Nutrition screening in old people: its place in a coherent practice of preventive health care.

The central demographic reality of our times is the rapid aging of our society. Preventive nutritional and preventive health care of older people, therefore, are pressing issues that must be contended with. Several strategies for this are possible, including the broadcasting of general nutritional and health messages to the population, the inclusion of preventive nutrition and health as part of routine primary care, and nutrition screening: a process of self-identification by the older population in which they judge for themselves whether they are at nutritional risk and, if so, seek the care of professionals. This review focuses on some of the necessities for screening: sensitive, specific, and inexpensively applied screening devices; and explicit interventions that do not have major public health benefit for those who screen negative. Unfortunately, there is little evidence that screening is beneficial, nor have the benefits of this strategy been compared with its alternatives. Thus, the ethical imperative of screening has not been met: that because the activity is being promoted (it is not initiated by the public), its benefit must be conclusive.