Seven case reports of alcoholism in the elderly are presented. These patients formed a significant proportion of 108 patients seen in the first eight months of a new comprehensive psychiatric service for the elderly. None of them initially presented as alcohol abusers; three were first seen by geriatricians because of repeated falls, and four who came directly to psychiatrists were referred for atypical dementia, confusion or self-neglect. Three patients had started to abuse alcohol only late in life; the remainder were life-long heavy drinkers. In three instances, close relatives who abused alcohol themselves, were in collusion. The diagnosis of alcohol abuse in these elderly patients depended upon the recognition of such manifestations as repeated falls, confusion, and self-neglect. The prognosis was influenced by age at onset, social and family factors, and the presence or absence of brain damage. In two of the patients, a poor prognosis was linked to collusion by alcohol-abusing children.