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[老年急性住院病房老年住院患者酒精消费筛查的患病率及问题]

[Prevalence and issues of screening for alcohol consumption among elderly inpatients admitted to acute geriatric inpatient unit].

作者信息

Henni Amel, Bideau Claire, Routon Xavier, Berrut Gilles, Cholet Jennyfer

机构信息

Service de court séjour gériatrique, Centre hospitalier, Ancenis, France.

出版信息

Geriatr Psychol Neuropsychiatr Vieil. 2013 Mar;11(1):33-41. doi: 10.1684/pnv.2013.0397.

Abstract

BACKGROUND

alcohol use disorders in the elderly are often underdiagnosed in spite of their effects worsened by age-related physiological changes, comorbidities and frequent polymedication.

OBJECTIVE

the aim of this study was to assess the prevalence of alcohol use in a geriatric acute care unit.

SUBJECTS AND METHODS

a prospective and descriptive study was carried out in an acute care geriatric unit in France, from November 2011 to March 2012. It included inpatients aged 75 and older. We gathered medical data from medical records and conducted one-to-one interviews assessing the inpatients' weekly alcohol intake and personal history of alcohol use. We screened alcohol abuse and dependence by using parts of the MINI (Mini international neuropsychiatric interview). We also assessed benzodiazepine and tobacco consumption. Comprehensive geriatric assessment was conducted using the CIRS-G (cumulative illness scale in geriatrics), the MMSE (Mini mental state evaluation), the MNA (Mini nutritional assessment), the mini GDS (mini Geriatric depression scale) and the 4-IADL (4-Instrumental activities of daily living). Patients were dispatched in five groups according the DSM-IV-TR classification.

RESULTS

the study included consicutively 100 inpatients (53 women and 47 men), with a mean age of 84.8±5.4 years. Forty-four percent had alcohol use disorders (29% at-risk users, 11% harmful users and 4% dependent). Very few inpatients with alcohol use disorders had been asked in the past about their alcohol consumption. They used benzodiazepine more often than the others. We did not find any differences in geriatric assessment when comparing the two sub-groups.

CONCLUSION

alcohol use disorders are very common in elderly inpatients of acute geriatric care units, especially when considering the group of at-risk users. Alcohol use should thus be screened for every elderly inpatient.

摘要

背景

尽管老年人酒精使用障碍会因年龄相关的生理变化、合并症及频繁的多种药物治疗而使病情恶化,但往往诊断不足。

目的

本研究旨在评估老年急性护理病房中酒精使用的患病率。

对象与方法

2011年11月至2012年3月在法国一家老年急性护理病房进行了一项前瞻性描述性研究。纳入年龄在75岁及以上的住院患者。我们从病历中收集医疗数据,并进行一对一访谈,评估住院患者的每周酒精摄入量及饮酒个人史。我们使用MINI(迷你国际神经精神访谈)的部分内容筛查酒精滥用和依赖情况。我们还评估了苯二氮䓬类药物和烟草的消费情况。使用CIRS-G(老年累积疾病量表)、MMSE(简易精神状态检查表)、MNA(简易营养评估)、迷你GDS(迷你老年抑郁量表)和4-IADL(4项日常生活能力量表)进行全面老年评估。根据《精神疾病诊断与统计手册》第四版修订版分类将患者分为五组。

结果

该研究连续纳入了100名住院患者(53名女性和47名男性),平均年龄为84.8±5.4岁。44%的患者存在酒精使用障碍(29%为有风险使用者,11%为有害使用者,4%为依赖者)。过去很少有酒精使用障碍的住院患者被询问过饮酒情况。他们比其他人更常使用苯二氮䓬类药物。比较两个亚组时,我们在老年评估中未发现任何差异。

结论

酒精使用障碍在老年急性护理病房的住院患者中非常常见,尤其是考虑到有风险使用者群体。因此,应对每位老年住院患者进行酒精使用筛查。

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