Validation of screening tools to assess appetite among geriatric patients
Validation of screening tools to assess appetite among geriatric patients
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DOI：
10.1007/s12603-012-0056-6
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发表时间：
2012-07-01
影响因子：
5.8
通讯作者：
Lee, F. S.
中科院分区：
文献类型：
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作者：
Hanisah, R.;Suzana, S.;Lee, F. S.
食欲不振是造成老年人营养状况不佳的主要因素之一。认识到评估食欲的重要性，进行了一项横断面研究，以确定食欲筛查工具的有效性，即营养食欲问卷委员会（CNAQ）和简化营养食欲问卷（SNAQ）与食欲、饥饿和感官知觉问卷（AHSPQ），衡量马来西亚主要综合医院老年患者的营养状况和食物摄入量。采用主观总体评估法（SGA）评估营养状况，采用膳食史问卷（DHQ）测量食物摄入量。人体测量参数包括体重、身高、身体质量指数（BMI）、小腿围（CC）和中上臂围（MUAC）。从马来西亚吉隆坡医院的门诊患者（35名）和住院患者（110名）中招募了145名年龄在60 - 86岁（68.3±5.8岁）的受试者，其中男性31.7%，女性68.3%。经SGA评估，大多数受试者为轻度至中度营养不良（50.4%），其次为正常（38.6%）和严重营养不良（11.0%）。根据CNAQ和SNAQ，分别有79.3%和57.2%的受试者被归为食欲不良。根据SGA评估的营养状况，CNAQ（80.9%）的敏感性高于SNAQ（69.7%）。但SNAQ的特异性（62.5%）高于CNAQ（23.2%）。CNAQ和SNAQ的阳性预测值分别为62.6%和74.7%。CNAQ和SNAQ的Cronbach's alpha分别为0.546和0.578。过去一年内体重减轻史（校正优势比2.49）（p < 0.01）和硫胺素摄入量低于推荐营养素摄入量（校正优势比3.04）（p < 0.05）是受试者食欲不良的危险因素。综上所述，老年门诊和住院患者普遍存在营养不良和食欲不振的问题。在这一特殊人群中，SNAQ作为食欲筛查工具更为可靠和有效。有必要定期将营养和食欲评估纳入早期干预措施，以预防营养不良的后果。
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.