A multidimensional malnutrition risk score for institutionalized older adults: development and preliminary evaluation

Purpose This study aims to develop a multidimensional screening score for identifying malnutrition risk in institutionalized older adults and to examine its preliminary diagnostic performance. Design/methodology/approach This cross-sectional pilot study included 149 adults aged 65 years and older living in a nursing home in Istanbul, Türkiye. Nutritional status was assessed using the mini nutritional assessment (MNA), functional status using the Katz activities of daily living index, metabolic risk using waist-to-hip ratio and sleep behavior using self-reported sleep duration. The multidimensional functional malnutrition score (MFMS) was created as a composite score ranging from 0 to 5 points. Receiver operating characteristic analysis was performed to evaluate discriminative performance. Findings According to the MNA, 28.9% of participants were malnourished and 41.6% were at risk of malnutrition. The MFMS showed good discriminative performance for identifying participants with malnutrition risk (area under the curve = 0.85). A cutoff value of = 4 demonstrated favorable sensitivity and specificity. Sleep-related risk was significantly associated with higher MFMS classification. Research limitations/implications The study was conducted in a single institution and included a predominantly male population. Further studies in larger and more diverse older adult populations are needed. Practical implications The MFMS may support routine nutritional risk screening in institutional care settings by combining functional, nutritional, metabolic and behavioral indicators within a simple assessment approach. Originality/value This study presents a multidimensional screening model that combines nutritional, functional, metabolic and behavioral factors for the assessment of malnutrition risk in institutionalized older adults.