
As we age, the body becomes less efficient at metabolizing alcohol. Enzymes in the liver break down alcohol at a slower pace. Unmetabolized alcohol continues circulating through the bloodstream, prolonging the effects.
With alcohol circulating longer, drinkers are more susceptible to experiencing next-day repercussions like nausea, dizziness, and fatigue. A slower metabolism turns a single drink into a heavier dose for aging drinkers.
Sensitive brain
Excessive drinking causes inflammation in the brain. This provokes hangover symptoms like headache, nausea, and fatigue. At the same time, alcohol depletes neurotransmitters like dopamine and serotonin which regulate mood and cognition.
As the brain ages, it becomes increasingly vulnerable to damage from heavy alcohol consumption. Older adults have more difficulty recovering from the neural disruption caused by drinking. The brain is already not functioning at optimal levels due to age, so the effects of alcohol are more punishing.
Poor sleep quality
While alcohol can help induce sleep, it reduces rapid eye movement (REM) and slow wave sleep. This prevents restorative sleep and leads to more nighttime awakenings. As a result, older adults do not sleep as deeply after having drinks.
This disturbed sleep makes hangover symptoms like exhaustion, irritability, and mental fogginess a lot worse. Older drinkers are more susceptible to alcohol’s sleep-disrupting influence.
Declining health
General health deteriorates with age, even in the absence of heavy drinking. Things like impaired vision, decreased hearing, osteoarthritis pain, slower reflexes, and weakened balance are common.
Alcohol compounds any existing health problems in older adults. For instance, balance issues become even worse after drinking, increasing the chance of falls. Frail older bodies have a harder time enduring hangovers.
Smaller body size
People tend to lose muscle mass and bone density as they age. Older adults also have a higher percentage of body fat compared to younger people. This means alcohol gets distributed into less total body water. With less fluid dilution, a given amount of alcohol reaches a higher concentration in the older body.
One standard drink leads to a higher blood alcohol level in a 150-pound 70-year-old compared to a 180-pound 30-year-old. The greater alcohol exposure accounts for more damaging hangover effects the next day.
Ineffective alcohol absorption
A key enzyme called alcohol dehydrogenase (ADH) binds with alcohol as soon as it enters the body. This facilitates rapid processing of alcohol in the liver. Levels of ADH decline significantly with age. This results in a larger fraction of ingested alcohol reaching the bloodstream unmetabolized.
The liver is less equipped to deal with alcohol in older people. More alcohol is then free to wreak havoc and cause hangover mayhem throughout the body. Even low amounts of drinking hit older adults harder.
Gut leakiness
Drinking raises the permeability of the intestinal lining. This allows bacteria and endotoxins from the gut to leak into the bloodstream. This influx of toxins triggers widespread inflammation. Older adults are more susceptible to alcohol-induced gut leakiness.
The subsequent inflammatory response is more pronounced. This magnifies unpleasant hangover symptoms like headache, nausea, dizziness, fatigue, and brain fog. Leaky gut syndrome explains why relatively minor drinking produces monster hangovers in older adults.
Damaged mitochondria
Mitochondria act as the powerhouses inside our cells, generating energy. Alcohol wreaks havoc on these vital organelles. Their membranes become weakened, their DNA mutated, and their energy production impaired. Mitochondrial dysfunction contributes to hangover misery.
Aging is associated with a decline in mitochondrial numbers and efficiency. Older mitochondria are already compromised, so the additive effects of alcohol are more damaging. Energy crisis and cell death instigate that “run over by a truck” feeling the day after drinking.
Bladder control issues
Having to urinate frequently is one of the most common hangover symptoms. Alcohol irritates the bladder causing urgency and regular trips to the bathroom. Bladder control tends to weaken with age, making matters worse.
Older drinkers are more likely to deal with incontinence and nocturia after a night of drinking. Breaking sleep repeatedly to pee just amplifies the next-day exhaustion and grogginess.
Cardiovascular effects
Alcohol causes a spike in blood pressure while drinking followed by a precipitous drop later on. This rollercoaster ride is more erratic in older drinkers given their cardiovascular system is less adaptable.
Low blood pressure in the morning combined with diuretic dehydration can produce pronouned dizziness, balance issues, and faintness. This syncope explains why older drinkers are prone to falls and injuries during a hangover.
Psychological factors
Mentally, hangovers become less tolerable with age. When you are young, they are considered an acceptable rite of passage. Being hungover at work is almost bragged about.
As you get older, hangovers lose their charm. You most likely have less free time to recover and more responsibilities that cannot be ignored. Being dysfunctional for a day is no longer an option. This amplifies the dread, frustration, and self-loathing.
Other considerations
A few other factors contribute to more severe hangovers in older drinkers:
- Weakened immune system – Cannot fight inflammation as effectively
- Social isolation – Less likely to have someone to help care for you while hungover
- Financial stress – Missing a day of work has greater consequences
- Gastric ulcers – Alcohol further irritates age-weakened gut lining
- Cognitive decline – Preexisting impairment worsened by hangover brain fog
- Menopause – Hormonal fluctuations worsen mood and headaches
Conclusion
Hangovers get progressively worse with age due to changes in the body that make it less equipped to handle alcohol’s effects. The root causes are increased dehydration, congener exposure, medication use, slowed metabolism, gut leakiness, bladder control issues, cardiovascular effects, and psychological factors.
The combined impact of these age-related factors is that older adults suffer more painful and persistent hangovers. The only way to prevent horrendous hangovers is to moderate drinking behavior. Older adults are generally better off having just one drink per day or abstaining completely to avoid feeling lousy.