Compatibility of the SNAQRC and SNAQ65+ in malnutrition screening in the elderly

Current government policy aims to support (vulnerable) older adults to live at home longer and to postpone placement in residential care. This may have consequences for the use of sector-specific screening tools for malnutrition in older adults, such as the Short Nutritional Assessment Questionnaire for residential care (SNAQ^RC) and SNAQ⁶⁵⁺ for community-dwelling older adults. Therefore, the aim was to determine the interchangeability of these screening tools in older adults in different living arrangements.

The SNAQ^RC and SNAQ⁶⁵⁺ were used for the screening of (the risk of) malnutrition in Dutch community-dwelling and rehabilitation older adults and older adults in residential care and nursing homes. The agreement of the screening results has been determined. Uni- and multivariable logistic regression analyses were performed to identify determinants associated with the degree of agreement.

In total, 540 older adults (81 ± 9 years, 66% female) were screened. The prevalence of malnutrition varied from 22-44% between the different living arrangements. The agreement between the screening results of the SNAQ^RC and SNAQ⁶⁵⁺ was 77%, ranging from 67-78% between the different living arrangements. In all living arrangements, the SNAQ⁶⁵⁺ classified fewer participants with ‘risk of malnutrition’ and ‘malnutrition’. Independent determinants that significantly reduced the chance of agreement between the screening results were “needing assistance with eating”, “decreased appetite in the past month” and “BMI of 20-22 kg/m²”. These determinants lead to the screening result ‘risk of malnutrition’.

The degree of agreement of the screening results of the SNAQ^RC and SNAQ⁶⁵⁺ can be considered as insufficient to interchange the screening tools. The limited agreement was mainly explained by the difference in the screening result ‘risk of malnutrition’. Therefore, it is recommended to use the screening tool in the population in which it was validated.

Keywords: malnutrition, screening, older adults