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Fenollal-Maldonado G, Brown D, Hoffman H, Kahlon C, Grossberg G. Alcohol Use Disorder in Older Adults. Clin Geriatr Med 2021; 38:1-22. [PMID: 34794695 DOI: 10.1016/j.cger.2021.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
As the number of older adults worldwide continues to grow, we observe a proportional growth of substance use. Despite the myriad of complications alcohol use disorder (AUD) has on the body with regards to organ systems and mental health, the topic has been underresearched in the older adult population. Thus, it is important to create awareness about the growing problem of AUD among older adults. In this way, we can mitigate the long-term complications and side effects observed with alcohol abuse in this vulnerable population.
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Affiliation(s)
- Gabriela Fenollal-Maldonado
- Department of Psychiatry and Behavioral Neuroscience, Division of Geriatric Psychiatry, St. Louis University School of Medicine, 1438 South Grand Boulevard, St Louis, MO 63104, US.
| | - Derek Brown
- Department of Psychiatry and Behavioral Neuroscience, Division of Geriatric Psychiatry, St. Louis University School of Medicine, 1438 South Grand Boulevard, St Louis, MO 63104, US
| | - Heidi Hoffman
- Saint Louis University School of Medicine, St. Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, US
| | - Chanchal Kahlon
- Saint Louis University School of Medicine, St. Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, US
| | - George Grossberg
- Department of Psychiatry and Behavioral Neuroscience, Division of Geriatric Psychiatry, St. Louis University School of Medicine, 1438 South Grand Boulevard, St Louis, MO 63104, USA
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Bhad R, Sarkar S, Sood E, Mishra A. Validated scales for substance use disorders in the geriatric population: A scoping review. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Minnich A, Erford BT, Bardhoshi G, Atalay Z, Chang CY, Muller LA. Systematic Evaluation of Psychometric Characteristics of the Michigan Alcoholism Screening Test 13-Item Short (SMAST) and 10-Item Brief (BMAST) Versions. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12231] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Amelia Minnich
- Education Specialties Department, Loyola University Maryland
- Now at St. Paul’s Lutheran School, Glen Burnie, Maryland
| | - Bradley T. Erford
- Department of Human and Organizational Development, Vanderbilt University
| | - Gerta Bardhoshi
- Rehabilitation and Counselor Education Department, University of Iowa
| | - Zümra Atalay
- Counseling Department, MEF University, Istanbul, Turkey
| | - Catharine Y. Chang
- Counseling and Psychological Services Department, Georgia State University
| | - Lauren A. Muller
- Department of Human and Organizational Development, Vanderbilt University
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Dias EG, Andrade FBD, Duarte YADO, Santos JLF, Lebrão ML. Advanced activities of daily living and incidence of cognitive decline in the elderly: the SABE Study. CAD SAUDE PUBLICA 2016; 31:1623-35. [PMID: 26375642 DOI: 10.1590/0102-311x00125014] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the association between advanced activities of daily living (AADL) and incidence of cognitive decline. The sample consisted of non-institutionalized older adults who participated in the second (2006) and third (2010) waves of the Health, Wellbeing, and Aging (SABE) cohort study in São Paulo, Brazil. Cognitive decline was measured using a modified Mini-Mental State Examination. Advanced activities of daily living covered 12 social, productive, physical, and leisure-time activities that involve higher cognitive functions. Other covariates included socio-demographic conditions, overall health, lifestyle, and functional disability. The association between the independent variables and incidence of cognitive decline was assessed by multiple Poisson regression. Incidence of cognitive decline was 7.9%. Mean number of AADL in 2006 was significantly higher among elders who had not developed cognitive decline. Multivariate analysis showed that the number of AADL performed was a significant inverse predictor of cognitive decline.
