Binge drinking is prevalent across generations, but the dangerous habit is growing among one age group in particular.

Long associated with college students, binge drinking, defined as having four or more drinks within two hours at least five times per month for women (five drinks for men) is on the rise among older adults. According to The National Survey on Drug Use and Health, 20% of adults aged 60 to 64, reported binge drinking in the last month. For those older than 65, the prevalence of binge drinking is 12%—a rate that has been increasing over the last decade, while binge drinking rates among young adults 18 to 25 have been going down.

What’s behind the concerning trend? It may be changing views on alcohol.

“Older adults who drink do so more frequently than people under 65,” says George F. Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism, adding that the data shows a larger percentage of those 65 and older drink 20 or more days a month compared to those 18 to 64.

Today’s young adults are increasingly embracing sobriety. One Gallup survey found that 65% of 18 to 34-year-olds say alcohol is bad for your health compared to 39% of those 55 and older.

While the percentage of older adults who are binge drinkers has increased slightly, the growing number of older adults who are in this age group will double in the next 40 years.

“As a result, even if the percentage of older adults who binge remained the same, the sheer number of older adult binge drinkers would continue to grow rapidly, potentially placing an increasing burden on our healthcare system,” Koob says.

What are the dangers of binge drinking for older adults?

For older adults, alcohol’s effects are intensified. The body’s ability to retain water decreases with age, so older adults feel the effects of alcohol faster. Older adults also metabolize alcohol differently, Koob says.

“The body changes as we age and these changes render us more susceptible to some of the harms that stem from alcohol use,” Koob says. “Older drinkers show bigger impairments than younger drinkers on some tasks, including driving performance, reaction time, memory, and balance.”

Moreover, older adults are more likely to struggle with balance and experience falls even without alcohol (Falling is the leading cause of injury for those 65 and older).

“Studies suggest the injuries sustained from falls while intoxicated tend to be more severe than injuries from falls that do not involve alcohol,” Koob says. The U.S. Centers for Disease Control and Prevention (CDC) estimates that nearly 40% of falls involve alcohol and at least a blood alcohol concentration of 0.10%.

Older adults are also more likely to be on several medications, including sleep medications and other drugs, which may be dangerous when taken in combination with alcohol.

Long term binge drinking can increase the risk of alcohol use disorder, certain cancers, heart disease, and mental health disorders.

Questions to help assess your alcohol habits

Symptoms of binge drinking can be hard to decipher, especially for older adults.

“Older drinkers might be retired, live alone, and socialize less. As a result, their drinking might have less of an impact on things like work attendance or school performance,” he says.

The Short Michigan Alcoholism Screening Test–Geriatric Version (SMAST-G) is one survey to help assess older adults’ drinking habits. Here are some of the questions:

• When talking with others, do you ever underestimate how much you drink?

• After a few drinks, have you sometimes not eaten or been able to skip a meal because you didn’t feel hungry?

• Does having a few drinks help decrease your shakiness or tremors?

• Does alcohol sometimes make it hard for you to remember parts of the day or night?

• Has a doctor or nurse ever said they were worried or concerned about your drinking?

• Have you ever made rules to manage your drinking?

• When you feel lonely, does having a drink help?