Alcohol related problems in elderly people are often difficult to diagnose because of denial and non specific presentation in this age group. This study examines the factors related to alcohol abuse in elderly people referred to a psychiatry of old age service over a six month period. Patients were specifically screened for alcohol related psychiatric, physical and social problems. Of the 150 patients referred, 23 (15%) had alcohol related problems, with 12 (52%) denying any history of alcohol abuse/dependence. The majority were female (15/23, 65%), of which 10 were late-onset drinkers. Loneliness was found to be a contributory factor in 10 (43%) patients. A large proportion of patients had physical, psychiatric and social problems related to alcohol. Twenty one patients (91%) required psychiatric follow-up. In conclusion, this study confirms elderly peoples vulnerability to the destructive effects of alcohol.