These differences stem from age-related changes in biological sensitivity and psychosocial stressors. Substance abuse problems in the elderly may be additionally complicated by the effects of alcohol interactions with prescription drugs including additive sedation, depression, and increased or decreased drug metabolism. Presenting symptoms of alcoholism in the elderly come in many forms, including repetitive injuries, diarrhea, incontinence, and lability of mood, chronic illness of almost any type, memory loss, dementia, and depression. In a group of 216 alcoholic patients over age 65, 42 percent were late onset alcoholics; and drinking generally was associated with a specific stressor such as death, retirement, or separation. Organic brain syndromes were the most important psychiatric symptom in this group. Medical problems were common, including alcoholic liver disease. In general, addiction-oriented inpatient programs are appropriate for elderly alcoholics. At the Mayo Clinic, the treatment program involves detoxification; a phase emphasizing education and abstinence and its fluctuating moods, improving cognition, and vacillating cravings; and the rehabilitation phase, focusing on medical or psychiatric treatment, psychosocial treatment, and problem areas (marital, financial, legal). 16 references. (Author abstract modified)