Identifying older people at risk of malnutrition and treatment in the community: prevalence and concurrent validation of the Patients Association Nutrition Checklist with 'MUST'.

Abstract

BACKGROUND: Despite policy guidance and quality standards, the majority of older adults with or at risk of malnutrition living in the community still remain under-detected and under-treated by health and social care professionals. The present study aimed to evaluate the concurrent validity of the Patients Association Nutrition Checklist against the 'Malnutrition Universal Screening Tool' ('MUST'). METHODS: This cross-sectional study involved 312 older adults recruited from 21 lunch and social groups. All participants were screened as per standard methodology for 'MUST'. For the Patients Association Nutrition Checklist, they provided information about signs of unintentional weight loss in the past 3-6 months, experiencing loss of appetite or interest in eating. Chance-corrected agreement (κ) was assessed. RESULTS: Mean (SD) age of participants was 79.6 (8.3) years and body mass index was 27.8 (5.6) kg m-2 . The majority (n = 197; 63%) were living alone. Using 'MUST', the overall prevalence of malnutrition was 9.9% (n = 31) comprising 6.7% at medium risk and 3.2% at high risk. There were 21.8% of participants (n = 68) rated at risk of overall malnutrition by the Patients Association Nutrition Checklist. Moderate agreement was observed between the two tools (κ = 0.47, P < 0.001). CONCLUSIONS: The Patients Association Nutrition Checklist has potential for early identification of malnutrition risk, attributed to unintentional weight loss and appetite changes with signposting to basic dietary advice and appropriate support. Further work is required to understand how this tool could be effectively used by stakeholders including volunteers, community workers and home care staff.