title: Screening for drug and alcohol abuse among older adults using a modified version of the CAGE.
abstract: This study examined the sensitivity, specificity, and receiver operating characteristics (ROC) curves of a modified version of the CAGE, a screening measure used in the detection of older alcohol- and drug-abusing individuals. In a retrospective review of clinical records of 976 patients screened by a geriatric substance abuse program, the authors examined patients' responses on a modified version of the CAGE that included queries regarding drug use. The CAGE was administered to individuals age 50 or over draw from three diagnostic groups: alcohol abuse/dependence, drug abuse/dependence, and normal controls. Analysis of variance and discriminant function analyses revealed that the modified CAGE was able to discriminate both alcohol and drug abusers from controls. Analyses examining test sensitivity, specificity, and ROC curves revealed the CAGE to demonstrate excellent sensitivity but poor specificity. Omitting the "cut down'' item from the CAGE significantly improved specificity with only a modest drop in sensitivity. Given the ease of administration and sensitivity to both alcohol and drug abuse, these data suggest that the modified CAGE is well suited as a screening instrument for geriatric drug and alcohol abuse.
authors.affiliation: Department of Psychiatry & Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA 90024, USA. chinkin@ucla.edu
authors.forename: C H
authors.initials: CH
authors.lastname: Hinkin
authors.forename: S A
authors.initials: SA
authors.lastname: Castellon
authors.forename: E
authors.initials: E
authors.lastname: Dickson-Fuhrman
authors.forename: G
authors.initials: G
authors.lastname: Daum
authors.forename: J
authors.initials: J
authors.lastname: Jaffe
authors.forename: L
authors.initials: L
authors.lastname: Jarvik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires