Lauren Power1, Deirdre Mullally2, Eileen R Gibney3, Michelle Clarke4, Marjolein Visser5, Dorothee Volkert6, Laura Bardon7, Marian A E de van der Schueren8, Clare A Corish9. 1. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; UCD Institute of Food and Health, University College Dublin, Dublin, Ireland. Electronic address: lapower@ucd.ie. 2. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; UCD Institute of Food and Health, University College Dublin, Dublin, Ireland. Electronic address: mullallydeirdre@outlook.com. 3. UCD Institute of Food and Health, University College Dublin, Dublin, Ireland; School of Agriculture and Food Science, University College Dublin, Dublin, Ireland. Electronic address: eileen.gibney@ucd.ie. 4. UCD Institute of Food and Health, University College Dublin, Dublin, Ireland; School of Agriculture and Food Science, University College Dublin, Dublin, Ireland. Electronic address: michelle.clarke@ucd.ie. 5. Department of Nutrition and Dietetics, VU University Medical Centre, Amsterdam, The Netherlands; Department of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands. Electronic address: m.visser@vu.nl. 6. Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany. Electronic address: dorothee.volkert@fau.de. 7. UCD Institute of Food and Health, University College Dublin, Dublin, Ireland; School of Agriculture and Food Science, University College Dublin, Dublin, Ireland. Electronic address: laura.bardon@ucdconnect.ie. 8. Department of Nutrition and Dietetics, VU University Medical Centre, Amsterdam, The Netherlands; Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands. Electronic address: marian.devanderschueren@han.nl. 9. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland; UCD Institute of Food and Health, University College Dublin, Dublin, Ireland. Electronic address: clare.corish@ucd.ie.
Abstract
BACKGROUND: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) 'Malnutrition in the Elderly Knowledge Hub' (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. METHODS: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. RESULTS: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12-100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. CONCLUSIONS: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.
BACKGROUND: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) 'Malnutrition in the Elderly Knowledge Hub' (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. METHODS: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. RESULTS: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12-100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. CONCLUSIONS: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.
Authors: D Volkert; M Visser; C A Corish; C Geisler; L de Groot; A J Cruz-Jentoft; C Lohrmann; E M O'Connor; K Schindler; M A E de van der Schueren Journal: Eur Geriatr Med Date: 2019-11-20 Impact factor: 1.710
Authors: Jos W Borkent; Elke Naumann; Emmelyne Vasse; Ellen van der Heijden; Marian A E de van der Schueren Journal: Int J Environ Res Public Health Date: 2019-05-04 Impact factor: 3.390