Screening older people at risk of malnutrition or malnourished using the Simplified Nutritional Appetite Questionnaire (SNAQ): a comparison with the Mini-Nutritional Assessment (MNA) tool

Abstract

Objectives: The Mini-Nutritional Assessment (MNA) is recommended to assess malnutrition in older people. However, its implementation is challenging in large elderly population, nursing home, or community or large clinical research programs. The Simplified Nutritional Appetite Questionnaire (SNAQ), a self-assessment nutritional screening tool that predicts weight loss, could be used to screen older people at risk of malnutrition or malnourishment. Our objective was to assess whether the SNAQ is related to the MNA and can screen older people at risk of malnutrition or malnourishment.

Design/setting/participants: Cross-sectional study conducted of 175 persons aged 65 or older who were community dwelling, hospitalized, and nursing home residents.

Measurements: The SNAQ and the MNA score were performed. Correlation between the scores was studied. The most discriminating SNAQ value, which separated the participant at risk of malnutrition or malnourishment from the participant with a normal nutrition status (defined by MNA), was calculated.

Results: The SNAQ and the MNA score were significantly correlated (Spearman test r = 0.48, P < .001). The distribution of the population using the SNAQ or the MNA was significantly different (MacNemar P < .01). The area under the receiver operator characteristic curve, which assesses the ability of the SNAQ score to predict an abnormal MNA score, was 0.767 (95% confidence interval, 0.69-0.85). An SNAQ score under 14 was the best clinical indicator of older people at risk of malnutrition or malnourishment (sensitivity = 71%, specificity = 74%). Using this cut-off, 26.8% of the population (n = 47) were misclassified. Most of them (n = 33; 18.8%) had an abnormal SNAQ with a normal MNA.

Conclusion: The SNAQ is a poor screening tool to predict older people with an abnormal MNA score. However, an abnormal SNAQ might identify those who will lose weight earlier than will the MNA.