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Beitrag zum Themenschwerpunkt

Diagnostik von alkoholbezogenen Störungen im Alter

Published Online:March 14, 2007https://doi.org/10.1024/1011-6877.19.4.201

Abstract

Zusammenfassung: Der Beitrag gibt einen Überblick zur Diagnostik von problematischem Alkoholkonsum im Alter. Dabei wird unterschieden zwischen riskantem Konsum, Alkoholabhängigkeit und -missbrauch. Es werden Screeningverfahren auf ihre Anwendbarkeit in der Gruppe der älteren Menschen überprüft und spezifische Verfahren vorgestellt. Zum Teil sind Modifikationen möglich und notwendig. Das gilt z. B. für den häufig eingesetzten CAGE, bei dem das Herabsetzten des Cut-off notwendig ist. Zur Erfassung der Trinkmengen kann auf bewährte Verfahren wie Q/F-Index oder Timeline-Follow-Back zurück gegriffen werden, es können jedoch spezifische Hilfen sinnvoll sein. Bei den Kriterien für Abhängigkeit und Missbrauch gelten zum Teil Besonderheiten, das gilt u. a. bei der Beurteilung von Toleranzentwicklung und Entzugserscheinungen. Dieses ist beim Einsatz von strukturierten oder standardisierten Interviewverfahren zu berücksichtigen.


Diagnostics of Alcohol-Related Disorders in the Elderly

Abstract: An overview is given with respect to diagnostic procedures for problematic drinking in the elderly. Screening instruments are evaluated according to their applicability in older age groups and specific devices are introduced. For some screening tests, modifications are necessary. For example, a lowering of the cut point is recommended for the widely used CAGE. Well proven methods such as Q/F-Index or Timeline-Follow-Back can be used to assess drinking amounts, however, specific memory aids might be useful. For the criteria of alcohol dependence or abuse, age-related specifics have to be taken into account, e.g. when assessing tolerance and withdrawal. These particularities have to be addressed in structured or standardized interviews.

References

  • Aertgeerts, B. Buntinx, F. Ansoms, S. Fevery, J. (2001). Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. British Journal of General Practice, 51, 172– 173 First citation in articleGoogle Scholar

  • Babor, T.F. de la Fuente, J.R. Saunders, J. Grant, M. (1989). The Alcohol Use Disorders Identification Test: Guidelines for use in primary health care . Geneva: World Health Organization, Division of Mental Health First citation in articleGoogle Scholar

  • Beresford, T.P. Blow, F.C. Hill, E. Lucey, M.R. (1990). Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism. Lancet, 336, 482– 485 First citation in articleCrossref, Google Scholar

  • Blow, F. Gillespie, B. Barry, K. (1998). Brief screening for alcohol problems in elderly populations using the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G). Alcoholism: Clinical and Experimental Research, 22(Suppl), 131A– First citation in articleGoogle Scholar

  • Blow, F.C. Brower, K.G. Schulenberg, J.E. Demo-Dananberg, L.M. Young, J.S. Beresfold, T.P. (1992). The Michigan Alcoholism Screening Test-Geriatric Version (MAST-G): A new elderly-specific screening instrument. Alcoholism: Clinical and Experimental Research, 16, 372– First citation in articleGoogle Scholar

  • Bradley, K.A. Bush, K.R. Epler, A.J. Dobie, D.J. Davis, T.M. Sporleder, J.L. (2003). Two brief alcohol-screening tests From the Alcohol Use Disorders Identification Test (AUDIT): Validation in a female Veterans Affairs patient population. Archives of Internal Medicine, 163, 821– 829 First citation in articleCrossref, Google Scholar

  • Bush, K. Kivlahan, D.R. McDonell, M.B. Fihn, S.D. Bradley, K.A. (1998). The AUDIT Alcohol Consumption Questions (AUDIT-C). An effective brief screening test for problem drinking. Archives of Internal Medicine, 158, 1789– 1795 First citation in articleCrossref, Google Scholar

  • Conigliaro, J. Kraemer, K. McNeil, M. (2000). Screening and identification of older adults with alcohol problems in primary care. Journal of Geriatric Psychiatry and Neurology, 13, 106– 114 First citation in articleCrossref, Google Scholar

  • Dawson, D.A. Grant, B.F. Stinson, F.S. Zhou, Y. (2005). Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcoholism, Clinical and Experimental Research, 19, 844– 854 First citation in articleCrossref, Google Scholar

  • Dilling, H. Mombour, W. Schmidt, M.H. (1991). Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F) . Bern: Huber First citation in articleGoogle Scholar

  • Dilling, H. Mombour, W. Schmidt, M.H. Schulte-Markwort, E. Eds. (1994). Internationale Klassifikation psychischer Störungen: ICD-10, Kapitel V (F). Forschungskriterien . Bern: Huber First citation in articleGoogle Scholar

  • Edwards, G. Ed. (1994). Alcohol policy and the public good . New York: Oxford University Press First citation in articleGoogle Scholar

  • Ewing, J.A. (1984). Detecting alcoholism: The CAGE questionnaire. Journal of the American Medical Association, 252, 1905– 1907 First citation in articleCrossref, Google Scholar

  • Fiellin, D.A. Reid, M.C. O'Connor, P.G. (2000). Screening for alcohol problems in primary care: A systematic review. Archives of Internal Medicine, 160, 1977– 1989 First citation in articleCrossref, Google Scholar

