Abstract
Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ), were completed by 185 ambulatory rehabilitation patients (48% male; median age 78 years) and results compared to the full MNA as a reference technique. Prevalence of risk of malnutrition was 63% according to the MNA. For identification of risk of malnutrition the CNAQ had sensitivity of 54%, specificity 81%, positive predictive value 83% and negative predictive value 51%, compared to 28%, 94%, 89% and 44%, respectively, using SNAQ. Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population.
Highlights
Malnutrition, used here to refer to under nutrition, is widespread in older adults across all settings [1].It is well documented that malnutrition is common amongst the ambulatory rehabilitation population, older adults, and often goes unrecognised
The prevalence in rehabilitation has been reported as 30%–50% [1], recent data indicate that 84% of older adults in ambulatory rehabilitation in two rehabilitation hospitals in New South Wales were malnourished or at risk of malnutrition [2]
From 225 ambulatory rehabilitation participants who were randomized in the primary randomized controlled trial (RCT), 185 were ≥60 years and had data available for inclusion in this secondary analysis
Summary
It is well documented that malnutrition is common amongst the ambulatory rehabilitation population, older adults, and often goes unrecognised. The prevalence in rehabilitation has been reported as 30%–50% [1], recent data indicate that 84% of older adults in ambulatory rehabilitation in two rehabilitation hospitals in New South Wales were malnourished or at risk of malnutrition [2]. As malnutrition is often undiagnosed and unreported hospitals may be missing out on reimbursements which may indicate that these costs are significantly underestimated. Those at risk of malnutrition may find it difficult to meet the increased physical and mental demands of a rehabilitation program, hindering their chances of success [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
