Screen elderly for Alcoholism

OB/GYN News, Nov 15, 2001 by Sally Koch Kubetin

Physicians are not doing a good job of recognizing alcohol abuse in the general population, but they're doing an even worse job in the geriatric population, Dr. Eric Weintraub said at the annual meeting of the American Association for Geriatric Psychiatry.

Clinicians need to be able to screen elderly patients for alcohol abuse, said Dr. Weintraub of the University of Maryland in Baltimore. Take a good history; ask about quantity, frequency, and pattern of use. People can drink episodically and still be problem drinkers. Someone who drinks 3-5 drinks, then drives, even if it's only once a week, is at risk. It is also important to remember that denial is part of the illness. Patients frequently underestimate their intake or don't even say how much they have been drinking.

Consider using screening instruments such as the Michigan Alcoholism Screening Test--Geriatric Version or the CAGE questionnaire, he said. The sensitivity of the CAGE questionnaire increases if the clinician also asks if the patient has ever been injured when drinking.

Alcohol abuse in women tends to show up in the late 40s and is usually a reaction to life stresses or as a way of medicating dysphoric moods. Other general risk factors include a previous history of alcohol abuse, even if the individual is in remission, as well as a loss of independence and autonomy associated with medical problems or job retirement, Dr. Weintraub said.