Fink Arlene, Tsai Mark C, Hays Ron D, Moore Alison A, Morton Sally C, Spritzer Karen, Beck John C
Department of Medicine, Division of General Internal Medicine, University of California at Los Angeles, CA 90095, USA.
Arch Gerontol Geriatr. 2002 Feb;34(1):55-78. doi: 10.1016/s0167-4943(01)00198-4.
Older drinkers may incur alcohol-related risks at low consumption levels, but commonly used screening measures do not address alcohol's effects among persons with declining health and increased medication use. We compared the newly developed Alcohol-Related Problems Survey (ARPS) to three validated alcohol screens: the Cut down, Annoyed, Guilty, Eye-opener (CAGE), Short-Michigan Alcohol Screening Test (SMAST), and Alcohol-Use Identification Test (AUDIT). The ARPS classifies drinking as non-hazardous, hazardous or harmful. Non-hazardous drinking is defined as consumption with no known risks for adverse physical or psychological health events. Hazardous drinking is consumption with such risks. Harmful drinking results in adverse events. The AUDIT screens for hazardous and harmful drinking; the CAGE and SMAST identify abusive (e.g. failure to fulfill social obligations) and dependent (e.g. having withdrawal symptoms) drinkers. In this study of 574 current drinkers 65 years and older who completed the ARPS and AUDIT in primary care clinics, half were randomly assigned to complete the CAGE and half, the SMAST. Drinkers who screened positive on the CAGE, SMAST or AUDIT were correctly classified by the ARPS as hazardous or harmful drinkers 91, 75, and 100% of the time, respectively. The majority of ARPS-identified hazardous or harmful drinkers did not screen positive on the CAGE, SMAST or AUDIT. These drinkers had medical conditions or used medications that placed them at risk for adverse health events, none of which was addressed in these three screens. In this study, the ARPS identified nearly all drinkers detected by the CAGE, SMAST, and AUDIT and detected hazardous and harmful drinkers not identified by these measures.
年长饮酒者即便饮酒量较低也可能面临与酒精相关的风险，但常用的筛查措施并未考虑到健康状况下降和用药增多人群中酒精的影响。我们将新开发的酒精相关问题调查（ARPS）与三种经过验证的酒精筛查方法进行了比较：即戒酒、烦恼、内疚、晨饮（CAGE）问卷、密歇根酒精筛查简表（SMAST）和酒精使用鉴定测试（AUDIT）。ARPS将饮酒分为无风险、有风险或有害三类。无风险饮酒被定义为饮酒不会对身体或心理健康产生已知的不良风险。有风险饮酒是指存在此类风险的饮酒行为。有害饮酒则会导致不良事件。AUDIT筛查有风险和有害饮酒；CAGE和SMAST识别酗酒（如无法履行社会义务）和依赖酒精（如有戒断症状）的饮酒者。在这项针对574名65岁及以上、在初级保健诊所完成ARPS和AUDIT的当前饮酒者的研究中，一半被随机分配完成CAGE，另一半完成SMAST。在CAGE、SMAST或AUDIT上筛查呈阳性的饮酒者，被ARPS正确分类为有风险或有害饮酒者的比例分别为91%、75%和100%。大多数被ARPS识别为有风险或有害的饮酒者在CAGE、SMAST或AUDIT上并未筛查呈阳性。这些饮酒者患有疾病或正在用药，这使他们面临健康不良事件的风险，而这三种筛查方法均未涉及这些情况。在本研究中，ARPS识别出了几乎所有被CAGE、SMAST和AUDIT检测出的饮酒者，还检测出了这些方法未识别出的有风险和有害饮酒者。
