Alcohol and acute medical admission of elderly people

In a prospective study of 539 consecutive elderly medical admissions (mean age 77.3 years; 275 men), 42 patients (7.8%; 36 men) were identified as alcohol abusers, 41 by an alcohol intake history and one by a positive response to the CAGE questionnaire; none was identified by laboratory screening (gamma glutamyltransferase and red cell mean corpuscular volume) alone. Thirteen admissions (2%) were alcohol-related. In alcohol abusers, 24% of admissions (n = 10; p less than 0.001) were alcohol-related. Alcohol abusers were predominantly men (86%; p less than 0.001) and independently mobile (88%; p less than 0.001), suggesting greater physical fitness. In these more active men (n = 167), the prevalence of alcohol abuse was 19.8% and 6% of admissions were alcohol-related. While the sensitivities of the CAGE questionnaire and laboratory screening were too low to be clinically useful, an alcohol intake history may allow for a significant opportunity in preventive medicine in this age group, particularly in the fitter men.