Alcohol consumption among the elderly primary health care patients: The impact of alcohol on overall health

Introduction: Alcoholism is the third most common psychiatric disorder among the elderly, yet it often goes undiagnosed in primary care setting. Objective: To estimate the prevalence of alcohol use disorders among elderly primary care patients in Bosnia and Herzegovina and to determine the presence of different health problems related to alcohol consumption. Method: The study was conducted in 10 family medicine practices. Family physicians randomly selected a group of 40 patients over 60 years of age registered with their practice. As a part of Comprehensive Geriatric Assessment, patients were asked to complete Alcohol Consumption Screening Questionnaire, Functional Status Questionnaire, Geriatric Depression Scale (GDS), Mini mental screening examination (MMSE), and Hamilton Anxiety Scale. Screening results were followed by additional clinical evaluation. To estimate the feasibility of Alcohol Consumption Screening Questionnaire, one family member or a caregiver of each patient was questioned about patient's habits and health problems. Results: Eighty-nine (22%) patients were current drinkers. Of those, 59% were harmful drinkers, 26% hazardous and 15% nonhazardous drinkers. Women accounted for 27% of current drinkers. MMSE revealed dementia symptoms in 37%, and symptoms of mild cognitive impairment (MCI) in 25% of current drinkers. Depression symptoms were found in 38% and anxiety symptoms in 6% of current drinkers. Functional status was decreased in hazardous and harmful drinkers. Conclusion: High percentage of older adults in Bosnia and Herzegovina is regular users of alcohol. Hazardous and harmful drinking is associated with significant morbidity. These findings demonstrate the usefulness and importance of the excess alcohol use screening in all primary care settings serving adults over age 60.