Alcohol in old age. Drinking habits, low risk drinking and alcohol-related disorders

Alcohol abuse and health problems due to alcohol increase in the elderly. The functional impact is more pronounced than in younger people; nevertheless, alcohol abuse in the elderly is often overlooked. Early onset and late onset alcoholics differ with respect to previous problems, social and health status and therapy prognosis. The severity of withdrawal depends on addiction severity and comorbidities but not on calendar age. It is important to support patients in developing a motivation for change. Brief interventions are effective in elderly persons with an at-risk consumption of alcohol. Guidelines for low risk alcohol consumption recommend two alcohol-free days per week. There is no evidence for the popular hypothesis of the beneficial effects of light to moderate drinking. This hypothesis was drawn from former observational studies but recent large and more thorough methodical studies suggest that these former results were due to statistical bias. Alcohol consumption is a matter of pleasure and not a matter of medical treatment or prevention. The new German guidelines on "Screening, assessment and treatment of alcohol use disorders" contain for the first time a special chapter on the elderly.