SUN-PO238: Prevalence and Determinants of Undernutrition in a Sample of Dutch Community-Dwelling Older Adults: Results from Two Online Screening Tools

Purpose Patient-reported outcomes (PROs) are an important feature in clinical evaluation of swallowing. The Eating Assessment Tool (EAT-10) and the Sydney Swallow Questionnaire (SSQ) are two validated dysphagia PROs commonly used in healthy older adult populations as screening tools for swallowing problems. The purpose of this study is to compare the consistency of the EAT-10 and SSQ scores for self-reported swallowing difficulties in a group of community-dwelling older adults (CDOA) completing both questionnaires. Method A total of 316 individuals over the age of 60 years completed the EAT-10, SSQ, and provided demographic data, including a self-report of any medical diagnoses. Participants were excluded if they had any diagnoses known to cause dysphagia. Questionnaire responses were analyzed for frequencies of responses across all participants. Results Seventy-five participants were identified as having dysphagia by the EAT-10 (23.7%), while 30 participants were identified by the SSQ (9.49%). When comparing the results of the two assessments, the scales agreed on 289 out of 316 participants (91%). There was a disagreement on the results in 27 of the 316 participants, with 26 of these self-reporting dysphagia symptoms on the EAT-10 but not on the SSQ. Conclusions Two commonly used dysphagia PROs resulted in different prevalence rates of self-reported dysphagia in a group of CDOA. CDOAs may need questionnaires specifically validated for them with special consideration for specific age-related risk factors, to ensure accurate early identification.

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Correlation between a comprehensive and simple falls screening tools among community dwelling older adults

Physiotherapy ◽

10.1016/j.physio.2015.03.1351 ◽

2015 ◽

Vol 101 ◽

pp. e1401

Author(s):

Z.A. Samah ◽

D.K.A. Singh ◽

N.A.M. Nordin ◽

S. Shahar

Keyword(s):

Older Adults ◽

Community Dwelling ◽

Screening Tools ◽

Community Dwelling Older Adults

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Validity of Nutritional Screening Tools for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2019.06.024 ◽

2019 ◽

Vol 20 (10) ◽

pp. 1351.e13-1351.e25 ◽

Cited By ~ 5

Author(s):

Jennifer M.J. Isautier ◽

Marija Bosnić ◽

Suey S.Y. Yeung ◽

Marijke C. Trappenburg ◽

Carel G.M. Meskers ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Meta Analysis ◽

Community Dwelling ◽

Screening Tools ◽

Nutritional Screening ◽

Community Dwelling Older Adults

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Anthropometric indicators as a discriminator of sarcopenia in community-dwelling older adults of the Amazon region: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-020-01923-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cássio Lima Esteves ◽

Daniela Gonçalves Ohara ◽

Areolino Pena Matos ◽

Vânia T. K. Ferreira ◽

Natalia C. R. Iosimuta ◽

...

Keyword(s):

Older Adults ◽

Roc Curve ◽

Cross Sectional Study ◽

Community Dwelling ◽

Screening Tools ◽

Inverse Association ◽

Sectional Study ◽

Cross Sectional ◽

Anthropometric Indicators ◽

Community Dwelling Older Adults

Abstract Background Sarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia. Methods This was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index – BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05. Results Adjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53–0.76), CC (OR: 0.73; 95%CI: 0.62–0.85), WC (OR: 0.93; 95%CI: 0.90–0.97) and BMI (OR: 0.64; 95%CI: 0.53–0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia. Conclusions An increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.

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Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

Proceedings of The Nutrition Society ◽

10.1017/s002966512000556x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Teresa Madeira ◽

Catarina Peixoto-Plácido ◽

Nuno Sousa-Santos ◽

Nuno Mendonça ◽

Osvaldo Santos ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Screening Tools ◽

World Health ◽

Anthropometric Measures ◽

Community Dwelling Older Adults

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.

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Validation and Screening Capacity of the European Portuguese Version of the SUNFRAIL Tool for Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041394 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1394

Author(s):

Ana Filipa Cardoso ◽

Elzbieta Bobrowicz-Campos ◽

Luísa Teixeira-Santos ◽

Daniela Cardoso ◽

Filipa Couto ◽

...

Keyword(s):

Older Adults ◽

Sensitivity And Specificity ◽

Internal Consistency ◽

Community Dwelling ◽

Screening Tools ◽

Validity And Reliability ◽

Convenience Sample ◽

Portuguese Version ◽

European Portuguese ◽

Community Dwelling Older Adults

Early detection of frailty may prevent or delay adverse health outcomes in community-dwelling older adults. In Portugal, there are currently no valid multidimensional frailty screening tools. SUNFRAIL is a user-friendly multidimensional tool for frailty screening that can be used in primary care. Aims: (i) to determine the validity and reliability of the European Portuguese version of the SUNFRAIL tool for use in community-dwelling older adults; (ii) to assess the screening capacity of this version of SUNFRAIL using Fried’s phenotypic model criteria for frailty as a reference test. Methods: Cross-sectional pilot study in a convenience sample of 128 community-dwelling older adults. Objective and subjective data were collected. Internal consistency, concurrent validity, sensitivity, and specificity (ROC curve analysis) were examined. Results: Internal consistency was low. Significant moderate to strong correlations were found between different domains and the total score. The differences between robust, pre-frail, and frail older adults were significant. SUNFRAIL was also correlated with multimorbidity. Sensitivity and specificity were satisfactory. Conclusions: The European Portuguese version of the SUNFRAIL tool is a promising frailty screening tool for community-dwelling older adults to be routinely used in clinical practice. However, more consistent results on its validity and reliability are needed to be used nationwide.

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Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

Geriatrics ◽

10.3390/geriatrics3040090 ◽

2018 ◽

Vol 3 (4) ◽

pp. 90 ◽

Cited By ~ 4

Author(s):

Aarthi Madhavan ◽

Giselle Carnaby ◽

Karishma Chhabria ◽

Michael Crary

Keyword(s):

Older Adults ◽

Construct Validity ◽

Internal Consistency ◽

Screening Tool ◽

Community Dwelling ◽

Screening Tools ◽

Face Validity ◽

Psychometric Validation ◽

Patient Reported ◽

Community Dwelling Older Adults

Evidence suggests that community dwelling older adults (CDOA) are at risk for dysphagia (swallowing difficulties). Dysphagia is often unidentified until related morbidities like under nutrition or pneumonia occur. These cases of unidentified dysphagia, prior to any clinical intervention, may be termed ‘pre-clinical dysphagia’. Identifying pre-clinical dysphagia is challenged by the lack of validated tools appropriate for CDOA. This study addresses preliminary development of a novel patient reported outcome (PRO) screening tool for pre-clinical dysphagia. Initially, 34 questions were developed from literature review and expert opinion. Following pilot testing (n = 53), the questionnaire was revised and tested on 335 additional CDOA. Face validity, content validity, item analysis, reliability (internal consistency), and construct validity (exploratory factor analysis) measures were completed. Psychometric validation resulted in a 17-question PRO tool. Construct analysis identified a three-factor model that explained 67.345% of the variance. Emergent factors represented swallowing effort, physical function, and cognitive function. The results revealed strong construct validity and internal consistency (Cronbach’s α = 0.90). A novel, simple PRO incorporating multiple function domains associated with aging demonstrated strong preliminary psychometric properties. This tool is more comprehensive and aging-focused than existing dysphagia screening tools. Inclusion of multiple domains may be key in early identification of pre-clinical dysphagia.

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