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How do you effectively evaluate the elderly for alcohol use disorder?

Moronkeji Fagbemi, MD, FASAM
Cleveland Clinic Journal of Medicine August 2021, 88 (8) 434-439; DOI: https://doi.org/10.3949/ccjm.88a.20123

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Tables

  • TABLE 1

    Presentation of alcohol problems in the elderlya

    Anxiety
    Poor hygiene, urinary or fecal incontinence
    Malnutrition
    Confusion, memory loss, dementia, or delirium
    Falls
    Marital problems
    Sleep problems
    Depression or mood swings
    Financial problems
    Seizures (new-onset, idiopathic)
    Worsening of chronic medical problems (hypertension, diabetes, heart failure)

    • ↵a Note: Crime, antisocial, and substance-seeking illegal behaviors are not common in this group.

  • TABLE 3

    Assessment of alcohol use disorder in the elderlya

    Previous diagnosis of alcohol-use disorder
    Drinking patterns, physiologic dependence, withdrawals
    Presence of intoxication
    Neuropsychiatric comorbidities or manifestations including suicidal ideation
    Medical comorbidities and complications including chronic pain; current medications
    Psychosocial evaluation including housing, dietary issues, finances, legal issues, sociability, family
    Prior treatment, including pharmacotherapy: success, failure, relapse, participation in support groups
    Patient’s level of motivation to change

    • ↵a Assessment should include screening, a thorough medical and psychosocial history, physical examination, and appropriate laboratory tests.

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