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- Title
The Simplified Nutritional Appetite Questionnaire (SNAQ) as a Screening Tool for Risk of Malnutrition: Optimal Cutoff, Factor Structure, and Validation in Healthy Community-Dwelling Older Adults.
- Authors
Lau, Sabrina; Pek, Kalene; Chew, Justin; Lim, Jun Pei; Ismail, Noor Hafizah; Ding, Yew Yoong; Cesari, Matteo; Lim, Wee Shiong
- Abstract
Malnutrition is an independent marker of adverse outcomes in older adults. While the Simplified Nutritional Appetite Questionnaire (SNAQ) for anorexia has been validated as a nutritional screening tool, its optimal cutoff and validity in healthy older adults is unclear. This study aims to determine the optimal cutoff for SNAQ in healthy community-dwelling older adults, and to examine its factor structure and validity. We studied 230 community-dwelling older adults (mean age 67.2 years) who were nonfrail (defined by Fatigue, Resistance, Ambulation, Illnesses & Loss (FRAIL) criteria). When compared against the risk of malnutrition using the Mini Nutritional Assessment (MNA), the optimal cutoff for SNAQ was ≤15 (area under receiver operating characteristic (ROC) curve: 0.706, sensitivity: 69.2%, specificity: 61.3%). Using exploratory factor analysis, we found a two-factor structure (Factor 1: Appetite Perception; Factor 2: Satiety and Intake) which accounted for 61.5% variance. SNAQ showed good convergent, discriminant and concurrent validity. In logistic regression adjusted for age, gender, education and MNA, SNAQ ≤15 was significantly associated with social frailty, unlike SNAQ ≤4 (odds ratio (OR) 1.99, p = 0.025 vs. OR 1.05, p = 0.890). Our study validates a higher cutoff of ≤15 to increase sensitivity of SNAQ for anorexia detection as a marker of malnutrition risk in healthy community-dwelling older adults, and explicates a novel two-factor structure which warrants further research.
- Subjects
MALNUTRITION; ANOREXIA nervosa; DISCRIMINANT analysis; FACTOR analysis; RESEARCH methodology; QUESTIONNAIRES; RESEARCH evaluation; RISK assessment; LOGISTIC regression analysis; INDEPENDENT living; RECEIVER operating characteristic curves; RESEARCH methodology evaluation; ODDS ratio; DISEASE risk factors; OLD age
- Publication
Nutrients, 2020, Vol 12, Issue 9, p2885
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu12092885