A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study

MaNuEL Consortium

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Background: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) ‘Malnutrition in the Elderly Knowledge Hub’ (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. Methods: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. Results: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12–100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. Conclusions: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.
Original languageEnglish
Pages (from-to)1-13
JournalClinical Nutrition ESPEN
Volume24
DOIs
Publication statusPublished - 2018

Cite this

@article{17b4ebb747bb436097c055fccdbf9060,
title = "A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study",
abstract = "Background: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) ‘Malnutrition in the Elderly Knowledge Hub’ (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. Methods: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. Results: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100{\%} and 12–100{\%} respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. Conclusions: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.",
author = "{MaNuEL Consortium} and Lauren Power and Deirdre Mullally and Gibney, {Eileen R.} and Michelle Clarke and Marjolein Visser and Dorothee Volkert and Laura Bardon and {de van der Schueren}, {Marian A. E.} and Corish, {Clare A.}",
year = "2018",
doi = "10.1016/j.clnesp.2018.02.005",
language = "English",
volume = "24",
pages = "1--13",
journal = "Clinical Nutrition ESPEN",
issn = "2405-4577",
publisher = "Elsevier Ltd",

}

A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study. / MaNuEL Consortium.

In: Clinical Nutrition ESPEN, Vol. 24, 2018, p. 1-13.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study

AU - MaNuEL Consortium

AU - Power, Lauren

AU - Mullally, Deirdre

AU - Gibney, Eileen R.

AU - Clarke, Michelle

AU - Visser, Marjolein

AU - Volkert, Dorothee

AU - Bardon, Laura

AU - de van der Schueren, Marian A. E.

AU - Corish, Clare A.

PY - 2018

Y1 - 2018

N2 - Background: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) ‘Malnutrition in the Elderly Knowledge Hub’ (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. Methods: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. Results: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12–100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. Conclusions: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.

AB - Background: Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) ‘Malnutrition in the Elderly Knowledge Hub’ (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. Methods: A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. Results: Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12–100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. Conclusions: Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29576345

U2 - 10.1016/j.clnesp.2018.02.005

DO - 10.1016/j.clnesp.2018.02.005

M3 - Review article

VL - 24

SP - 1

EP - 13

JO - Clinical Nutrition ESPEN

JF - Clinical Nutrition ESPEN

SN - 2405-4577

ER -