Skip to main content
Log in

Using a criterion standard to validate the Alcohol-Related Problems Survey (ARPS): A screening measure to identify harmful and hazardous drinking in older persons

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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.

    Google Scholar 

  2. Lieber C.S.: Medical disorders of alcoholism. N. Engl. J. Med. 333: 1058–1065, 1995.

    Article  CAS  PubMed  Google Scholar 

  3. 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.

    Article  CAS  PubMed  Google Scholar 

  4. Stinson F.S., Dufour M.C., Bertolucci D.: Alcohol-related morbidity in the aging population. Alcohol Health Res. World 13: 80–87, 1989.

    Google Scholar 

  5. Dufour M.C., Archer L., Gordis E.: Alcohol and the elderly. Clin. Geriatr. Med. 8: 127–141, 1992.

    CAS  PubMed  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. American Geriatrics Association: Clinical Guidelines: Alcohol use disorders in older adults. American Geriatrics Association, New York, NY, 1997.

    Google Scholar 

  8. American Medical Association: Alcoholism in the elderly: Diagnosis, treatment, prevention. American Medical Association, Chicago, IL, 1993.

    Google Scholar 

  9. 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.

    Google Scholar 

  10. Mayfield D., McLeod G., Hall P: The CAGE questionnaire: Validation of a new alcoholism screening instrument. Am. J. Psychiatry 131: 1121–1123, 1974.

    CAS  PubMed  Google Scholar 

  11. 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.

    Google Scholar 

  12. 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.

    Article  CAS  PubMed  Google Scholar 

  13. Morton J.L., Jones T.V., Manganaro M.A.: Performance of alcoholism screening questionnaires in elderly veterans. Am. J. Med. 101: 153–159, 1996.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  PubMed  Google Scholar 

  16. 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.

    Google Scholar 

  17. Adams W.L., Cox N.S.: Epidemiology of problem drinking among elderly people. Int. J. Addict. 30: 1693–1716, 1995.

    CAS  PubMed  Google Scholar 

  18. World Health Organization: The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. World Health Organization, Geneva, Switzerland, 1992.

    Google Scholar 

  19. 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.

    Article  CAS  PubMed  Google Scholar 

  20. 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.

    Article  CAS  PubMed  Google Scholar 

  21. Spitzer R.L.: Psychiatric diagnosis: Are clinicians still necessary? Compr. Psychiatry 24: 399–411, 1983.

    Article  CAS  PubMed  Google Scholar 

  22. 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.

    Article  CAS  PubMed  Google Scholar 

  23. World Health Organization: Composite International Diagnostic Interview 2.1. World Health Organization, Geneva, Switzerland, 1997.

    Google Scholar 

  24. 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.

    Article  CAS  PubMed  Google Scholar 

  25. 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.

    Article  CAS  PubMed  Google Scholar 

  26. 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.

    Google Scholar 

  27. 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.

    Chapter  Google Scholar 

  28. Cohen J.: Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychol. Bull. 70: 213–220, 1968.

    Article  CAS  PubMed  Google Scholar 

  29. Landis J.R., Koch G.G.: The measurement of observer agreement for categorical data. Biometrics 33: 159–174, 1977.

    Article  CAS  PubMed  Google Scholar 

  30. Graham K.: Identifying and measuring alcohol abuse among the elderly: serious problems with existing instrumentation. J. Stud. Alcohol. 47: 322–326, 1986.

    CAS  PubMed  Google Scholar 

  31. 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.

    Article  CAS  PubMed  Google Scholar 

  32. Fletcher R.H., Fletcher S.W., Wagner E.H.: Clinical epidemiology: the essentials. Williams & Wilkins, Baltimore, 1988.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. A. Moore M.D., M.P.H..

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03339839

Key words

Navigation