There are complex relationships between alcohol use; processes of ageing both social and biological; and cognitive impairment. This paper takes Scotland as a case study to begin to unpick and explore these relationships and their implications for people who drink as they age. In recent years several policy documents have been published in Scotland that acknowledge the increasing prevalence of alcohol problems among people as they age. This paper is based on a review of the literature, analysis of recent Scottish policy documents and two research projects undertaken by the author. The links between alcohol use and dementia are discussed, focusing on biological and social implications for individuals as they age. Current responses in Scotland to these different issues are examined from individual, cultural and policy perspectives. Despite efforts in Scotland the needs of ageing and older individuals who experience alcohol-related morbidity are not sufficiently addressed.