Development and validation of criteria for determining undernutrition in community-dwelling older men and women: The Short Nutritional Assessment Questionnaire 65+

Clin Nutr. 2012 Jun;31(3):351-8. doi: 10.1016/j.clnu.2011.10.013. Epub 2011 Nov 25.


Background & aims: There is no valid, fast and easy-to-apply set of criteria to determine (risk of) undernutrition in community-dwelling older persons. The aim of this study was to develop and validate such criteria.

Methods: Selection of potential anthropometric and undernutrition-related items was based on consensus literature. The criteria were developed using 15-year mortality in community-dwelling older persons ≥ 65 years (Longitudinal Aging Study Amsterdam, n = 1687) and validated in an independent sample (InCHIANTI, n = 1142).

Results: Groups distinguished were: (1) undernutrition (mid-upper arm circumference <25 cm or involuntary weight loss ≥4 kg/6 months); (2) risk of undernutrition (poor appetite and difficulties climbing staircase); and (3) no undernutrition (others). Respective hazard ratio's for 15-year mortality were: (1) 2.22 (95% CI 1.83-2.69); and (2) 1.57 (1.22-2.01) ((3) = reference). The area under the curve (AUC) was 0.55. Comparable results were found stratified by sex, excluding cancer/obstructive lung disease/(past) smoking, using 6-year mortality, and applying results to the InCHIANTI study (hazard ratio's 2.12 and 2.46, AUC 0.59).

Conclusions: The developed set of criteria (SNAQ⁶⁵⁺) for determining (risk of) undernutrition in community-dwelling older persons shows good face validity and moderate predictive validity based on the consistent association with mortality in a second independent study sample.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging*
  • Body Weights and Measures
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Humans
  • Longitudinal Studies
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / epidemiology
  • Malnutrition / mortality
  • Netherlands / epidemiology
  • Nutrition Assessment*
  • Predictive Value of Tests
  • Prevalence
  • Residence Characteristics
  • Risk
  • Surveys and Questionnaires
  • Weight Loss