Although most free-living people over age 55 yr use alcohol occasionally, both the fraction of people drinking and the magnitude of individual alcohol consumption decrease with every decade of age. Overall, approximately 5% of drinkers over age 55 yr use alcohol at excessive levels, i.e., sufficient to interfere with health or social functioning. As age increases, the fraction of drinkers with alcohol-caused central nervous system disease and cirrhosis increases, indicating increased sensitivity to alcohol injury. Beyond age 70 yr, new-onset alcoholism is more common than long-standing alcoholism. Malnutrition in the elderly alcoholic person is rare; it usually is caused by multiple factors, including alcohol displacing nutrient-rich diet factors, disease, limited availability of food, or altered metabolism increasing nutrient requirement. The recognition of alcohol and malnutrition problems in the elderly is more difficult than in younger people.