Screening for alcohol misuse in older people.

OBJECTIVES: To evaluate whether the CAGE, MAST-G or an abnormally high MCV are effective screening instruments for alcohol misuse and if not to devise a new instrument.

DESIGN: Questionnaire survey of randomly selected patients.

SETTING: Acute admission wards of two district general hospitals.

PERIOD: 9 months.

SUBJECTS: Randomly selected patients, aged 65 and over, admitted as emergencies.

MAIN OUTCOME MEASURES: Excessive alcohol intake, alcohol dependence.

RESULTS: The sensitivities of the CAGE, MAST-G and an abnormally high MCV for excess alcohol intake and alcohol abuse are low, ranging from 0.13 to 0.54.

CONCLUSION: The results confirm previous UK studies which indicate that the CAGE and an abnormally high MCV are poor screening instruments for alcohol misuse in older patients and also indicate that the MAST-G is an insensitive screening instrument. A new two-step instrument with five questions in total was generated. This requires further validation.