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Identification of alcoholism and depression in a geriatric medicine outpatient clinic
G Fulop1, J Reinhardt, J J Strain
1Division of Behavioral Medicine, Mount Sinai School of Medicine, New York, New York.
Objective:
To examine the utility of brief screening instruments for alcoholism and depression in the frail elderly medical outpatient.
Design:
Cross-sectional examination.
Setting:
Coffey Geriatric Outpatient Clinic, The Mount Sinai School of Medicine, New York City.
Subjects:
Convenience sample of 84 consenting male and female outpatients over 62 years of age.
Measurements:
The Michigan Alcohol Screening Test (MAST), CAGE questionnaire, and the Geriatric Depression Scale (GDS).
Results:
Four subjects (5%) scored positive for alcoholism on the MAST, all of whom had been previously identified by the geriatric clinic staff. In contrast, the CAGE only identified 1 (1.4%) alcoholic subject. Thirty-two percent of subjects scored positive for depression on the GDS, yet only one-third of these depressed patients had been previously identified by the geriatric team as depressed. Among the depressed outpatients, 19% were labeled anxious and received anxiolytics from the geriatric medical staff.
Conclusions:
Whereas brief alcohol screening instruments to detect alcoholism did not augment the geriatrician's clinical assessment, screening for depression with the GDS may be an important adjunct to the identification of depression in geriatric medical patients.