Onset of alcohol drinking and alcohol use disorder in the eighth decade of  life: a case report

Introduction
Alcohol use disorder (AUD) in the geriatric population is often missed although the prevalence ranges from 1.1% to 4.1%. However, the first drink in the eighth decade of life is rare. Here we report a patient who started drinking at 72 years of age and developed dependence within a year.

Case description
Mr P. was referred for alcohol dependence treatment from the Department of Surgery, diagnosed with benign prostatic hyperplasia and hypertension. He was 74 years old and had started drinking alcohol (whiskey) only in the last 2 years due to boredom. He also had suffered from postural and action tremors for the last 30 years, which decreased on drinking. Initially starting with 30 mg of alcohol once in a month due to peer pressure, he quickly developed tolerance within 1 year, requiring 60 mg about 2 to 3 times/week. It helped to reduce his boredom and tremors. At the time of our interview, his last drink was 20 days ago and he showed no withdrawal symptoms apart from non-specific sleep problems. There was no history of blackouts, falls, head injury, memory disturbances, syndromal depression, disorientation and parkinsonism, cerebellar dysfunction, alcoholic liver disease or neuropathy on examination. He also smoked tobacco for the last 10-12 years and his motivation to quit both (alcohol and tobacco) was poor.

Commentary
Boredom and health issues led to the onset of alcohol use in our patient. This further progressed to AUD. The onset at 72 years and rapid tolerance shows us that alcohol use problems have no age limits.