Senior Alcohol Misuse Indicator (SAMI)

B Purcell

M C Flower

U. Busto

Brief description

The topic of alcohol use in the senior population is often associated with stigma, which may elicit denial and defensiveness from respondents. The Senior Alcohol Misuse Indicator (SAMI) is a brief, senior-specific screening tool designed to start a gentle, non-threatening conversation about alcohol consumption.

This approach may be helpful for those health care professionals that provide outreach care in seniors’ homes and whose first priority is establishing and maintaining rapport, which may preclude asking confrontational questions about alcohol consumption. Follow-up by a skilled clinician for diagnostic and treatment purposes is required.

Download the Senior Alcohol Misuse Indicator (SAMI) 

To use the fillable fields function in the questionnaire and scoring key:

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Target population

The SAMI aims to assist in identifying older adults who are currently experiencing problem drinking (i.e., problem drinkers) or who are at-risk for developing drinking problems.

Administration and Scoring

The SAMI is a 5-item questionnaire. It is administered by a health care professional. Read aloud each question to the respondent and record their responses. Mark the checkboxes in the scoring key to correspond with the responses and add up the final score. Any score of 1 or above indicates that the respondent is likely a problem or at-risk drinker.

Note: The SAMI includes some open-ended questions to reduce the likelihood of denial and defensiveness in its respondents.  The scoring key has been identified as a challenge as it requires health care providers to identify both single response and multiple responses to come up with a total score (Lum, 2005; Purcell & Olmstead, 2014).

Validation

In the development of the SAMI, the authors recruited health care providers that work with seniors in their home to help develop the questions and field-test the tool with their own clients.

The original validation study for the SAMI reported adequate sensitivity and specificity at 79% and 55%, respectively in a community setting, and was also well received by the health care workers and their clients participating in the study (Lum, 2005).

A cross validation study compared the performance of SAMI to two other commonly used screening tools and found the SAMI to be superior to the CAGE and SMAST-G in terms of sensitivity (83.72% vs. 34.88% and 13.64%, respectively), but the poorest specificity (54.55% vs. 79.55% and 95.45%, respectively) (Purcell & Olmstead, 2014).

Cost and copyright

Cost: none

Copyright: © Centre for Addiction and Mental Health, 2003

The Senior Alcohol Misuse Indicator is licensed for reuse under the terms of Creative Commons Attribution-NonCommercial-NoDerivs CC BY-NC-ND. You may download, print and use the SAMI provided that you credit the developer and copyright holder. You need permission from the developer (bonnie.lum@utoronto.ca) if you want to modify the scale in any way including translation to other languages.

References

Lum, B. (2005). The development and validation of the Senior Alcohol Misuse Indicator (SAMI). Poster session presented at the annual meeting of the Canadian Association on Gerontology, Halifax, NS.

Purcell, B. & Olmstead, M.C. (2014). The performance and feasibility of three brief alcohol screening tools in a senior population. Canadian Psychology, 55(2a): 19.