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Affiliation(s)
| | | | | | | | - Maria Lúcia Lebrão
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, BR
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Abstract
Alcohol problems in older adults aged 65 years or over, in the United Kingdom and internationally, have risen steadily over the past decade. These are a common but underdiagnosed and under-recognized problem. A UK survey in 2008 found that 21% of men and 10% of women aged 65 years and over reported drinking more than four and three units of alcohol respectively on at least one day per week (National Health Service Information Centre, 2010). A recent Royal College of Psychiatrists Report (2011) cited research that showed there has been a rise in the number drinking over weekly recommended limits by 60% in men and 100% in women between 1990 and 2006 with the number of people aged over 65 years requiring treatment for a substance misuse problem, set to more than double between 2001 and 2020, all of which points to a significant public health problem both now and in the future (National Health Service Information Centre, 2009).
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Kano MY, Santos MAD, Pillon SC. Use of alcohol in the elderly: transcultural validation of the Michigan Alcoholism Screening Test – Geriatric Version (MAST-G). Rev Esc Enferm USP 2014. [DOI: 10.1590/s0080-623420140000400011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate the internal consistency of the version of the Michigan Alcoholism Screening Test – Geriatric Version (MAST-G) instrument, translated and adapted for Brazil. Method: This was a descriptive, cross-sectional study. Data were collected through a demographic questionnaire, the ICD-10 and the MAST-G, following the steps of translation and cultural adaptation. One hundred eleven elderly in the city of São Carlos, SP, Brazil were interviewed. Results: The mean age of those interviewed was 70 years, with 45% men and 55% women, with the mean education of three years; 92% resided with family; 48% of the subjects consumed alcoholic beverages. The MAST-G presented a good level of reliability, with Cronbach’s α = 0.7873, and good levels of sensitivity and specificity with a cutoff score of five positive responses. Conclusion: The Brazilian version of the MAST-G presented internal consistency values similar to the original English version,showing it to be adequate for use in the national context.
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Bertholet N, Winter MR, Cheng DM, Samet JH, Saitz R. How accurate are blood (or breath) tests for identifying self-reported heavy drinking among people with alcohol dependence? Alcohol Alcohol 2014; 49:423-9. [PMID: 24740846 DOI: 10.1093/alcalc/agu016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Managing patients with alcohol dependence includes assessment for heavy drinking, typically by asking patients. Some recommend biomarkers to detect heavy drinking but evidence of accuracy is limited. METHODS Among people with dependence, we assessed the performance of disialo-carbohydrate-deficient transferrin (%dCDT, ≥1.7%), gamma-glutamyltransferase (GGT, ≥66 U/l), either %dCDT or GGT positive, and breath alcohol (> 0) for identifying 3 self-reported heavy drinking levels: any heavy drinking (≥4 drinks/day or >7 drinks/week for women, ≥5 drinks/day or >14 drinks/week for men), recurrent (≥5 drinks/day on ≥5 days) and persistent heavy drinking (≥5 drinks/day on ≥7 consecutive days). Subjects (n = 402) with dependence and current heavy drinking were referred to primary care and assessed 6 months later with biomarkers and validated self-reported calendar method assessment of past 30-day alcohol use. RESULTS The self-reported prevalence of any, recurrent and persistent heavy drinking was 54, 34 and 17%. Sensitivity of %dCDT for detecting any, recurrent and persistent self-reported heavy drinking was 41, 53 and 66%. Specificity was 96, 90 and 84%, respectively. %dCDT had higher sensitivity than GGT and breath test for each alcohol use level but was not adequately sensitive to detect heavy drinking (missing 34-59% of the cases). Either %dCDT or GGT positive improved sensitivity but not to satisfactory levels, and specificity decreased. Neither a breath test nor GGT was sufficiently sensitive (both tests missed 70-80% of cases). CONCLUSIONS Although biomarkers may provide some useful information, their sensitivity is low the incremental value over self-report in clinical settings is questionable.
