Although they may not be as visible, national studies estimate that between 10% and 20% of all older persons suffer from alcoholism. Some people assume that if an older person is an alcoholic he/she didn't develop the disease until later in life. They believe it may be a

reaction to the death of a spouse, retirement or other significant changes or losses. But the fact of the matter is that the majority of older alcoholics have been drinking for a long period of time and contrary to what many of us might believe is possible, they reach advanced ages as active alcoholics.

Part of our confusion about alcoholism results from the fact that it is seldom identified, diagnosed or treated in older persons. One study has estimated that as many as 60% of the elderly admitted to acute medical wards are active alcoholics. Yet, among these hospital patients, alcoholism is rarely listed as the presenting condition, which decreases the likelihood that the addiction will be treated. Many of the symptoms of alcoholism are mistaken or confused with symptoms of diseases that can occur with advanced age. Failure to recognize alcoholism results in the treatment of a symptom (confusion, depression, disorientation, falls, etc.) rather than the real problem.

Elderly alcoholics are a "hidden" group that too many doctors overlook, says the American Medical Association.

The doctors' group has released guidelines for family doctors on how to identify older patients who might be alcoholics and what to do to get them help. Doctors should:

Consider problem drinking as a factor when treating a patient for falls, appetite and memory problems, trouble sleeping, and depression.

Use open, non-judgmental questions such as "Do you use alcohol?''

Watch for possible interactions between alcohol and prescription drugs, especially anti-anxiety, barbiturate and sedative medications.

Part of the problem is getting doctors to accept that elderly alcoholics exist, says the AMA report.

"They may deny that the patient has a drinking problem, or be reluctant to make a diagnosis, because they are uncertain about how to treat the disease or because they question whether treatment is likely to be successful with this age group,'' the report says.

Until recently many professionals in the alcohol treatment field believed that older adults were not good candidates to enter and complete treatment or to maintain their sobriety. Many may have felt that the long years of addiction caused irreversible brain damage which would make it difficult to modify the older alcoholic's behavior. Still others maintained that older adults were incapable of change and, after all, "you can't teach an old dog new tricks". But studies have shown that the elderly have a high success rate of completing treatment and maintaining their sobriety. The problem is getting the older person into treatment. Few people young or old readily volunteer to go into treatment and the elderly alcoholic may not have the same social and familial pressures that are exerted on younger persons. Families are typically more tolerant of the behavior, fearful of alienation and the stigma of alcoholism and are often more protective and accepting of an older person's denial of the problem. Unfortunately many families feel that drinking is one of the few "pleasures" left to their older relative and are hesitant to take it away from them.

If you know an older person who is suffering from alcohol addiction, it is important that he/she receive treatment. It is also important for family members to receive counseling and deal with their own issues revolving around the older person's alcoholism.

Here are some things to be aware of:

** Alcohol has a particularly toxic effect on older persons. This is due to dramatically reduced body water volume that occurs with advanced age. Therefore, even relatively small doses of alcohol can have a serious effect on older persons. It is easier for them to become

intoxicated and to stay intoxicated longer.

** Brain tissue of the elderly is extremely sensitive to alcohol. This sensitivity can cause memory loss, confusion, disorientation and loss of motor control that can result in serious/fatal falls.

** The effects of alcohol addiction are further complicated when the alcohol is combined with medications. Often the older person who is abusing alcohol may also be abusing or misusing medications.

** The elderly alcoholic can respond to treatment and should seek help for alcohol addiction.