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July/August 2022
Nutrition: The Pros and Cons of Coffee Consumption for Older Adults A Look at What the Studies Say About Grabbing That Cup of Joe in the Morning Coffee is one of the most popular beverages on the planet, and more than 250 million Americans consume it on a daily basis, a number that grows annually. According to data from the National Coffee Association, older adults drink more coffee than do other age groups, with those older than 64 averaging three cups per day. In some cultures, it’s even common for children to drink coffee from a young age, while in others, it is more regarded as an adult’s drink. So while older adults make up one of the age groups that drink the most coffee, it’s often a well-established habit by their age. “Coffee drinking is common for many reasons—it is tradition, it is social, and it is flavorful,” says Lauri Wright, PhD, RDN, LD, FAND, director of the Center for Nutrition and Food Security at the University of North Florida. “And given older adults may have been drinking coffee for 40, 50, or more years, it is also a pleasurable habit.” But there’s long been a debate over whether drinking coffee at older ages is healthy. In fact, the Mayo Clinic notes that while caffeine is not bad for older people if not excessive, those who drink more than four cups daily can experience anxiety, headaches, restlessness, and heart palpitations, as too much caffeine overstimulates the nervous system, leading to jitters, an upset stomach, and even sleep issues. Yet there are arguments in favor of coffee drinking as well, with several studies suggesting a reduced risk of Alzheimer’s disease (AD) among coffee drinkers among its benefits. Samantha Gardener, PhD, a research fellow at Edith Cowan University in Australia, led one such study looking at this reduced risk. “In the absence of effective disease-modifying treatments for Alzheimer’s disease, our research is looking at modifiable risk factors that could delay the onset of the disease,” she says. “Even a five-year delay would have a massive social and economic benefit, and these dietary modifications are generally accessible to all as well as being less expensive than medications and with less side effects.” The study investigated the relationship between self-reported habitual coffee intake and cognitive decline assessed using a comprehensive neuropsychological battery in 227 cognitively normal older adults from the Australian Imaging, Biomarkers, and Lifestyle study over 126 months.1 Based on the results, Gardener and the research team suggest that if the average cup of coffee made at home is 240 g, increasing intake from one to two cups per day could provide up to an 8% increase in executive function decline and up to a 5% decrease in cerebral amyloid beta accumulation over 18 months. Executive function includes activities such as planning, organization, time management, and working memory.1 “Our results support the hypothesis that coffee intake may be a protective factor against Alzheimer’s disease, with increased coffee consumption potentially reducing cognitive decline by slowing accumulation of the toxic brain protein which is thought to cause Alzheimer’s disease and thus attenuating the associated neurotoxicity,” Gardener says. “However, finding a maximum number of beneficial cups of coffee is a question for future research, which we were not able to identify in the current study. Unfortunately, there will be a limit whereby more cups will not produce any further positive effects.” Examining the Pros During Gardener’s study, the researchers found that those with higher coffee consumption at the start of the study had slower decline in executive function and attention cognitive domains. “We also found that of those with higher coffee consumption at the start of the study had less chance of transitioning to mild cognitive impairment [MCI] or AD status, and MCI often precedes AD,” she says. “In regard to how this might be happening, we saw that those with higher coffee consumption at the start of the study had slower accumulation in the brain of the sticky amyloid protein. So, the coffee could be reducing the accumulation, which then reduces the loss of neurons, and cognition declines slower.” But there have been plenty of other studies in support of drinking coffee at older ages. The Cardiovascular Risk Factors, Aging, and Dementia study looked at a cohort of people from middle age into their 70s and older and concluded that caffeine may lower an older adult’s lifetime risk of dementia. Meanwhile, a study by AARP and the National Institutes of Health discovered that older adults who regularly drank coffee had a lower overall risk of death. Wright cites several pros of coffee drinking that are based on science. “For one, it increases one’s energy level,” she says. “Coffee contains caffeine, which is a stimulant that boosts energy levels and fights off fatigue, which can be very beneficial to older adults.” Drinking coffee also boosts mood, as studies have shown that it’s associated with less depression and better mental health. “Caffeine may also help prevent age-related mild cognitive impairment,” Wright says. “It also helps with weight control. Caffeine can suppress appetite and has been associated with a healthier body weight.” Then there’s the impact on liver health, often a big problem as people age. Both regular and decaf coffee seem to have a protective effect on the liver, Wright notes, as research shows that coffee drinkers are more likely to have liver enzyme levels within a healthy range than are people who don’t drink coffee. According to the Dietary Guidelines for Americans, it’s safe for most older adults to drink four cups of coffee—or less than 400 mg of caffeine a day. “If your consumption exceeds these recommendations, consider switching some of your cups to decaffeinated,” Wright says. Exploring the Negatives Wright points to elevated blood pressure as a major one, as the stimulant effect of coffee can elevate blood pressure, and though this effect is temporary, it may be dangerous for people with hypertension. “Similarly, the caffeine in coffee increases heart rate,” she says. “This is a problem in older adults with heart arrhythmias.” In addition, there may be gastrointestinal problems as the caffeine in coffee can speed digestion, which can lead to diarrhea, and coffee’s high acid content may also worsen acid reflux. “Coffee consumption can also lead to dehydration,” Wright says. “The stimulant effect of coffee increases urine output, which can lead to dehydration.” While Gardener’s study didn’t examine the negatives associated with coffee drinking, she advises that any recommendations for increasing coffee intake would have to be personalized to the individuals, taking into consideration any other medical conditions they have that may contraindicate coffee consumption. Additional studies that follow participants for more than 10 years, studies that include a more diverse range of participants, and intervention studies in which participants are assigned a specific amount and type of coffee to drink, are required to validate Gardener’s findings. “Our study did not have data on midlife coffee consumption; consequently, potential positive or negative effects of coffee intake at midlife cannot be assessed in the current study,” she says. “It was also not possible for us to determine the potential consequences of varying methods of coffee preparation (eg, decaffeinated coffee, brewing method, with or without milk or sugar) on the associations observed, so these are both major methodological points to include in future research.” — Keith Loria is a D.C.-based award-winning journalist who has been writing for major publications for nearly 20 years on topics as diverse as real estate, travel, Broadway, and health care.
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