Substance Use
Patterns of Alcohol Misuse Screening in a Nationally Representative Sample of Older Adults Samantha Brown* Samantha Brown Iva Magas Jennifer Hoenig
Background: Alcohol misuse among U.S. older adults is a growing concern. Alcohol screening is a crucial intervention point for older adults given their frequent contact with healthcare. This study examines national patterns in alcohol screening among adults aged 65 or older who had outpatient medical visits.
Methods: The 2021-2022 National Surveys on Drug Use and Health were analyzed. Alcohol misuse screening was defined as having been asked by a healthcare provider about the amount or frequency of alcohol use or presence of problematic alcohol use. The prevalence of past-year alcohol misuse screening, alcohol use disorder (AUD), and past-month binge drinking were examined by population characteristics. Analyses were conducted in SUDAAN.
Results: Among past-year alcohol users 65 or older, 91.9% had an outpatient medical visit, of whom 48.1% were screened for alcohol misuse. Screenings were more prevalent among those who were younger (ages 65-69: 53.5%, 70-79: 48.3%, ≥80: 33.7%), male (52.8%, female: 43.6%), veterans (54.7%, non-veterans: 46.5%), or had higher income (≥$75K: 53.4%, $50K-$74,999K: 50.0% vs $20K-$49,999: 41.7%, <$20K: 40.5%). Additionally, 8.5% of alcohol users 65 or older with an outpatient medical visit had AUD and 18.6% were binge drinkers, of whom 67.6% and 56.1% were screened, respectively. While older adults with lower income were less likely to be screened, they were more likely to have AUD (<$20K: 13.7% vs $50K-$74,999K: 6.1%, ≥$75K: 8.0%) or binge drink (<$20K: 24.9% vs $50K-$74,999: 15.3%, ≥$75K: 17.4%).
Discussion: Despite guidelines for universal substance misuse screening in older adults, less than half of older adults examined were screened for alcohol misuse and a third of those with AUD were not screened. Screening was lowest among adults 80 or older, who suffer more severe health consequences from alcohol. Further research is needed to understand the screening gap among low-income older adults, who were more likely to have alcohol misuse.