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The paper examines assessment and outcomes of alcohol misuse and dual diagnosis from liaison psychiatry services for older people. The authors used a retrospective case note survey for referrals to four older adult liaison psychiatry services was carried out on consecutive anonymised in-patient records for admissions from 2006 to 2011. Notes were examined for all older people with alcohol-related problems seen by liaison psychiatry services, with documentation of reason for admission, accompanying mental disorder, referral to mental health services and 6 month follow-up. Four hundred and twenty unique case notes were identified, with 108 patients being eligible for inclusion. Sixty patients were admitted with alcohol withdrawal syndrome, 42 of whom were given a diagnosis of alcohol-related brain injury (ARBI). Fifty patients were taken on by community mental health teams (CMHTs); a further 14 were placed in continuing care facilities. Of the patients under CMHTs, 19 patients (38%) had achieved abstinence from alcohol or controlled drinking at 6 month follow-up. Patients with ARBI were less likely than those without it to have changed their drinking behaviour after 6 months. This is the first UK naturalistic study to show positive outcomes from community treatment of alcohol misuse and dual diagnosis. In spite of the high rate of referral to mental health services and positive outcomes, there was little indication of clear pathways being used in the assessment, treatment and referral of older people with alcohol misuse in medical wards. [ABSTRACT FROM PUBLISHER]