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
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...
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MDPI AG
2020-09-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/12/9/2885 |
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| author | Sabrina Lau Kalene Pek Justin Chew Jun Pei Lim Noor Hafizah Ismail Yew Yoong Ding Matteo Cesari Wee Shiong Lim |
| author_facet | Sabrina Lau Kalene Pek Justin Chew Jun Pei Lim Noor Hafizah Ismail Yew Yoong Ding Matteo Cesari Wee Shiong Lim |
| author_sort | Sabrina Lau |
| collection | DOAJ |
| description | 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, <i>p</i> = 0.025 vs. OR 1.05, <i>p</i> = 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. |
| first_indexed | 2024-03-10T16:09:47Z |
| format | Article |
| id | doaj.art-7e4bfcb4155c4ed6b7c921072702622d |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T16:09:47Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-7e4bfcb4155c4ed6b7c921072702622d2023-11-20T14:33:44ZengMDPI AGNutrients2072-66432020-09-01129288510.3390/nu12092885The Simplified Nutritional Appetite Questionnaire (SNAQ) as a Screening Tool for Risk of Malnutrition: Optimal Cutoff, Factor Structure, and Validation in Healthy Community-Dwelling Older AdultsSabrina Lau0Kalene Pek1Justin Chew2Jun Pei Lim3Noor Hafizah Ismail4Yew Yoong Ding5Matteo Cesari6Wee Shiong Lim7Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, SingaporeInstitute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore 308433, SingaporeDepartment of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, SingaporeDepartment of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, SingaporeInstitute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore 308433, SingaporeDepartment of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, SingaporeDepartment of Clinical Sciences and Community Health, University of Milan, 20122 Milan, ItalyDepartment of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, SingaporeMalnutrition 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, <i>p</i> = 0.025 vs. OR 1.05, <i>p</i> = 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.https://www.mdpi.com/2072-6643/12/9/2885malnutritionanorexiaolder adultscutofffactor structurevalidity |
| spellingShingle | Sabrina Lau Kalene Pek Justin Chew Jun Pei Lim Noor Hafizah Ismail Yew Yoong Ding Matteo Cesari Wee Shiong Lim 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 Nutrients malnutrition anorexia older adults cutoff factor structure validity |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | malnutrition anorexia older adults cutoff factor structure validity |
| url | https://www.mdpi.com/2072-6643/12/9/2885 |
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