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Development and validation of criteria for determining undernutrition in community-dwelling older men and women: the Short Nutritional Assessment Questionnaire 65+.

Wijnhoven, H.A.H., Schilp, J., Bokhorst-de van der Schueren, M.A.E. van, Vet, H.C.W. de, Kruizenga, H.M., Deeg, D.J.H., Ferrucci, L., Visser, M. Development and validation of criteria for determining undernutrition in community-dwelling older men and women: the Short Nutritional Assessment Questionnaire 65+. Clinical Nutrition: 2012, 31(3), p. 351-358.
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Background & aims: There is no valid, fast and easy-to-apply set of criteria to determine (risk of) undernutrition in community-dwelling older persons. The aim of this study was to develop and validate such criteria. Methods: Selection of potential anthropometric and undernutrition-related items was based on consensus literature. The criteria were developed using 15-year mortality in community-dwelling older persons ≥ 65 years (Longitudinal Aging Study Amsterdam, n = 1687) and validated in an independent sample (InCHIANTI, n = 1142). Results: Groups distinguished were: (1) undernutrition (mid-upper arm circumference <25 cm or involuntary weight loss ≥4 kg/6 months); (2) risk of undernutrition (poor appetite and difficulties climbing staircase); and (3) no undernutrition (others). Respective hazard ratio’s for 15-year mortality were: (1) 2.22 (95% CI 1.83–2.69); and (2) 1.57 (1.22–2.01) ((3) = reference). The area under the curve (AUC) was 0.55. Comparable results were found stratified by sex, excluding cancer/obstructive lung disease/(past) smoking, using 6-year mortality, and applying results to the InCHIANTI study (hazard ratio’s 2.12 and 2.46, AUC 0.59). Conclusions: The developed set of criteria (SNAQ65+) for determining (risk of) undernutrition in community-dwelling older persons shows good face validity and moderate predictive validity based on the consistent association with mortality in a second independent study sample. (aut.ref.)