Curtis J R, Geller G, Stokes E J, Levine D M, Moore R D
Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
J Am Geriatr Soc. 1989 Apr;37(4):310-6. doi: 10.1111/j.1532-5415.1989.tb05496.x.
The purpose of this study is to examine the ability of physicians to diagnose alcoholism in the elderly patient and to define characteristics specific to the elderly patient with alcoholism. During a 3-month period, all new admissions to the medical service of The Johns Hopkins Hospital were screened for alcoholism with two screening tests (the CAGE questionnaire and Short Michigan Alcohol Screening Test). The prevalence of screen-positive alcoholism was 27% in patients under 60 years of age and 21% in patients 60 years and older. Elderly patients with alcoholism were more likely to be black (P less than .01), but did not differ significantly in any other way from elderly patients who did not have alcoholism. Although 60% of screen-positive young patients with alcoholism were identified by their houseofficers, only 37% of elderly patients with screen-positive alcoholism were so identified (P less than .05). The elderly patients with alcoholism were significantly less likely to be diagnosed by their houseofficer if they were white, female, or had completed high school (P less than .01). Even when diagnosed, elderly patients with alcoholism were less likely than younger patients with alcoholism to have treatment recommended by their houseofficers (P less than .05) and, if treatment were recommended, it was less likely to be initiated (P less than .05). These data suggest that current medical education is deficient in providing physicians with the skills to detect and treat elderly patients with alcoholism.
本研究的目的是检验医生诊断老年患者酒精中毒的能力，并确定老年酒精中毒患者的特定特征。在3个月的时间里，约翰·霍普金斯医院内科服务的所有新入院患者都接受了两项筛查测试（CAGE问卷和密歇根酒精筛查简表）以筛查酒精中毒。60岁以下患者筛查阳性的酒精中毒患病率为27%，60岁及以上患者为21%。老年酒精中毒患者更可能是黑人（P<0.01），但在其他方面与未患酒精中毒的老年患者无显著差异。虽然60%筛查阳性的年轻酒精中毒患者是由住院医生识别出来的，但筛查阳性的老年酒精中毒患者中只有37%是这样被识别出来的（P<0.05）。如果老年酒精中毒患者是白人、女性或已完成高中学业，那么他们被住院医生诊断出来的可能性显著降低（P<0.01）。即使被诊断出来，老年酒精中毒患者比年轻酒精中毒患者更不可能得到住院医生推荐的治疗（P<0.05），而且，如果推荐了治疗，开始治疗的可能性也较小（P<0.05）。这些数据表明，目前的医学教育在为医生提供检测和治疗老年酒精中毒患者的技能方面存在不足。
