The effect of alcohol abuse on the health status of older adults seen in the emergency department

Objective: To examine the effect of alcohol abuse on the subsequent health status of elderly patients seen in an emergency department (ED). Patients a nd methods: A sample of 966 patients aged 65 or older who presented to one urban academic ED between the hours of 8 A.M.. and 12 midnight was followed for 1 year. A personal interview was administered during the ED visit. Cur rent problem drinkers had a score of 1 or greater on the CAGE questionnaire at ED presentation and drank within the prior 6 months; former problem dri nkers had a score of 1 or greater on the CAGE questionnaire at ED presentat ion and a last drink more than 6 months previously. We used 13 items from t he Medical Outcomes Study short form adopted to the ED setting and 6 items from the Index of Activities of Daily Living (ADL) to measure health status . Results: In multivariate models for repeated-measures controlling for pot ential confounding factors, current problem drinkers had worse overall heal th (parameter estimate beta -3.6; 95% CI -7.1 to -0.04), and former problem drinkers had worse mental health (beta -3.6; CI -6.9 to -0.24) on follow-u p. We could find no effect of problem drinking on physical health or social function. Conclusions: Current problem drinking is associated with worse s elf-perceived health among elderly patients in the year following presentat ion to an ED. The magnitude of decline in health perception may approximate the effect of having back pain, sciatica, or other musculoskeletal complai nts. Elderly former problem drinkers suffer from more severe mental health problems over that same period.