The negative effects of alcohol far outweigh the benefits.

There is rather compelling evidence that alcohol in moderation may reduce the risk of heart attacks. The evidence is most solid for red wine where benefits are noted among those consuming two glasses daily. Most believe that the wine benefits occur from antioxidants, particularly resveratrol, but there is also evidence that two cocktails nightly have the same effect.

Because of this fact, some experts believe the positive effects on the heart come from the alcohol.

Now for the downside. Most alarming is a report published recently in the American Journal of Public Health suggesting that 1 in 30 cancer deaths can be directly related to alcohol. The authors maintain that alcohol is a cancer-causing substance and that consuming as little as 1.5 drinks daily -- or even less -- increases cancer risk. They report that this amount accounts for 15 percent of all breast cancer deaths. And the more you drink, the greater the risk.

To examine the link between alcohol and cancer, researchers from the National Cancer Institute examined a series of registries that followed a large group's alcohol consumption and other elements of their health. In men, alcohol increased the risk of cancers of the mouth, throat, esophagus and, together with breast cancer in women, led to 6,000 deaths annually.

Alcohol has also been incriminated as a contributing factor to liver, colon and rectal cancer. Of even greater concern are the combined effects of smoking and alcohol acting synergistically to increase the incidence of cancers of the mouth, throat, larynx and esophagus. All in all, these experts say alcohol causes 20,000 cancer deaths annually compared to about 100,000 for smoking.

No one knows how alcohol leads to cancer. Perhaps it damages individual cells, leading to abnormalities, and that predisposes to malignancy or, in the case of breast cancer, maybe it affects estrogen levels directly or indirectly by interfering with the ability of the liver to break down the hormones.

This report documenting negative effects of small amounts of alcohol creates a quandary for many who believe that two glasses of wine or two small cocktails each night may prevent heart attacks and help reduce stress. For those who are otherwise healthy and have no significant medical problems, the downside is small enough that continuing to drink in moderation seems acceptable. Remember, however, that many do not stick religiously to the "two drinks or fewer" rule.

And with advancing age, the body's ability to neutralize alcohol becomes less and potential adverse effects are increased. Of concern are negative effects of alcohol on the brain. In older people, even in moderation, alcohol consumption can lead to memory loss, problems with gait and balance and damage to the nerves of the arms and feet. Whenever a patient is evaluated for memory loss, a careful history of alcohol consumption must be documented and for those with proven memory loss, alcohol should be avoided.

While it can cause memory loss per se, it will also aggravate symptoms of Alzheimer's disease.

Alcohol must always be considered as a cause of behavioral problems in older adults. Sadly, alcohol abuse is no less common in the elderly than in younger people. The negative effects of alcohol are made worse when combined with multiple medications such as tranquilizers, sedatives, antidepressants and pain pills.

Alcohol and multiple drug use may cause memory loss, in which case stopping these potentially lethal combinations can be highly beneficial.

At every age, alcohol in excess not only damages the brain but leads to heart disease, liver disease, hematological problems including severe anemia and bleeding, and a high risk of gastrointestinal bleeding, not to overlook the role it plays in physical violence, abuse and profound impairment of work performance.

In the case of alcohol, even a little can be harmful. And while it is a central part of our culture, it must be consumed with even more caution by older people or those with any other illness that may be aggravated by even a small amount of alcohol.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz visit www.drdavidhealth.com.