Validity of CAGE for Older Adults with Alcohol Use Disorder in Community

ABSTRACT

OBJECTIVE: The purpose of this study was to assess the validity of CAGE (cut down, annoyed, guilty feeling, eye-opener) for older adults in community METHODS: Randomly selected alcohol drinking 182 older adults over 65 years of age in Incheon-Chungu participated in this study. We assessed alcohol use disorder by Korean Composite International Diagnostic Interview (K-CIDI) and interviewed by CAGE. The CAGE questionnaire is a brief alcohol screening questionnaire that can be interviewer or self-administered. Sensitivity, specificity, positive predictive value and receiver operating characteristics (ROC) curve for CAGE scores of 1-4 for older adults over 65 years of age was calculated. RESULTS: The mean age of 182 people was 71.3 (+/-5.2) years old and the number of male and female was 142 (78.0%) and 40 (22.0%) respectively. In 239 alcohol drinking older adults, 182 (76.2%) people answered in CAGE and CIDI. Among 182 people, 58 was Alcohol Use Disorder (AUD) and 124 was non-AUD. There was no age and educational differences between 182 people (case group) and 57 people (exclusion group). The sensitivity and specificity for a cut-off score of two was 72.5% and 85.5% respectively. The calculation of area under curve (AUC) by Receiver Operating Characteristics (ROC) was 0.806. CONCLUSION: The CAGE can easily discriminate older adults with alcohol use disorder from those without such a history. We suggest a score of '2' as the optimal cut-off score of CAGE.