Skip to main content Accessibility help
Hostname: page-component-544b6db54f-4nk8m Total loading time: 0.147 Render date: 2021-10-20T01:54:50.363Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Late onset alcoholism

Published online by Cambridge University Press:  16 April 2020

Clemens Veltrup
Department of Psychiatry, University Medical School of Lübeck, Lübeck, Germany
Ulrich John
Department of Psychiatry, University Medical School of Lübeck, Lübeck, Germany
Martin Driessen
Department of Psychiatry, University Medical School of Lübeck, Lübeck, Germany
Get access


Rather high prevalence rates of alcohol abuse in the elderly have been reported in the literature. However, there is some evidence that many elderly persons with alcohol problems are not identified, probably due to the nonspecificity of alcohol-related presentations in old individuals. Thus, there is an ongoing discussion on appropriate diagnostic criteria for alcohol dependence in elder people who frequently begin to abuse alcohol in late life. This study was aimed to explore whether alcoholics with late onset (beginning after the age of 45) differ from those with an early onset (prior the age of 25). Two hundred and sixty eight subjects consecutively referred to a ward of a general hospital specialized for alcohol detoxification were divided into three groups by the age at onset of harmful alcohol consumption. The duration of harmful drinking was rather similar in all groups. However, alcohol dependence according to the ICD-10 criteria (three or more have to be fulfilled) was diagnosed in 94.1% of the alcoholics with an early onset (≤ 25 years), but only in 62.2% of those with late onset (P < 0.0001). Significant differences between these groups were found for the following criteria: preoccupation with drinking (P < 0.0001), impaired capacity to control drinking (P < 0.01), strong desire to drink alcohol (P < 0.01), and a trend towards a lower rate of lifetime psychiatric comorbidity. The alcoholics with late onset reported fewer previous detoxifications and a lower actual alcohol consumption. Moreover, they showed a higher rate of abstinence in the 12 month follow-up. Regarding the difficulties in comparing groups of different ages at onset of harmful alcohol use our results suggest that the alcoholics with late onset differ in many ways from those with early onset.

Original article
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)



Present address: Therapieverbund Ostsee, Lübeck, Germany.


Present address: Institute of Epidemiology and Social Medicine, University of Greifswald, Germany.


Present address: Gilead Hospital, Bielefeld, Germany.


