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The signs, symptoms, alcohol history, and histological findings together with prognosis of 208 consecutive patients with alcoholic liver disease (ALD) are presented in respect of age. 200 were followed for at least 1 year. 28% of patients first presented over age 60, 6% over 70 years. Signs and symptoms were more severe at presentation in the 70+-year-old age group than in the young patients though the elderly more often presented with symptoms not directly related to liver disease. Prognosis was age-related, 1 year mortality was 50% among cirrhotics over the age of 60 versus 7% under 60 years. Alcohol consumption at presentation was similar in all age groups with no evidence of a significant reduction in the elderly. The care of older patients with ALD will become an increasing problem in developed countries where alcohol consumption has continued to rise.

We examined the presenting features, clinical course and prognosis in relation to age in 121 patients with primary biliary cirrhosis (PBC) for a mean follow-up of 4.6 years. 35 patients (29%) were over age 65 years at presentation/detection. There was a higher proportion of patients asymptomatic of liver disease in the older (over 65 years old) than younger (under 65 years old) group. The clinical features of PBC were less marked in the older patients both in number of symptoms (p less than 0.05) and in progression of serum bilirubin, a marker of prognosis (p less than 0.001). There was no difference in liver-related mortality between old and young patients during the follow-up period. Overall mortality in patients with PBC presenting over age 65 was no different from age- and sex-matched controls.