LATE-ONSET PROBLEM DRINKING IN OLDER ADULTS

After the first descriptions of late onset alcoholism in the early 197 0s, no systematic attention followed for more than a decade. In the pa st 10 years, however, that has changed, and this report seeks to summa rize recently acquired knowledge about late onset problem drinking, in cluding the author's own work on this phenomenon. The incidence of new alcoholism cases does decline with age but remains appreciable into t he late sixties. Samples of ageing alcoholics in treatment show that a s many as 1/4 to 2/3 of cases had onset after age 60. Risk factors for late onset alcoholism include female gender, higher socioeconomic sta tus and (in some but not all studies) life stressors, but neither psyc hiatric comorbidity nor positive family history of alcoholism appears to contribute in a majority of cases. Compared to longstanding alcohol ics, late onset cases tend to be milder and more circumscribed, and th ey may also fluctuate more, with an apparently high likelihood of spon taneous remission, at least over the short term. These characteristics have implications for the use of brief and informal interventions to prevent and reduce late onset problem drinking, but also suggest cauti on in interpreting the response of late onset cases to treatment in un controlled studies. Present knowledge of late onset alcoholism is frag mentary; more systematic clinical research on its characteristics and treatment is needed.