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Screening for problem drinking in older primary care patients

W L Adams¹, K L Barry, M F Fleming

¹Medical College of Wisconsin, Milwaukee, USA. wadams@netserv.unmc.edu

|December 25, 1996

Summary

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Hazardous alcohol use is common in elderly primary care patients. The CAGE questionnaire is insufficient for detecting heavy or binge drinking in this population.

Area of Science:

Geriatrics
Public Health
Addiction Medicine

Background:

Potentially hazardous alcohol consumption is prevalent among elderly individuals.
Screening tools are needed to identify at-risk older adults in primary care settings.

Purpose of the Study:

To describe hazardous alcohol use in elderly primary care patients.
To evaluate the CAGE questionnaire's effectiveness in detecting heavy and binge drinking in this demographic.

Main Methods:

Cross-sectional study involving 5065 patients over 60 years old across 21 primary care sites.
Utilized a self-administered questionnaire including quantity/frequency of drinking, binge drinking episodes, and the CAGE questionnaire.
Assessed alcohol consumption against National Institute of Alcohol Abuse and Alcoholism guidelines.

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Main Results:

15% of men and 12% of women exceeded recommended weekly alcohol limits.
9% of men and 3% of women screened positive on the CAGE questionnaire.
The CAGE questionnaire identified less than half of heavy or binge drinkers.

Conclusions:

Excessive alcohol consumption is common among elderly outpatients.
The CAGE questionnaire alone is inadequate for detecting hazardous drinking in older adults.
Combining CAGE with quantity/frequency questions improves detection of problem drinking.