Abstract
Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) against the Appetite, Hunger and Sensory Perception Questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the Subjective Global Assessment (SGA) while food intake was measured using the Dietary History Questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach’s alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the Recommended Nutrient Intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special group of population. There is a need to regularly include nutritional and appetite assessment for early intervention measures in order to prevent consequences of malnutrition.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Keller, K. 2008. Encyclopaedia of Obesity. 1st ed. California: Golson Books, Ltd
Payette, H., Coulombe, C., Boutier, V., Gray-Donald, K. 2000. Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population. Journal of Clinical Epidemiology 53(6): 579–587.
Payette, H., Gray — Donald, K., Cyr, R., Boutier, V. 1994. Predictors of dietary intake in a functionally dependent elderly population in the community. American Journal of Public Health 85(5): 677–683
Suzana, S. & Yow, B.C. 2009. Factors Influencing Appetite and Depression among Institutionalised Chinese Elderly in Penang. Jurnal Sains Kesihatan Malaysia 7(2): 73–88
Mowe, M., Bohmer, T. 1991. The prevalence of undiagnosed protein-caloric undernutrition in a population of hospitalised elderly patients. Journal of the American Geriatrics Society 39: 1089–92
Ranhoff, A.H., Gjoen, A.U., Mowe, M. 2005. Screening for malnutrition in elderly acute medical patients: The usefulness of MNA — SF. The Journal of Nutrition, Health & Aging 9(4): 221–225
de Jong, N., Mulder, I., de Graaf, C., van Staveren, W.A. 1999. Impaired sensory functioning in elders: The relation with its potential determinants and nutritional intake. Journal of Gerontology: Biological Sciences 54(8): 324–331
Savina, C., Donini, L.M., Anzivino, R., de Felice, M.R., de Bernadini, L., Cannella, C. 2003.Administering the “AHSP questionnaire” (Appetite, hunger, sensory perception) in a geriatric rehabilitation care. The Journal of Nutrition, Health & Aging 7(6): 385–389.
Wilson, M.G., Thomas, D.R., Rubenstein, L.Z., Chibnall, J.T., Anderson, S., Baxi, A., Diebold, M.R., Morley, J.E. 2005. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. American Journal of Clinical Nutrition 82: 1074–1081
Suzana, S., Kan, Y.C., Pa’ Wan Chik, W.C. 2002. Food intakes and preferences of hospitalized geriatric patients. Biomed Central Geriatrics 2: 1–6
National Coordinating Committee of Food and Nutrition. 2005. Recommended Nutrient Intakes of Malaysia. Kuala Lumpur: Technical Working Group on Nutritional Guidelines
Gibson, R.S. 1990. Principles of Nutritional Assessment. Oxford: Oxford University Press
Suzana, S. & Ng, S.P. 2003. Predictive equation for estimation of stature in Malaysian elderly. Asia Pacific Journal of Clinical Nutrition 12(1): 80–84
Ferro-Luzzi, A. & James, W.P.T. 1996. Adult malnutrition: simple assessment techniques for use in emergencies. British Journal of Nutrition 75:3–10.
Sakinah, H. 2006. Pembentukan alat penyaringan risiko malpemakanan hospital (MRST-H) untuk mengenalpasti malpemakanan di kalangan pesakit warga tua. PhD Thesis. Universiti Kebangsaan Malaysia
World Health Organization. 1995. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization, 1995
Baumgartner, R.N., Waters, D.L., Gallgher, D., Morley, J.E., Garry, P.J. 1999. Predictors of skeletal muscle mass in elderly men and women. Mechanisms of aging and development 107: 123–136
Spitalnic, S. 2004. Test properties 1: Sensitivity, specificity and predictive values. Hospital Physician: 27–31
Chen, S. & Vieira, A. 2007. Body Mass Index and Dietary Intake of Thiamin: Evidence for a Sexually Dimorphic Relation. Journal of Human Ecology 15: 17–22
Donini, L.M., Savina, C., Cannelle, C. 2003. Eating Habits and Appetite Control in the Elderly: The Anorexia of Aging. International Psychogeriatrics 15(1): 73–87
Blaum, C.S., Fries, B.E., Fiatarone, M.A. 1994. Factors Associated With Low Body Mass Index and Weight Loss in Nursing Home Residents. The Journals of Gerontology 50A(3): M162–M168
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hanisah, R., Shahar, S. & Lee, F.S. Validation of screening tools to assess appetite among geriatric patients. J Nutr Health Aging 16, 660–665 (2012). https://doi.org/10.1007/s12603-012-0056-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-012-0056-6