Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Int J Geriatr Psychiatry. 2011 Sep;26(9):881-5. doi: 10.1002/gps.2498. Epub 2010 Jul 26.
OBJECTIVE: The performance of the Alcohol Use Disorders Identification Test (AUDIT) in screening for heavy drinking among the elderly has been unsatisfactory. The aim of the present study was to determine whether tailoring the cut point improves the performance of the AUDIT and its derivatives in this age group. METHODS: From a stratified random sample of 804 Finns aged 65-74 years, 517 subjects (64.3%) completed the AUDIT and the Timeline Follow-back (TLFB) interview regarding alcohol consumption. A subject was defined as a heavy drinker if consumption of ≥8 drinks (approx. 12 g) on average in a week or ≥4 drinks at least in 1 day during the prior 28 days was reported. Combinations in which both sensitivity and specificity are ≥0.8 were defined as optimal. The elderly specific AUDIT-3 is a modification in which the binge drinking threshold is ≥4 drinks. RESULTS: Based on the TLFB, 118 subjects (22.8%) were heavy drinkers. The areas under receiving operating characteristics curves (AUROCs) were equivalent (≥0.898) for all questionnaires. When using the standard cut point of ≥8 for the AUDIT, the sensitivity was 0.48. Lowering the cut point to ≥5 led to both a sensitivity and specificity over 0.85. The optimal cut point of the AUDIT-C was ≥4. The AUDIT-QF, AUDIT-3 and elderly specific AUDIT-3 did not provide optimal combinations of sensitivity and specificity with any cut point. CONCLUSIONS: The AUDIT and AUDIT-C are accurate in screening for heavy drinking among the elderly if the cut points are tailored to this age group.
目的:酒精使用障碍识别测试(AUDIT)在筛查老年人重度饮酒方面的表现并不令人满意。本研究旨在确定是否调整切点可以提高 AUDIT 及其衍生工具在该年龄组中的性能。
方法:从分层随机抽取的 804 名 65-74 岁的芬兰人中,有 517 名受试者(64.3%)完成了 AUDIT 和 Timeline Follow-back(TLFB)访谈,以了解酒精摄入量。如果报告在过去 28 天内每周平均饮酒≥8 杯(约 12 克)或至少有 1 天每天饮酒≥4 杯,则定义为重度饮酒者。定义同时具有≥0.8 的敏感性和特异性的组合为最佳组合。老年人专用的 AUDIT-3 是一种修改版本,其中暴饮阈值为≥4 杯。
结果:根据 TLFB,有 118 名受试者(22.8%)为重度饮酒者。接受者操作特征曲线下的面积(AUROCs)均相等(≥0.898)。当使用 AUDIT 的标准切点≥8 时,敏感性为 0.48。将切点降低至≥5 可使敏感性和特异性均超过 0.85。AUDIT-C 的最佳切点为≥4。AUDIT-QF、AUDIT-3 和老年人专用的 AUDIT-3 没有提供任何切点的敏感性和特异性的最佳组合。
结论:如果针对该年龄组调整切点,AUDIT 和 AUDIT-C 可准确筛查老年人的重度饮酒。
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