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09.2004

Massachusetts Beverage Business

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Can We Get Too Old for Wine?

Article By: Harvey Finkel, MD

While enormous attention understandably has been directed to the effects of maternal drinking upon the earliest stages of life, not much has been written about beneficial or adverse consequences to those of us several years beyond the age of 39.
CAN WE GET TOO OLD for WINE?



I shall not dare strictly to define "elderly", likely viewed by most as 15 years older than they. In general, medical studies of elderly populations concern themselves with people over 65, perhaps over 70.

Many well-meaning commentators intuitively advise older folks not to drink, or to limit themselves to droplet quantities. Is this blanket caution backed up by data?

First, I would belabor the obvious - some individuals, at any given age, are far more frail and vulnerable than others - true at all ages, more so among the elderly. Many older people can rewardingly and safely equal or even outperform those younger. Most often, sensible pacing enables most of us to continue our activities as we age. It is clear that as we age we do enjoy narrower margins of error, so some restraint is prudent, and that we should not drink more just because we get older. We must remain aware of possible interactions with medicines. My reportage herein must not be used as individual medical advice.

We'll review the results of research specifically directed at the elderly. Be aware that, for most of the organ-systems of the body, there is little or no difference in wine's effects based on age, at least not qualitatively, among non-pregnant adults.

The most feared and destructive of disorders of the elderly are those that impair brain function. Alcohol abuse, but not moderate use, often damages the nervous system, variously and severely. Let's look at what recent data tell us.

Letenneur, Dartigues and Orgogozo, of the University of Bordeaux, found no deleterious effects of wine on the intellect of 3766 elderly individuals, even in more than moderate quantity. Moderate wine consumption appeared at first glance to be associated with reduced risk of cognitive deficit compared to abstention, but the favorable difference did not stand up to strict statistical rigors. The authors concluded: "Wine consumption remains one of the last pleasures of this stage of life; our findings argue against prohibiting mild or moderate wine consumption in the elderly."

Investigators at the schools of medicine of Indiana University and Duke University studied the mental effects of long-term alcohol use on aging twins, thus minimizing confounding influences of genetic and other factors. Neither abstainers nor alcoholics were included. Cognitive function of five groups, stratified by usual consumption, was compared. The intellectual scores of cotwins averaging one to two drinks per day are higher than those of their counterparts who drank either more or less. We appear to have still another J-shaped curve.

A study of the elderly population of East Boston revealed that neither mild-to-moderate consumption of alcohol nor smoking increases the risk of developing Alzheimer's disease. While smoking is associated with weakness, poor balance and neuromuscular performance of older women, moderate drinkers in the study group of 9704 women over 65 have better neuromuscular function than nondrinkers. The Cardiovascular Health Study's recently published findings are impressive. Residents of North Carolina, California, Maryland, and Pennsylvania - 65 years of age and older - were carefully followed (including examinations of mental state and cognition and brain MRIs) over several years. Abstainers have twice the risk of dementia of those who consume between one and six drinks per week. (In one particularly sensitive genetic group, consumption of seven or more drinks per week raised the dementia risk.) One mechanism of preservation of brain function may be the familiar protection of blood vessels supplying the brain by light-to-moderate drinking. Indeed, the brain-feeding carotid arteries of the moderate drinkers are less arteriosclerotic than those of abstainers.

We have long observed that modest doses of alcohol in older individuals help to stimulate appetite, regularize bowel function, improve mood and socialization, and reduce the requirement for drugs - though effects on sleep may be mixed.

What though youth gave love and roses, Age still leaves us friends and wine. -Thomas


We must be impressed by a very large project, in which 6871 elderly individuals in Massachusetts, Iowa and Connecticut were studied by investigators from the medical centers of Harvard and Yale universities, the universities of Massachusetts, Washington, Iowa, and Hawaii, and the National Institutes of Health. Like so many other studies, this one indicates that low or moderate alcohol consumption is associated with reduced deaths resulting from cardiovascular disease. No evidence of increased cancer risk was found associated with alcohol consumption.

We tend to accumulate inflammatory disorders as we age. (Arthritis is the most familiar of these.) We are coming to understand that inflammation plays an important role in coronary disease, and probably in atherosclerotic disease of other blood vessels. Increased levels of markers of inflammation in the blood, such as C-reactive protein and interleukin-6, are predictive of disease and death due to cardiovascular disease in middle-aged and older people. A just-published study of men and women in their 70s in Memphis and Pittsburgh confirmed that, compared to abstention, light drinking has an anti-inflammatory effect, reducing blood levels of the markers, and, perhaps reducing cardiac risk.



MATCHING FOOD and WINE

My wife, a children's librarian, was reading a story to a first-grade class. It was Doctor de Soto, by William Steig, an account of a skilled dentist, who happened to be a mouse, reluctantly treating a fox with a toothache. While under gas, the fox dreamed of ungratefully eating his murine dentist, mumbling, "M-m-m, yummy. How I love them raw . . . with just a pinch of salt, and a . . . dry . . . white wine." A little boy from the class, raised his hand and protested, "White wine doesn't go with it!" -HARVEY FINKEL


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