Alcohol use and abuse in the frail, homebound elderly: a clinical analysis of 103 persons

Are There Differences Between Older Persons Who Screen Positive on the CAGE Questionnaire and the Short Michigan Alcoholism Screening Test—Geriatric Version?

“…Our response rate was relatively low (15%) and was likely affected by the length of the HRA‐E questionnaire (43 minutes on average to complete). Unlike other studies, 16–19,22 our sample had fairly equal proportions of men and women who reported positive screening responses to the questions. As compared with older adults in population‐based studies, this population was better educated and healthier 32,33 .…”

“…Moreover, the older populations used to derive these test characteristics have been primarily male, closer to 65 than 75 years of age, and either veterans or persons attending urban academic medicine clinics. Also, measures like the CAGE may have limited ability to detect older women with alcohol use disorders 3,9,20–22 …”

A systematic review of the utility of self‐report alcohol screening instruments in the elderly

“…Reading of the review articles yielded a further 13 original research papers (Moran et al, 1990;Buchsbaum et al, 1992;Bercsi et al, 1993;Jones et al, 1993;Joseph et al, 1995;Adams et al, 1996;Morton et al, 1996;Bradley et al, 1998;Farragher et al, 1998;Lehman et al, 1999;Bradley et al, 2001;Hinkin et al, 2001;Bradley et al, 2003) and hand-search of recent issues of journals relevant to Old Age Psychiatry yielded one further paper (Philpot et al, 2003), giving a total yield of eighteen original research papers.…”

“…MAST-G sensitivity was demonstrated to be low in inpatients (50%) and medical outpatients (52%). Likewise, Bercsi et al (1993) demonstrated low sensitivity of the SMAST in a frail homebound population. Specificity for variations of the MAST were better with only one study demonstrating poor specificity (65%) when the standard cut-off of 5 was used by Joseph et al (1995) in a VA nursing-home population.…”

Optimal Management of Anxiety in Older Patients

“…Also avoided is the tendency to 'self-medicate' with alcohol (ethanol), [18][19][20] a substance clearly more toxic than antianxiety agents. [21] Finally, since suicide is prevalent among older patients, [22] and comorbid anxiety and depression may destroy quality of life, the decision to treat medically is rarely regretted.…”