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Healthcare 2015, 3(3), 822-829; doi:10.3390/healthcare3030822

Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools

1,†,* , 2,†
and
1,†
1
Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
2
Rehabilitation, Aged and Extended Care, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Sampath Parthasarathy
Received: 27 May 2015 / Revised: 31 August 2015 / Accepted: 7 September 2015 / Published: 11 September 2015
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Abstract

Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ), were completed by 185 ambulatory rehabilitation patients (48% male; median age 78 years) and results compared to the full MNA as a reference technique. Prevalence of risk of malnutrition was 63% according to the MNA. For identification of risk of malnutrition the CNAQ had sensitivity of 54%, specificity 81%, positive predictive value 83% and negative predictive value 51%, compared to 28%, 94%, 89% and 44%, respectively, using SNAQ. Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population. View Full-Text
Keywords: malnutrition; older adult; screening; rehabilitation malnutrition; older adult; screening; rehabilitation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Yaxley, A.; Crotty, M.; Miller, M. Identifying Malnutrition in an Elderly Ambulatory Rehabilitation Population: Agreement between Mini Nutritional Assessment and Validated Screening Tools. Healthcare 2015, 3, 822-829.

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