[Use and abuse of alcohol among elderly women in Iceland. Comparison of clinical symptoms of abuse with liver function tests and mean corpuscular volume.].
OBJECTIVE
This study was conducted to investigate the prevalence of alcohol abuse and dependency among elderly women in Iceland and to make an assessment of the sensitivity and specificity of liver function tests and mean corpuscular volume (MCV) in the diagnosis of alcohol abuse.


METHODS
The group was made of 280 women (age 55-74 years, mean age 61.9 years) from the Reykjavik Study. The diagnoses were based on a questionnaire (eight symptoms) which has been used in epidemiological studies of alcoholism in Iceland since 1974. To this questionnaire there were added five questions aiding to the diagnosis of the lifetime prevalence rate of abuse. The CAGE questionnaire is implicated in this scale of 13 symptoms.


RESULTS
Among 263 respondents (93.9%), there were 156 consumers (59.3%). Of the consumers 16% had at least one symptom indicating alcohol abuse. The diagnosis of abuse was made when three symptoms of eight occurred together. Abuse occured among 2.6% of consumers (1.5% of respondents). Symptom triad of dependency occurred among 1.3% of consumers (0.8% of respondents). Heavy drinking was equally frequent as dependency. Mean values of gamma glutamyl transferase (G-GT) and MCV increase with increasing number of symptoms of abuse. The sensitivity of G-GT and MCV is low (20%) but the specificity is high (94%) for both. Bilirubin and alkaline phosphatase do neither have a sensitivity nor specificity for the diagnosis of abuse.


CONCLUSIONS
These findings indicate that these blood tests are not a reliable method for the screening of alcohol abuse among elderly women. A questionnaire searching for clinical symptoms of abuse is the best method for the diagnosis of abuse. Among elderly women, the symptom of guilty feelings connected to alcohol consumption, is the most sensitive indicator of abuse. But there are probably more women that experience guilty feelings than those which can be considered alcohol abusers.
Gardarsson
H G
HG
Hardarson
T
T
Helgason
T
T