Abstract
We compared the Alcohol-Related Problems Survey (ARPS), a new screening measure targeted at harmful and hazardous drinking among older individuals, to a criterion standard (CS) among 22 persons aged 65 and older who reported consuming at least one drink of alcohol in the previous 12 months. The CS was conducted by a study physician and research assistant. It assessed risks from alcohol use, and consisted of a structured review of each subject’s medical record, clinical interview, physical examination, and an interview with a collateral informant. Analyses included descriptive statistics for demographic and health characteristics, inter-rater reliability, agreement between the ARPS and the CS, reasons for disagreement, and sensitivity and specificity of the ARPS as compared to the CS. Using Landis and Koch criteria, inter-rater reliability between two physicians for 11 subjects was substantial (weighted kappa 0.79), but agreement between the ARPS and the CS was only fair (weighted kappa 0.28). Reasons for disagreement included problems with ARPS’ questions and classification rules, and problems with study physicians’ assessments of drinking risk. Based on these reasons for disagreement, we made revisions in the ARPS and its classification rules. Agreement between the revised ARPS and the CS improved substantially (weighted kappa 0.62). Sensitivity and specificity of the original ARPS were 80% and 50%, respectively, and both improved to 82% after revisions. The revised ARPS is sensitive and specific for identifying harmful and hazardous drinking in older persons as determined by clinicians.
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Secretary of Health and Human Services: Ninth Special Report to the U.S. Congress on alcohol and health. Government Printing Office, NIH publication no. 97-4017, Washington, D.C., 1997.
Lieber C.S.: Medical disorders of alcoholism. N. Engl. J. Med. 333: 1058–1065, 1995.
Chermack S.T., Blow F.C., Hill E.M., Mudd S.A.: The relationship between alcohol symptoms and consumption among older drinkers. Alcohol. Clin. Exp. Res. 20: 1153–1158, 1996.
Stinson F.S., Dufour M.C., Bertolucci D.: Alcohol-related morbidity in the aging population. Alcohol Health Res. World 13: 80–87, 1989.
Dufour M.C., Archer L., Gordis E.: Alcohol and the elderly. Clin. Geriatr. Med. 8: 127–141, 1992.
Fink A., Hays R.D., Moore A.A., Beck J.C.: Alcohol-related problems in older persons: Determinants, consequences and screening. Arch. Intern. Med. 156: 1150–1156, 1996.
American Geriatrics Association: Clinical Guidelines: Alcohol use disorders in older adults. American Geriatrics Association, New York, NY, 1997.
American Medical Association: Alcoholism in the elderly: Diagnosis, treatment, prevention. American Medical Association, Chicago, IL, 1993.
Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment: Substance abuse among older adults. Treatment Improvement Protocol 26. DHHS Publication No. (SMA) 98-3179, 1998.
Mayfield D., McLeod G., Hall P: The CAGE questionnaire: Validation of a new alcoholism screening instrument. Am. J. Psychiatry 131: 1121–1123, 1974.
Blow F.C., Brower K.J., Schulenbert J.E., Demo-Dananberg L.M., Young J.P., Beresford T.P.: The Michigan Alcoholism Screening Test-Geriatric version. A new elderly-specific screening instrument. Alcohol. Clin. Exp. Res. 16: 372, 1992.
Jones T.V., Lindsey B.A., Yount P., Soltys R., Farani-Enayat B.: Alcoholism screening questionnaires: Are they valid in elderly medical outpatients? J. Gen. Intern. Med. 8: 674–678, 1993.
Morton J.L., Jones T.V., Manganaro M.A.: Performance of alcoholism screening questionnaires in elderly veterans. Am. J. Med. 101: 153–159, 1996.
Joseph C.L., Ganzini L., Atkinson R.M.: Screening for alcohol use disorders in the nursing home. J. Am. Geriatr. Soc. 43: 368–373, 1995.
Myers J.K., Weissman M.M., Tischler G.L., Holzer C.E. 3d, Leaf P.J., Orvaschel H., Anthony J.C., Boyd J.H., Burke J.D. Jr., Kramer M., Stolzman R.: Six-month prevalence of psychiatric disorders in three communities. Arch. Gen. Psychiatry 41: 959–967, 1984.
Helzer J.E., Burnam A., McEvoy L.T.: Alcohol abuse and dependence. In: Robins L.N., Regier D.A. (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area Study. Free Press, New York, 1991, pp. 81–115.
Adams W.L., Cox N.S.: Epidemiology of problem drinking among elderly people. Int. J. Addict. 30: 1693–1716, 1995.
World Health Organization: The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. World Health Organization, Geneva, Switzerland, 1992.
Moore A.A., Morton S.C., Beck J.C., Hays R.D., Oishi S.M., Partridge J.M., Genovese B.J., Fink A.: A new paradigm for alcohol use in older persons. Med. Care 37: 165–179, 1999.
Saunders J.B., Aasland O.G., Babor T.F., de la Fuente J.R., Grant M.: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 88: 791–804, 1993.
Spitzer R.L.: Psychiatric diagnosis: Are clinicians still necessary? Compr. Psychiatry 24: 399–411, 1983.
Kranzler H.R., Tennen H., Babor T.F., Kadden R.M., Rounsaville B.J.: Validity of the longitudinal, expert, all data procedure for psychiatric diagnosis in patient with psychoactive substance use disorders. Drug Alcohol Depend. 45: 93–104, 1997.
World Health Organization: Composite International Diagnostic Interview 2.1. World Health Organization, Geneva, Switzerland, 1997.
Robins L.N., Wing J., Wittchen H.U., Helzer J.E., Babor T.F., Burke J., Farmer A., Jablenski A., Pickens R., Regier D.A., Sartorius N., Towle L.H.: The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch. Gen. Psychiatry 45: 1069–1077, 1988.
Wittchen H.U., Robins L.N., Cottler L.B., Sartorius N., Burke J.D., Regier D.: Participants in the Multicentre WHO/ADAMHA Field Trials. Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). Br. J. Psychiatry 159: 645–653, 1991.
Wittchen H.U.: Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. J. Psychiatr. Res. 90: 73–83, 1994.
Sobel L.C., Sobel M.B.: Timeline Followback: A technique for assessing self-reported ethanol consumption. In: Allen J., Litten R.Z. (Eds.), Measuring alcohol consumption: Psychosocial and biological methods. Humana Press, Totowa, NJ, 1992, pp. 41–72.
Cohen J.: Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychol. Bull. 70: 213–220, 1968.
Landis J.R., Koch G.G.: The measurement of observer agreement for categorical data. Biometrics 33: 159–174, 1977.
Graham K.: Identifying and measuring alcohol abuse among the elderly: serious problems with existing instrumentation. J. Stud. Alcohol. 47: 322–326, 1986.
Werch C.E., Groman D.R., Marty P.J.: Relationship between alcohol consumption and alcohol problems in young adults. J. Drug Educ. 17: 261–276, 1987.
Fletcher R.H., Fletcher S.W., Wagner E.H.: Clinical epidemiology: the essentials. Williams & Wilkins, Baltimore, 1988.
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Moore, A.A., Hays, R.D., Reuben, D.B. et al. Using a criterion standard to validate the Alcohol-Related Problems Survey (ARPS): A screening measure to identify harmful and hazardous drinking in older persons. Aging Clin Exp Res 12, 221–227 (2000). https://doi.org/10.1007/BF03339839
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DOI: https://doi.org/10.1007/BF03339839