  • Graham, K. (1986). Identifying and measuring alcohol abuse among the elderly: Serious problems with existing instrumentation. Journal of Studies on Alcohol, 47, 322– 326 First citation in articleCrossref, Google Scholar

  • Köbberling, J. Richter, K. Trampisch, H.-J. Windeler, J. (1991). Methodologie der medizinischen Diagnostik: Entwicklung, Beurteilung und Anwendung von Diagnoseverfahren in der Medizin . Berlin: Springer-Verlag First citation in articleGoogle Scholar

  • Mayfield, D. McLeod, G. Hall, P. (1974). The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument. American Journal of Psychiatry, 131, 1121– 1123 First citation in articleGoogle Scholar

  • Morrison, A.S. (1992). Screening in chronic disease (2nd ed. Vol. 19). New York: Oxford University Press First citation in articleGoogle Scholar

  • Morton, J. Jones, T. Manganaro, M. (1996). Performance of alcoholism screening questionnaires in elderly veterans. American Journal of Medicine, 101, 153– 159 First citation in articleCrossref, Google Scholar

  • Murray, R.M. (1977). Screening and early detection instruments for disabilities related to alcohol consumption. In G. Edwards, M.M. Gross, M. Keller, J. Moser & R. Room (Eds.), Alcohol-related disabilities (pp. 89-105). Geneva: World Health Organization First citation in articleGoogle Scholar

  • National Institute of Alcoholism and Alcohol Abuse (1995). The physicians guide to helping patients with alcohol problems . NIH Publications no. 95-3769 First citation in articleGoogle Scholar

  • O'Connel, H. Chin, A.-V. Hamilton, F. Cunningham, C. Walsh, J.B. Coakley, D. Lawlor, B.A. (2004). A systematic review of the utility of self-report alcohol screening instruments in the elderly. International Journal of Geriatric Psychiatry, 19, 1074– 1086 First citation in articleCrossref, Google Scholar

  • Oslin, D.W. (2004). Late-life alcoholism. American Journal of Geriatric Psychiatry, 12, 571– 583 First citation in articleCrossref, Google Scholar

  • Philpot, M. Pearson, N. Petratou, V. Dayanandan, R. Silverman, M. Marshall, J. (2003). Screening for problem drinking in older people referred to a mental health service: A comparison of CAGE and AUDIT. Aging and Mental Health, 7, 171– 175 First citation in articleCrossref, Google Scholar

  • Rumpf, H.-J. Bromisch, B. Botzet, M. Hill, A. Hapke, U. John, U. (1998). Epidemiologie des Alkoholmißbrauchs im höheren Alter. In U. Havemann-Reinecke, S. Weyerer & H. Fleischmann (Hrsg.), Alkohol und Medikamente, Mißbrauch und Abhängigkeit im Alter (pp. 29-37). Freiburg i. Br.: Lambertus First citation in articleGoogle Scholar

  • Rumpf, H.-J. Hapke, U. Erfurth, A. John, U. (1998). Screening questionnaires in the detection of hazardous alcohol consumption in the general hospital - Direct or disguised assessment?. Journal of Studies on Alcohol, 59, 698– 703 First citation in articleCrossref, Google Scholar

  • Rumpf, H.-J. Hapke, U. John, U. (2001). Der CAGE Fragebogen. In A. Glöckner-Rist & F. Rist (Eds.), Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES). Version 1.00. Mannheim: Zentrum für Umfragen, Methoden und Analysen First citation in articleGoogle Scholar

  • Rumpf, H.-J. Meyer, C. Hapke, U. John, U. (2001). Deutsche Version des Alcohol Use Disorders Identification Test (AUDIT). In A. Glöckner-Rist & F. Rist (Hrsg.), Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES). Version 1.0. Mannheim: Zentrum für Umfragen, Methoden und Analysen First citation in articleGoogle Scholar

  • Saß, H. Wittchen, H.-U. Zaudig, M. (1996). Diagnostisches und Statistisches Manual psychischer Störungen DSM-IV . Göttingen: Hogrefe First citation in articleGoogle Scholar

  • Selzer, M.L. (1968). Michigan Alcoholism Screening Test (MAST): Preliminary report. Journal of the University of the Michigan Medical Center, 34, 143– 145 First citation in articleGoogle Scholar

  • Sobell, L.C. Agrawal, S. Annis, H. Ayala-Velazquez, H. Echeverria, L. Leo, G.I. (2001). Cross-cultural evaluation of two drinking assessment instruments: Alcohol timeline follow-back and inventory of drinking situations. Substance Use and Misuse, 36, 313– 331 First citation in articleCrossref, Google Scholar

  • Wittchen, H.-U. Beloch, E. Garczynski, E. Holly, A. Lachner, G. Perkonigg, A. (1995). Münchener Composite International Diagnostic Interview (M-CIDI), Version 2.2 . München: Max-Planck-Institut für Psychiatrie First citation in articleGoogle Scholar

  • Wittchen, H.-U. Wunderlich, U. Gruschwitz, S. Zaudig, M. (1997). SKID-I. Strukturiertes Klinisches Interview für DSM-IV. Achse I: Psychische Störungen . Göttingen: Hogrefe First citation in articleGoogle Scholar