The purpose of this descriptive ex-post facto pilot study is to develop and validate an assessment method to detect alcohol abuse and dependence and alcohol misuse (e.g., inadvertently using it with prescribed or over- the-counter drugs) among elderly female acute care inpatients. Women over 65 who are admitted to general medical and cardiology units and who fit the criteria will be invited to participate. About 12 1/2% of such women are known to be abusing or dependent on alcohol, but their chances of both diagnosis and treatment of this problem is less than 1 in 64. Physicians and nurses do not do adequate alcohol histories on women, especially older women because of ageism, stereotyping, lack of knowledge about addictions, and lack of knowledge about the biology of aging. The 60 women subjects will be divided into an abstainer group (N = 30) and an alcohol abuser/dependent group (N = 30) based on cut-points of Carbohydrate-deficient transferrin (CDT) radio-immunoassays, which is the gold standard to be used in this study. The CDT test has 82% sensitivity and 97% specificity for alcohol abuse and dependence. The assessments to be tested against the CDT gold standard are: 1. an interview schedule as part of the hospital exam, which includes quantity and frequency questions and the T-ACE instruments for 'risk drinking'; and 2. analyses of 12 lead ECG and 48 holter monitor ECG for indications of early cardiac arrhythmias that occur with alcohol and dependence. The proposed study will serve as pilot work for a future clinical trial of a validated assessment tool to detect alcohol misuse, abuse, or dependence in elderly women acute care inpatients. This group's use of psychotropic drugs, over-the-counter drugs and alcohol is currently overlooked in hospital admission screening, medical histories, and physical exams.
| Masters, Joan A; Stevenson, Joanne Sabol; Schaal, Stephen F (2004) The association between moderate drinking and heart rate variability in healthy community-dwelling older women. Biol Res Nurs 5:222-33 |
