Development of the nutrition risk assessment tool for older adults

Background: Malnutrition is a lack of proper nutrition associated with different chronic diseases, comorbidities, frailty, and a higher prevalence of morbidity and mortality. Aim: The aim of the study was to determine the most appropriate items that reflect nutrition status in this population group and incorporate them into the nutrition risk screening and malnutrition assessment tool. Methods: A cross-sectional validation study was conducted in Bosnia and Herzegovina among 300 individuals older than 65 years. An eight-step approach that included correspondence analysis, generation of the pool item, content validity, internal consistency, construct validity, criterion validity, face validity, and reliability was performed. Results: Correspondence analyses were performed using the contingency table's low-dimensional graphical representation of the rows and columns. After identifying nutrition status assessment-related topics via correspondence analyses, a literature review was performed to determine additional items. The assessment tool's accuracy was measured against clinical judgement as a reference standard. To test face validity of the tool, cognitive interviewing was used. Responses were analyzed and necessary changes were made. The final version of the tool included 14 items. Possible range score on the assessment tool was 0-21. Lower scores indicated nutrition risk. The screening and assessment tool showed acceptable validity and internal consistency.