For the elderly it threatens independent living. Elderly alcoholics often don't come to the attention of physicians because they are rarely arrested for driving a car while intoxicated. They often live alone and don't get into domestic quarrels. They are not likely to be violent, however they are accident prone and the elderly seen in emergency rooms should be closely questioned. Nearly everyone is exposed to alcohol and only a few go on to develop serious problems that have to be identified.
Alcoholism is underrecognized, underdiagnosed, and underreported.
The outlook in older drinkers is good and is better than in younger abusers. Heavy drinkers increase their risk of death from sclerosis or hardening of the liver, motor vehicle accidents, suicide, homicide, high blood pressure, certain cancers, hemhoragic stroke and generalized weakness of the heart. There is a higher incidence of depression and this is often a good place to start. Drinkers may stop spontaneously when their depression has been adequately treated. When heavy drinkers were followed up five years after at the Mayo Clinic, a third had died of alcohol related brain disease.