Sex Differences in Older Adults with Risky Alcohol Consumption: Medication Use, Comorbidities, and Hepatic Biomarkers

Background/Objectives: Alcohol consumption and medication use have increased among older population, potentially increasing the risk of alcohol-drug interactions and adverse outcomes. Biological sex differences may further influence these effects. This study aimed to assess sex-related differences in medication use, comorbidities, and hepatic biomarkers among older adults with risky alcohol consumption. Methods: A cross-sectional, multicenter study was conducted in 455 adults aged ≥65 years. Sociodemographic and clinical characteristics, medication prescriptions, and hepatic biomarkers were collected. Results: Of the participants, 41% were women, with a mean age of 71 years. The median weekly alcohol consumption was 7 standard drink units. Overall, 90% were taking at least one medication, with antihypertensives being the most prescribed (62%). Significant sex differences were observed (p ≤ 0.01): men showed higher use of antidiabetic drugs (24%), anticoagulants (8%), and nitrates (4%), whereas women more frequently used anxiolytics (35%), non-steroidal anti-inflammatory drugs (22%), and antidepressants (18%). Although risky alcohol consumption was more prevalent among men, women had a higher overall medication use. Significant differences were also observed in hepatic biomarkers, with higher gamma-glutamyl transferase levels and a higher prevalence of elevated FIB-4 values among men (p ≤ 0.01). Conclusions: These findings highlight the importance of routinely assessing alcohol consumption and medication use in older adults and support incorporating a sex-specific perspective into clinical practice and future research.