Evaluation of nutrition screening initiative screening tools in characterizing nutritional status of older adults

Abstract

The Nutrition Screening Initiative (NSI) has developed screening tools for use in identifying nutritional risk and presence of factors associated with malnutrition in older Americans. However, these tools have not yet been adequately assessed for reliability or validity. This study was conducted to determine if the NSI screening tools are effective in identifying older adults who are at increased nutritional risk. The study used a nonprobability convenience sampling procedure where subjects were recruited from various agencies frequented by older adults (i.e., congregate meals, senior centers, etc.). Eligibility criteria included age 60 or older, independently living and signed consent. All subjects filled out the NSI DETERMINE Your Nutritional Health Checklist and a demographic questionnaire; the dietitian completed the NSI Level I Screen and measured height and weight for each subject. 106 older adults (73 females and 33 males) were surveyed. Demographics of the subjects were as follows: mean age was 76.1 years; 33% were married, 47% were widowed and 20% were single; 53% lived alone, 33% lived with their spouse and 14% lived with others; 15% had total household income less than $6000/yr, 32% had income between $6000 and 10,000, 12% had income between $10,000 and 15,000 and 41% had income greater than $15,000/yr; mean number of medications was 2.8 per day. Based on the NSI DETERMINE Checklist, 33% of the sample were at moderate nutritional risk (score of 3–5) while 26% were at high nutritional risk (score of 6 or more). Scores on the DETERMINE Checklist were highly correlated (r=.72, P .001) with the number of risk factors identified on the NSI Level I Screen. In addition, 75% of the subjects identified as being underweight were classified as at nutritional risk by the DETERMINE Checklist. In summary, the DETERMINE Checklist was effective as an early screening tool for nutritional risk in older adults. It can be used as an educational tool to alert older adults of potential health problems before malnutrition occurs.