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Affiliation(s)
- Nicolas Bertholet
- Alcohol Treatment Center, Department of Community Medicine and Health, Lausanne University Hospital, Lausanne, Switzerland
| | - Michael R Winter
- Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA
| | - Debbie M Cheng
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University and Boston Medical Center, Boston, MA, USA Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey H Samet
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University and Boston Medical Center, Boston, MA, USA Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Richard Saitz
- Data Coordinating Center, Boston University School of Public Health, Boston, MA, USA Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Ryou YI, Kim JS, Jung JG, Kim SS, Choi DH. Usefulness of Alcohol-screening Instruments in Detecting Problem Drinking among Elderly Male Drinkers. Korean J Fam Med 2012; 33:126-33. [PMID: 22787534 PMCID: PMC3391637 DOI: 10.4082/kjfm.2012.33.3.126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 04/17/2012] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In Korea, few studies have been performed on screening instruments for the detection of at-risk drinking and alcohol use disorders in the elderly. This study evaluated the validity of three screening instruments in elderly male drinkers. METHODS The subjects were 242 Korean men aged ≥ 65 years. Face-to-face interviews were used to identify at-risk drinking and alcohol use disorders. At-risk drinking was defined according to the criteria for heavy or binge drinking of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV-text revision. The Alcohol Use Disorder Identification Test (AUDIT), Short Michigan Alcoholism Screening Test-geriatric version (SMAST-G), and cut down, annoyed, guilty, eye-opener (CAGE) questionnaire were used as the alcohol-screening instruments. Based on the diagnostic interview results, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the instruments were compared. RESULTS For identification of at-risk drinking, the AUDIT AUROC demonstrated greater diagnostic power than did those of SMAST-G and CAGE (both P < 0.001). In screening for alcohol use disorders, the AUDIT AUROC was also significantly higher than those of SMAST-G and CAGE (both P < 0.001). The sensitivity and specificity of screening for at-risk drinking with an AUDIT score ≥ 7 were 77.3% and 85.1%, respectively, whereas those for the alcohol use disorders with an AUDIT score ≥ 11 were 91.3% and 90.8%, respectively. CONCLUSION The results suggest that the AUDIT is the most effective tool in identifying problem drinkers among elderly male drinkers.
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Affiliation(s)
- Young Il Ryou
- Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea
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Alcohol use disorders in the elderly: a brief overview from epidemiology to treatment options. Exp Gerontol 2012; 47:411-6. [PMID: 22575256 DOI: 10.1016/j.exger.2012.03.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 02/09/2012] [Accepted: 03/27/2012] [Indexed: 11/24/2022]
Abstract
Alcohol-use-disorders (AUDs) afflict 1-3% of elderly subjects. The CAGE, SMAST-G, and AUDIT are the most common and validated questionnaires used to identify AUDs in the elderly, and some laboratory markers of alcohol abuse (AST, GGT, MCV, and CDT) may also be helpful. In particular, the sensitivity of MCV or GGT in detecting alcohol misuse is higher in older than in younger populations. The incidence of medical and neurological complications during alcohol withdrawal syndrome in elderly alcoholics is higher than in younger alcoholics. Chronic alcohol abuse is associated with tissue damage to several organs. Namely, an increased level of blood pressure is more frequent in the elderly than in younger adults, and a greater vulnerability to the onset of alcoholic liver disease, and an increasing risk of breast cancer in menopausal women have been described. In addition, the prevalence of dementia in elderly alcoholics is almost 5 times higher than in non-alcoholic elderly individuals, approximately 25% of elderly patients with dementia also present AUDs, and almost 20% of individuals aged 65 and over with a diagnosis of depression have a co-occurring AUD. Moreover, prevention of drinking relapse in older alcoholics is, in some cases, better than in younger patients; indeed, more than 20% of treated elderly alcohol-dependent patients remain abstinent after 4 years. Considering that the incidence of AUDs in the elderly is fairly high, and AUDs in the elderly are still underestimated, more studies in the fields of epidemiology, prevention and pharmacological and psychotherapeutic treatment of AUDs in the elderly are warranted.
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