One methodological difference between the two surveys that could explain both overall differences in lifetime abuse prevalence as well as the heightened discrepancy in older age cohorts is how recurrence/duration is assessed (see Table 1). Recall that NLAES requires explicit recurrence/duration for a prior-to-past-12-month abuse diagnosis whereas in NESARC there is no comparable items in the scoring (although duration criteria were embedded in most questions; see Table 1). In order to assess the potential impact of the recurrence/duration items on the overall lifetime rates of alcohol abuse in NLAES, estimates not requiring the endorsement of these items were calculated. Critically, when these requirements were removed for abuse diagnosis in NLAES, the lifetime rates of abuse became substantially more similar across all cohorts (see Figure 2). Specifically, the adjusted lifetime prevalence of AUD in NLAES (28.89%) is much more similar to NESARC (30.28%), reflecting more comparable levels of lifetime alcohol abuse in NLAES (15.59%) compared to NESARC (17.80%). Therefore, when the specific recurrence/duration items in NLAES are removed from scoring algorithms, NLAES and NESARC provide a similar picture of lifetime AUDs.
