Cross-Country Differences and Similarities in Undernutrition Prevalence and Risk as Measured by SCREEN II in Community-Dwelling Older Adults

Abstract

Undernutrition is highly prevalent among community-dwelling older adults. Early identification of nutrition risk is important to prevent or treat undernutrition. This study describes the prevalence rates of nutrition risk in community-dwelling older adults (aged ≥ 65) using the same validated tool across different countries and aims to identify differences in nutritional risk factors. Cross-sectional data was obtained from three datasets including participants from the Netherlands (NL), Canada (CA) and New Zealand (NZ). Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) was used to assess nutritional risk factors and prevalence of risk. Differences between countries were tested with logistic and linear regression. Sensitivity analyses were conducted to test the influence of sampling strategy. A total of 13,340 participants were included, and 66.3% were found to be at high nutrition risk. After stratifying the data for method of data sampling, prevalence rates showed some differences across countries (NL: 61.5%, NZ: 68.2%, CA: 70.1%). Risk factor items that contributed to nutrition risk also differed among countries: NZ and CA participants scored higher for weight change, skipping meals, problems with meal preparation, use of meal replacements, problems with biting and chewing, low fluid intake and problems with doing groceries, as compared to participants in NL. Low intake of fruits and vegetables and meat were more prevalent in NL. In conclusion: nutrition risk is a worldwide, highly prevalent problem among community-dwelling older adults, but risk factors contributing to nutrition risk differ by country.

Differentiation of Nutritional Risk among Polish Seniors Based on Selected Lifestyle Characteristics

“…Our study showed that nearly 75% of people over 60 years of age were at high nutritional risk. Similarly, studies carried out in Canada, New Zealand, and the Netherlands have reported high proportions of elderly people at high nutritional risk (61.5–70.1%) [ 23 ]. Elements that may have influenced the difference in the proportion of people found in our study to be at high nutritional risk include the final number of participants (320 vs. 13,340); it should be taken into account that our study included only two provinces in Poland, whereas the study by Borkent et al (2020) [ 23 ] examined three countries.…”

“…Similarly, studies carried out in Canada, New Zealand, and the Netherlands have reported high proportions of elderly people at high nutritional risk (61.5–70.1%) [ 23 ]. Elements that may have influenced the difference in the proportion of people found in our study to be at high nutritional risk include the final number of participants (320 vs. 13,340); it should be taken into account that our study included only two provinces in Poland, whereas the study by Borkent et al (2020) [ 23 ] examined three countries. In addition, the majority of respondents in our study were 60–74-year olds (73.6%) ( Table 2 ), while in the aforementioned study, 65.8% were 65–74-year olds.…”

“…Studies conducted in different countries of the world using the SCREEN II questionnaire have reported the prevalence of high nutritional risk in between 61.5 and 70.1% of people over 65 years of age [ 23 ]. However, few studies have focused on the association of nutritional risk with lifestyle characteristics in older adults [ 3 , 20 , 24 ].…”

Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

“…Approximately two-thirds of older adults in Canada are identified as having nutrition risk [ 4 ]. It is recognized that better screening as well as identifying opportunities for prevention could help older adults retain their independence and improve their quality of life as well reduce hospital length of stay and associated costs.…”

“…Using standardized methodology and cut-points, a tri-country study (Canada, New Zealand, The Netherlands) found a uniformly high prevalence of high nutrition risk (61.5–70.1%) in community-dwelling adults ≥65 years of age [ 4 ]. The validated screening tool (SCREEN II) is considered useful for identifying upstream factors (e.g., determinants of food intake such as grocery shopping difficulty) that may predict future as well as current malnutrition [ 5 ].…”