Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use

Abstract

ABSTRACTAimsSurvey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study is to examine age-based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinkingDesignCross sectional surveySettingAustralia.ParticipantsData was taken from 17,399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross-sectional survey on substance use.MeasurementRespondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT.FindingsIn older drinkers, quantity per occasion (β=0.53 (0.43, 0.64 95%CI in 43-47 year olds as an example) is a stronger predictor of dependence than frequency per occasion (β=0.24 (0.17, 0.31). In younger drinkers the reverse was true with frequency a stronger predictor (β=0.54 (0.39, 0.69) in 23-27 year olds) than quantity (β=0.26 (0.18, 0.34) in 23-27 year olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 and over (β=-0.03 (−0.08, 0.02)). Similar patterns were found when predicting harmful drinking. Despite this, since frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 and over.ConclusionsThe items with a weaker association with dependent or harmful drinking in younger and older drinkers are the same items with the strongest influence on overall AUDIT scores. Further investigation into age-specific scoring of screening tools is recommended.