Age-Based Differences in Quantity and Frequency of Consumption When Screening for Harmful Alcohol Use
Abstract
Background and aims
Survey questions on the usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify alcohol users requiring intervention. The aim of this study was to measure 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 at-risk or dependent alcohol use.
Design
Cross-sectional survey.
Setting: Australia.
Participants
Data were 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.
Measurement
Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT.
Findings
In older alcohol users, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43-47-year-olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger alcohol users the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23-27-year-olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23-27-year-olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = -0.03, 95% CI = -0.08, 0.02). Similar patterns were found when predicting at-risk alcohol use. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in alcohol users aged 53 years and over.
Conclusions
In younger alcohol users, frequent alcohol use is more strongly linked to dependence and harmful [at-risk] alcohol use subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older alcohol use, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful [at-risk] alcohol use subscale.