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Eur J Clin Nutr. 2019 Feb 28. doi: 10.1038/s41430-019-0411-3. [Epub ahead of print]

SCREEN III: working towards a condensed screening tool to detect nutrition risk in community-dwelling older adults using CLSA data.

Author information

1
Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada. jill.morrison@uwaterloo.ca.
2
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
3
Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
4
Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada.

Abstract

BACKGROUND/OBJECTIVES:

Screening for nutrition risk in community-dwelling older adults increases the likelihood of early intervention to improve nutritional status, with short screening tools preferred. SCREEN-II-AB is a valid 8-item tool. The current study determines whether SCREEN-III, a proposed 3-item version, adequately classifies nutrition risk in comparison.

SUBJECTS/METHODS:

Baseline data from the Canadian Longitudinal Study on Aging were used. Seventy-two percent (n = 24,456) of eligible participants (>55 years, complete SCREEN-II-AB) were included. Sensitivity and specificity of various SCREEN-III values compared with SCREEN-II-AB risk determined a nutrition risk cut-point and the proportion misclassified (False[-]) was calculated. Construct validity was tested against a composite variable summarizing outcomes associated with nutrition risk (e.g., self-reported health, hospitalization) using logistic regression adjusted for individual factors (e.g., marital status).

RESULTS:

A SCREEN-III cut-point of <22 performed best on sensitivity (0.83 [95% CI = 0.82, 0.84]) and specificity (0.73 [95% CI = 0.72, 0.74]) compared to SCREEN-II-AB (Cramer's V = 0.53). Of those at-risk using SCREEN-II-AB, 16.7% were misclassified as False(-) by SCREEN-III. The False(-) group did not differ significantly from the True(-) group. Based on SCREEN-III, 45.3% of individuals were at nutrition risk, 44% of whom reported the outcome composite. SCREEN-III nutrition risk was associated with greater odds of the outcome composite compared to those not at-risk (OR = 1.40, 95% CI = 1.33, 1.48, P < 0.0001).

CONCLUSION:

The proposed version of SCREEN-III demonstrated construct validity, but misclassification of risk may be problematic; further validation of a 3-item version is recommended.

PMID:
30820028
DOI:
10.1038/s41430-019-0411-3

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