Screening for drinking disorders in the elderly using the CAGE questionnaire.
OBJECTIVE
To assess the performance of the CAGE questionnaire in identifying elderly medicine outpatients with drinking problems.


METHODS
Cross-sectional design, with the alcohol module of the Diagnostic Interview Schedule as the criterion standard.


METHODS
The outpatient medical practice of an urban university teaching hospital.


METHODS
Consecutive patients 18 years or older who signed a consent form approved by the university's institutional review board. For this study, 323 patients greater than or equal to 60 years old.


METHODS
Sensitivity, specificity, receiver operating characteristics (ROC) curve and positive predictive value for CAGE scores of 0-4 for patients 60 years or older.


RESULTS
Thirty-three percent of the sample group met study criteria for a history of drinking problems, including 63% of the male patients and 22% of the female patients. The sensitivity and specificity for a cut-off score of one for all patients was 86% and 78%, respectively, and 70% and 91% for a cut-off of two. The calculation of the area under the ROC curve was .86, and the positive predictive value of CAGE scores of 0-4 were 33%, 66%, 79%, 82%, and 94%, respectively. The predictive value for any score was higher in males than females, reflecting the higher prevalence of problems in the male population.


CONCLUSIONS
The CAGE can effectively discriminate elderly patients with a history of drinking problems from those without such a history. The chosen cut-off score should consider the prevalence of drinking problems in the population being tested.
Buchsbaum
D G
DG
Division of General Medicine, Virginia Commonwealth University, Richmond.
Buchanan
R G
RG
Welsh
J
J
Centor
R M
RM
Schnoll
S H
SH
D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D016002:Discriminant Analysis; D015577:Geriatric Assessment; D006784:Hospitals, Teaching; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D012680:Sensitivity and Specificity; D012737:Sex Factors; D011795:Surveys and Questionnaires / Q000592:standards*; D014768:Virginia / Q000453:epidemiology