Aims: Age of onset is an important criterion to distinguish subgroups of alcohol-dependent patients. This study investigated physical and mental health and social functioning of older inpatients with early (age <25), late (25-44), and very late (≥45) onset of alcohol dependence. Methods: In a specialized detoxification ward for older patients in The Hague, the Netherlands, 157 older alcohol-dependent inpatients (38% women, mean age 62.7 ± 6.5) were interviewed with the European version of the Addiction Severity Index. Results: As a group, older alcohol-dependent patients had substantial physical, mental and social problems, which were largely independent of the age of onset of alcohol dependence. Patients with early-onset alcohol dependence had more chronic medical problems and more suicidal thoughts than patients with late-onset alcohol dependence. The very-late-onset group did not significantly differ from the other two groups in any of the variables under study. Conclusions: Despite previous studies showing more favourable outcomes for the (very) late-onset compared to the early-onset alcohol-dependent group, their comorbid (mental) health and social problems are in many respects similar, and require careful assessment and treatment. This may be crucial for successful treatment and improving quality of life in these patients.

This study shows that most social factors are-unexpectedly-not associated with rehospitalization of older alcohol-dependent patients after detoxification. "Spending leisure time alone" warrants further study as a potentially modifiable predictor.

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