The simplified nutritional appetite questionnaire (Snaq) as a screening tool for risk of malnutrition: Optimal cutoff, factor structure, and validation in healthy community-dwelling older adults

Sabrina Lau, Kalene Pek, Justin Chew, Jun Pei Lim, Noor Hafizah Ismail, Yew Yoong Ding, Matteo Cesari, Wee Shiong Lim

Research output: Contribution to journalArticlepeer-review

Abstract

Malnutrition is an independent marker of adverse outcomes in older adults. While the Simplified Nutritional Appetite Questionnaire (SNAQ) for anorexia has been validated as a nutritional screening tool, its optimal cutoff and validity in healthy older adults is unclear. This study aims to determine the optimal cutoff for SNAQ in healthy community-dwelling older adults, and to examine its factor structure and validity. We studied 230 community-dwelling older adults (mean age 67.2 years) who were nonfrail (defined by Fatigue, Resistance, Ambulation, Illnesses & Loss (FRAIL) criteria). When compared against the risk of malnutrition using the Mini Nutritional Assessment (MNA), the optimal cutoff for SNAQ was ≤15 (area under receiver operating characteristic (ROC) curve: 0.706, sensitivity: 69.2%, specificity: 61.3%). Using exploratory factor analysis, we found a two-factor structure (Factor 1: Appetite Perception; Factor 2: Satiety and Intake) which accounted for 61.5% variance. SNAQ showed good convergent, discriminant and concurrent validity. In logistic regression adjusted for age, gender, education and MNA, SNAQ ≤15 was significantly associated with social frailty, unlike SNAQ ≤4 (odds ratio (OR) 1.99, p = 0.025 vs. OR 1.05, p = 0.890). Our study validates a higher cutoff of ≤15 to increase sensitivity of SNAQ for anorexia detection as a marker of malnutrition risk in healthy community-dwelling older adults, and explicates a novel two-factor structure which warrants further research.

Original languageEnglish
Article number2885
Pages (from-to)1-17
Number of pages17
JournalNutrients
Volume12
Issue number9
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Anorexia
  • Cutoff
  • Factor structure
  • Malnutrition
  • Older adults
  • Validity

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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