Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A. Aziz, 50300 Kuala Lumpur, Malaysia.
J Nutr Health Aging. 2012 Jul;16(7):660-5. doi: 10.1007/s12603-012-0056-6.
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.
食欲不振是老年人营养状况不佳的主要原因之一。由于认识到评估食欲的重要性，本横断面研究旨在确定食欲筛查工具的有效性，即营养食欲问卷（CNAQ）和简化营养食欲问卷（SNAQ），与食欲、饥饿和感官感知问卷（AHSPQ）、营养状况和食物摄入的测量值在马来西亚主要综合医院的老年患者中的关系。营养状况采用主观全面评估（SGA）进行评估，而食物摄入量则采用膳食史问卷（DHQ）进行测量。人体测量参数包括体重、身高、体重指数（BMI）、小腿围（CC）和上臂中部围（MUAC）。共招募了 145 名年龄在 60 至 86 岁之间（68.3±5.8 岁）的患者，其中 31.7%为男性，68.3%为女性，他们来自马来西亚吉隆坡医院的门诊（35 名患者）和住院患者（110 名患者）。根据 SGA 评估，大多数患者被归类为轻度至中度营养不良（50.4%），其次是正常（38.6%）和严重营养不良（11.0%）。根据 CNAQ 和 SNAQ，分别有 79.3%和 57.2%的患者被归类为食欲不振。当使用 SGA 评估营养状况时，CNAQ（80.9%）的敏感性高于 SNAQ（69.7%）。然而，SNAQ（62.5%）的特异性高于 CNAQ（23.2%）。CNAQ 和 SNAQ 的阳性预测值分别为 62.6%和 74.7%。CNAQ 和 SNAQ 的克朗巴赫系数分别为 0.546 和 0.578。过去一年体重减轻（调整后的优势比 2.49）（p<0.01）和硫胺素摄入量低于推荐营养素摄入量（RNI）（调整后的优势比 3.04）（p<0.05）是患者食欲不佳的危险因素。综上所述，营养不良和食欲不振在老年门诊和住院患者中很常见。SNAQ 是该特殊人群中更可靠和有效的食欲筛查工具。为了预防营养不良的后果，需要定期进行营养和食欲评估，以便采取早期干预措施。
