The Michigan Alcohol Screening Test, Geriatric (MAST-G) is a 24-item yes or no questionnaire developed to identify at-risk and problem drinking in adults age 65 and older. It captures the presentation of alcohol misuse in later life, including stress-related drinking, physical symptoms, and social changes that standard adult screeners often miss.
Why healthcare providers use the MAST-G
- Age-specific detection. It is calibrated to how alcohol problems present in older adults, catching cases that general screeners overlook.
- Brief and self-report. Patients answer 24 yes or no items without a clinician-led interview, which fits busy visits.
- Nonjudgmental framing. Questions ask about everyday experiences rather than labels, which lowers defensiveness in older patients.
- Widely referenced. It is one of the most cited geriatric alcohol screeners, supporting consistency across care teams.
Which settings use the MAST-G?
- Primary care. Clinicians screen older patients during annual wellness and routine visits.
- Geriatric clinics. Teams include it in a comprehensive assessment of cognition, mood, and function.
- Behavioral health. Providers use it to flag alcohol misuse alongside depression and anxiety screening.
- Inpatient and rehabilitation. Staff screen older adults when falls, medication interactions, or confusion raise concern.
What does the MAST-G measure?
The MAST-G measures behavioral, physical, and psychosocial signs of alcohol misuse specific to later life. Because the instrument is copyrighted by the Regents of the University of Michigan, the domains below summarize its content rather than reproducing individual items.
- Consumption and dependence signs. Patterns of drinking, loss of control, and reliance on alcohol.
- Physical and cognitive effects. Physical complaints, memory changes, and sleep problems linked to drinking.
- Coping and emotional use. Drinking in response to loss, loneliness, stress, or grief.
- Social and functional impact. Effects on relationships, daily activities, and concealment of use.
Scoring the MAST-G
- Number of items: 24.
- Per-item scale: each item is answered yes (1 point) or no (0 points).
- Total score range: 0 to 24.
- Score direction: higher scores indicate a greater likelihood of an alcohol problem.
The MAST-G is a screening tool, not a diagnostic instrument. A positive screen guides clinical decision-making and prompts further assessment; it does not confirm an alcohol use disorder. Interpret scores alongside history, physical findings, and collateral information, and account for cognitive or sensory limitations that can affect self-report.
The recognized cutoff is five or more yes responses, which reflects a positive screen warranting further assessment (Blow et al., 1992). The two-row summary below reflects this single published threshold rather than graded severity bands.
| Score | Interpretation | Suggested next step |
|---|---|---|
| 0 to 4 | Below the screening threshold | Routine monitoring |
| 5 to 24 | Positive screen for a possible alcohol problem | Consider further assessment |
Best practices for administration
- Screen proactively. Include the MAST-G in routine older-adult visits rather than waiting for obvious signs.
- Explain the purpose. Tell patients the questions are a standard part of health screening to reduce stigma.
- Support readability. Offer large print or read items aloud for patients with vision or literacy barriers.
- Clarify the timeframe. Confirm whether items refer to lifetime or recent drinking, consistent with your protocol.
- Pair with follow-up. Have a plan for brief assessment or referral ready when a screen is positive.
How Zentake helps with the MAST-G
- Automatic scoring. Totals are calculated on submit, so there is no hand-tallying.
- Before the visit. Patients complete the MAST-G from home on any device, so primary care practices start the visit already informed.
- HIPAA compliant. Responses are encrypted, with a signed BAA on every plan.
References
Blow FC, Brower KJ, Schulenberg JE, Demo-Dananberg LM, Young JP, Beresford TP. The Michigan Alcoholism Screening Test - Geriatric Version (MAST-G): a new elderly-specific screening instrument. Alcoholism: Clinical and Experimental Research. 1992;16:372. This work introduced the 24-item instrument and its cutoff of five or more positive responses.
The Hartford Institute for Geriatric Nursing summarizes MAST-G administration and reports a sensitivity of 93.9% and specificity of 78.1% in the original validation sample.
Last updated: August 2026