Table 2.
Screening tools for problematic alcohol and substance use validated in older adults
| Tool | Description | Comment | Link | |
|---|---|---|---|---|
| Alcohol use | ||||
| AUDIT-C | 3-item screening tool modified from the 10 question AUDIT tool used to identify at-risk drinkers who may not be alcohol-dependent. Cutoff ≥ 5 in men and ≥ 4 in women | Shown to be superior to the Cut Down, Annoyed, Guilty, and Eye-Opener (CAGE) questionnaire [4, 9] | https://www.mdcalc.com/calc/2021/audit-c-alcohol-use | |
| CAGE | 4-item screening tool for excessive drinking and alcoholism. Cutoff ≥ 2 although the Consensus Panel recommends that primary care clinicians lower the threshold to one positive answer to cast a wider net and identify more patients who may have substance abuse disorders | https://www.mdcalc.com/calc/1729/cage-questions-alcohol-use | ||
| CARET | An updated and revised version of the Alcohol-Related Problems Survey (ARPS) to identify alcohol-related problems in older adults. It considers comorbidities, high-risk behaviors, and concomitant medication use that are more common in older adults | Takes into consideration comorbidities, high-risk behaviors, and concomitant mediation use that can be place older alcohol users at elevated risk [10] | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896609/ | |
| MAST-G | 24-items screening tool for detecting potential alcohol problem and suggests need for further assessment. Differs from MAST in that questions highlight the special employment and social situations of someone who is retired and how that can relate to alcohol use. Cutoff ≥ 5 | Focuses on life stressors and behaviors specific to older population [11] | https://docs.clinicaltools.com/pdf/sbirt/MAST-G.pdf | |
| Drug use | ||||
| ASSIST | 8-item screening tool developed by the World Health Organization to screen for the following substances: tobacco products, alcohol, cannabis, cocaine, amphetamine-type stimulants, sedatives and sleeping pills (benzodiazepines), hallucinogens, inhalants, opioids, other drugs. it determines a risk score for each substance which is used to start a discussion with clients about their substance use. It can identify acute intoxication, regular use, dependent or 'high risk' use and injecting behavior | https://www.who.int/publications/i/item/978924159938-2 | ||
| CAGE-AID | 4-item screening tool adapted from the CAGE Questionnaire for the purpose of combining screening for alcohol and drug problems. Cutoff ≥ 1 | https://www.hiv.uw.edu/page/substance-use/cage-aid | ||
AUDIT-C Alcohol use disorders identification test-consumption; CAGE Cut down, annoyed, guilty, and eye-opener; CARET Comorbidity alcohol risk evaluation tool; MAST-G Michigan alcoholism screening test-geriatric version; ASSIST Alcohol, smoking and substance involvement screening test; CAGE-AID Cut down, annoyed, guilty, eye-opener – adapted to include drugs