Malnutrition and Frailty Screening in Older Adults

Abstract

We conducted a Web-based survey of Commission on Dietetic Registration members to identify opportunities and challenges related to malnutrition and frailty screening among older adults (≥65 years old). Of the 9279 surveys sent out in emails, 903 registered dietitian nutritionists (RDNs) returned the surveys (10% response rate), and of those who responded, 576 RDNs were working with adults 65 years or older. They reported greater familiarity with screening tools for malnutrition than for frailty and little use of any frailty screening tools. For malnutrition screening, RDNs were most familiar with the body mass index (99%), Subjective Global Assessment (79%), and Malnutrition Screening Tool (75%). The body mass index (86%) and Malnutrition Screening Tool (42%) were most commonly used for malnutrition screening. For frailty screening, virtually all of the respondents (90%) were unfamiliar with individual tools. Registered dietitian nutritionists were most familiar with the Frailty Index (9%) and Simple FRAIL Questionnaire (6%), and the Simple FRAIL Questionnaire (2%) and Frailty Index (2%) were most commonly used. Major risk factors RDNs considered when screening for malnutrition and frailty were weight loss (malnutrition, 99%; frailty, 87%) and appetite loss (malnutrition, 95%; frailty, 45%), respectively. Although 70% of respondents reported their organizations had policies for malnutrition screening, only 6% did for frailty screening. Most RDNs (68%) agreed that dietetic professionals should play a role in frailty screening. To take a leading role in frailty screening and intervention, RDNs working with older adults need skills-based competency, education, and training.