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.