American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. (DSM-IV). Washington DC: American Psychiatric Press; 1994.Google Scholar
Atkinson, RM. Aging and alcohol use disorders: diagnostic issues in the elderly. Int Psychogeriat 1990;2:55–72.Google ScholarPubMed
Atkinson, RM, Kofoed, LL. Alcohol and drug abuse in old age: a clinical perspective. Substance Alcohol Actions/Misuse 1982;3: 353–68.Google ScholarPubMed
Atkinson, RM, Tolson, RL, Turner, JA. Late versus early onset problem drinking in older men. Alcohol Clin Exp Res 1990;14:574–9.Google ScholarPubMed
Conigrave, KM, Saunders, JB, Whitfield, JB. Diagnostic tests for alcohol consumption. Alcohol Alcohol 1995;30:13–26.Google ScholarPubMed
Council on Scientific Affairs. Alcoholism in the elderly: council report. JAMA 1996;275:797–801.CrossRefGoogle Scholar
Curtis, JR, Geller, G, Stokes, EJ, Levine, DM, Moore, RD. Characteristics, diagnosis, and treatment of alcoholism in elderly patients. J Am Geriatr Soc 1989;37:310–6.CrossRefGoogle ScholarPubMed
Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. editors. Dokumentationsstandards 2 für die Behandlung von Abhän-gigen. Freiburg/Br, Germany: Lambertus, 1991.Google Scholar
Di Chiara, G, Acquas, E, Carboni, E. Drug motivation and abuse: a neurobiological perspective. Ann NY Acad Sci 1998;654:207–19.CrossRefGoogle Scholar
Dufour, M, Fuller, RK. Alcohol in the elderly. Ann Rev Med 1995;46: 123–32.CrossRefGoogle ScholarPubMed
Fichter, MM, editor. Verlauf psychischer Erkrankungen in der Bev-ölkerung. Berlin, Germany: Springer; 1990.CrossRefGoogle Scholar
Fink, A, Hays, RD, Moore, AA, Beck, JC. Alcohol-related problems in older persons. Determinants, consequences, and screening. Arch Intern Med 1996;156:1150–6.CrossRefGoogle ScholarPubMed
Finlayson, RE, Hurt, RD, Davis Jr, LJ, Morse, RM. Alcoholism in elderly persons: a study of the psychiatric and psychosocial features of 216 inpatients. Mayo Clin Proc 1988;63:761–8.CrossRefGoogle ScholarPubMed
Fitzgerald, JL, Mulford, HA. Elderly, vs. younger problem drinker ‘treatment’ and recovery experiences. Br J Addict 1992;87(9): 1281–91.CrossRefGoogle ScholarPubMed
Gaitz, CM, Baer, PE. Characteristics of elderly persons with alcoholism. Arch Gen Psychiatry 1971;24:372–8.CrossRefGoogle ScholarPubMed
John, U, Veltrup, C, Drienssen, M, Wetterling, T, Dilling, H. An individual counseling vs. a group treatment approach for alcohol dependent inpatients. Alcohol Clin Exp Res (in revision).Google Scholar
Liberto, JG, Oslin, DW, Ruskin, PE. Alcoholism in older persons: a review of the literature. Hosp Comm Psychiatry 1992;43:43–54.Google ScholarPubMed
Litten, RZ, Allen, JP. Fertig, JB. y-glutamyltranspeptidase and carbohydrate deficient transferrin: alternative measures of excessive alcohol consumption. Alcohol Clin Exp Res 1995;19:1541–6.CrossRefGoogle Scholar
Mirand, AL, Welte, JW. Alcohol consumption among the elderly in a general population, Erie County, New York. Am J Public Health 1996;86:978–84.CrossRefGoogle Scholar
Mulford, HA, Fitzgerald, JL. Elderly versus younger problem drinker profiles: do they indicatea need for special programms for the elderly? J Stud Alcohol 1992;53:601–10.CrossRefGoogle Scholar
Neve, RJ, Lemmens, PH, Drop, MJ. Older and younger male alcoholics in outpatient treatment. Addict Behav 1999;24:661–72.CrossRefGoogle ScholarPubMed
Oneta, CM, Pedrosa, M, Lattmann, J, Rüttimann, S, Russell, RM, Seitz, HK. Age affects first pass metabolism and serum distribution of ethanol significantly. Alcohol Alcohol 1999;34:462.Google Scholar
Regier, DA, Boyd, JH, Burke, JD, Rae, DS, Myers, JK, Kramer, M, et al.One-month prevalence of mental disorders in the United States. Arch Gen Psychiatry 1988;45:977–86.CrossRefGoogle ScholarPubMed
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, et al.The composite international diagnostic interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988;45: 1069–77.CrossRefGoogle ScholarPubMed
Schuckit, MA, Miller, PA. Alcoholism in the elderly men: a survey of a general medical ward. Ann NY Acad Sci 1976;273:558–71.CrossRefGoogle ScholarPubMed
Tucker, JA, Gavornik, MG, Vuchinich, RE, Rudd, EJ, Harris, CV. Predicting the drinking behavior of older adults from questionnaires measures of alcohol consumption. Addict Behav 1989;14:655–8.CrossRefGoogle Scholar
Varma, VK, Basu, D, MalhotraA, SharmaA, Mattoo, SK. Correlates of early- and late-onset alcohol dependence. Addict Behav 1994;19: 609–19.CrossRefGoogle ScholarPubMed
Vestal, RE, McGuire, EA, Tobin, JD, Andres, R, Norris, AH, Mezey, E. Aging and ethanol metabolism in man. Clin Pharmacol Ther 1977;21: 343–54.Google Scholar
Vogel-Sprott, M, Barrett, P. Age, drinking habits and the effects of alcohol. J Stud Alcohol 1984;45:517–21.CrossRefGoogle ScholarPubMed
Volkow, ND, Gur, RC, Wang, GJ, Fowler, JS, Moberg, P J, Ding, YS, et al.Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals. Am J Psychiatry 1998;155:344–9.Google ScholarPubMed
Watson, CG, Hancock, M, Gearhart, LP, Malovrh, P, Mendez, C, Raden, MA. Comparison of the symptoms associated with early and late onset alcohol dependence. J Nerv Ment Dis 1997.Google ScholarPubMed
Wetterling, T, Kanitz, R- D, Rumpf, HJ, Hapke, U, Fischer, D. Comparison of CAGE and MAST with the alcohol markers CDT, y-GT, ALAT, ASAT and MCV Alcohol Alcohol 1998;33:424–30.CrossRefGoogle Scholar
WHO. International classification of diseases, 10th revision (ICD-10), Geneva; 1992 [Chapter F].Google Scholar
Wiens, AN, Menustik, CE, Miller, SI, Schmitz, RE. Medical-behavioral treatment of the older alcohol patient. Am J Drug Alcohol Abuse 1982;9:461–75.CrossRefGoogle Scholar
Williams, GD, DeBakey, SF. Changes in levels of alcohol consumption: United States 1983–1988. Br J Addiction 1992;87: 643–8.Google ScholarPubMed
Zimberg, S. Diagnosis and treatment of the elderly alcoholic. Alcohol Clin Exp Res 1978;2:27–9.CrossRefGoogle ScholarPubMed
Submit a response


No Comments have been published for this article.
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Late onset alcoholism
Available formats

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Late onset alcoholism
Available formats

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Late onset alcoholism
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *