Alcohol and the elderly.

Alcohol abuse and dependence are the third most common psychiatric diagnoses in elderly men in the community, occurring in 3% over the age of 65. Elderly patients may present in a number of atypical guises to medical, social, psychiatric and forensic services. When they do, their alcohol problem is often missed. They have high rates of physical morbidity and are most often found in the general hospital setting. While there is a steady decline in consumption and alcohol-related problems with age, up to a third of elderly abusers take up drinking in late life, possibly in response to psychosocial stressors. Recognition has been a major barrier to effective management. Intervention studies point to difficulties in attracting patients to treatment, with little consensus on treatment regimes or goals. Given these problems, a regionally based service responsible for identifying and managing alcohol abuse in the elderly is proposed. Such a service could improve liaison with community and hospital-based programmes and allow practical research to be undertaken into this enigmatic problem.