Alcohol is the best-marketed carcinogen out there. Cigarettes and obesity only wish they were able to devote the money to positive imaging that alcohol, one of the top three lifestyle killers, receives. Instead, governments devote billions to education and awareness of those two while the only tepid warning about alcohol is not to drive after you roll the dice on cancer.

When it comes to BPA, PFAS, or weedkillers, government epidemiologists say any presence should be considered pathological but say nothing at all about alcohol use despite it being scientifically shown, unlike most epidemiology, and addictive.

Age is a comorbidity for everything. Even COVID-19 had far greater impact on the old than the young, and if other factors are in play, risk is substantially higher. Like alcohol. A new study found that falls remain the leading cause of both fatal and non-fatal injuries in older adults and are the leading cause of traumatic brain injury. In 2021, they contributed to the deaths of 36,500 older adults in the United States.


Photo: Andreas Levers

Using data from the Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP), the authors created a prospective cohort of consecutive patients presenting to the emergency departments (ED) of two level one, university-affiliated trauma centers in Palm Beach County, Florida with annual volumes of 50,000 and 69,000. Patients aged 65 and older who sustained blunt head trauma following a fall were included in the study. Trained research assistants screened all older ED patients to enroll those with head trauma. Data collected included age, race, sex, smoking, alcohol use, drug use, antiplatelet use, anticoagulant use, mechanism of injury, past medical history, and loss of consciousness. The total pool was 3,128 participants who underwent an initial head CT after head trauma from a fall. Of these, 433 (13.5%) were diagnosed with Intracranial hemorrhage (ICH). Notably, 561 (18.2%) of older adults in the ED with head trauma reported drinking alcohol, with 6% indicating daily consumption. 

All patients were asked about alcohol use and were asked to categorize their use as none, occasional, weekly, or daily. ICH head trauma was determined from the patient’s head CT scan as read by the attending hospital radiologist.

Weekly and daily alcohol users tended to be younger, with a mean age of 78 years, while non-alcohol users tended to be older, with a mean age of 83 years. ICH was more significantly common in alcohol users than in nonusers (22% vs. 12%). Strikingly, the prevalence of ICH increased with increasing frequency of alcohol use. While the risk of ICH was already high for non-alcohol users, the absolute risk of differences for ICH associated with alcohol use were substantial, rising from a risk increase of 8.5% in occasional alcohol users to an increase of 13.1% in daily alcohol users.

Many risk factors for falling have been identified in older adults such as polypharmacy, a sudden drop in blood pressure, and home environmental dangers. Findings from this study warrant the consideration that alcohol use should be regarded as another important, independent, modifiable risk factor for fallingb.

“We observed that occasional alcohol use was associated with double the odds of intracranial hemorrhage when compared to patients with no alcohol use. Daily alcohol use was associated with 150% increased odds of intracranial hemorrhage,” said Richard Shih, M.D., corresponding author and a professor of emergency medicine, FAU Schmidt College of Medicine. “One of the unexpected findings in our study was the strong dose‒response relationship between reported alcohol use and intracranial hemorrhage.

“Drinking alcohol can make you more likely to fall because it affects your balance, concentration and awareness. It’s also worth noting that as individuals age, the effects of alcohol are increased. This is because older adults often have a higher percentage of body fat to body water ratio, thus increasing the concentration of alcohol in the bloodstream. Furthermore, alcohol metabolism decreases with age, exacerbating this effect, because older adults don’t process alcohol as efficiently as they used to.”