{"doi":"10.1002/emp2.12196","title":"Identification and characterization of older emergency department patients with high‐risk alcohol use","abstract":"Background High-risk alcohol use in the elderly is a common but underrecognized problem. We tested a brief screening instrument to identify high-risk individuals. Methods This was a prospective, cross-sectional study conducted at a single emergency department. High-risk alcohol use was defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines as >7 drinks/week or >3 drinks/occasion. We assessed alcohol use in patients aged ≥ 65 years using the timeline follow back (TLFB) method as a reference standard and a new, 2-question screener based on NIAAA guidelines. The Alcohol Use Disorders Identification Test (AUDIT) and Cut down, Annoyed, Guilty, Eye-opener (CAGE) screens were used for comparison. We collected demographic information from a convenience sample of high- and low-risk drinkers. Results We screened 2250 older adults and 180 (8%) met criteria for high-risk use. Ninety-eight high-risk and 124 low-risk individuals were enrolled. The 2-question screener had sensitivity of 98% (95% CI, 93%–100%) and specificity of 87% (95% CI, 80%–92%) using TLFB as the reference. It had higher sensitivity than the AUDIT or CAGE tools. The high-risk group was predominantly male (65% vs 35%, P < 0.001). They drank a median of 14 drinks per week across all ages from 65 to 92. They had higher rates of prior substance use treatment (17% vs 2%, P < 0.001) and current tobacco use (24% vs 9%, P = 0.004). Conclusion A rapid, 2-question screener can identify high-risk drinkers with higher sensitivity than AUDIT or CAGE screening. It could be used in concert with more specific questionnaires to guide treatment.","journal":"Journal of the American College of Emergency Physicians Open","year":2020,"id":89178,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9588,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":451273,"name":"Mark A. Weaver","orcid":"0000-0001-9020-7264","position":1,"is_corresponding":false},{"id":451274,"name":"Kevin Biese","orcid":"0000-0002-8318-6888","position":2,"is_corresponding":false},{"id":409501,"name":"Yushan Wang","orcid":"0000-0001-9223-2228","position":3,"is_corresponding":false},{"id":451275,"name":"Rishab Revankar","orcid":"0000-0002-3951-2703","position":4,"is_corresponding":false},{"id":451276,"name":"Yetunde A. Fatade","orcid":"0000-0002-2257-6188","position":5,"is_corresponding":false},{"id":451277,"name":"Aileen Aylward","orcid":"0000-0002-8829-5178","position":6,"is_corresponding":false},{"id":452197,"name":"Jan Busby‐Whitehead","orcid":null,"position":7,"is_corresponding":false},{"id":451278,"name":"Timothy F. Platts‐Mills","orcid":"0000-0002-9881-3194","position":8,"is_corresponding":false},{"id":31024,"name":"Gail D’Onofrio","orcid":"0000-0002-3833-1871","position":9,"is_corresponding":false},{"id":451272,"name":"Christina Shenvi","orcid":"0000-0003-2944-8581","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":null,"created_at":"2026-07-18T22:01:50.225871Z","pmid":"33145524","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}