Nutritional risk and time to death; predictive validity of SCREEN (Seniors in the Community Risk Evaluation for Eating and Nutrition).
BACKGROUND
Undernutrition in community-living seniors is common and has the potential to adversely influence health outcomes. Nutritional risk screening tools can help identify seniors at risk, but few have predicted health outcomes.


METHODS
Seniors were recruited from 23 community service providers. The 8-item abbreviated version SCREEN (Seniors in the Community Risk Evaluation for Eating and Nutrition) was used to identify nutritional risk in 367 seniors; demographics, health, activities of daily living, and psychosocial variables were included in a baseline assessment. The seniors were followed-up by telephone for 18 months to determine the occurrence of health outcomes, including death. Cox regression was used to identify predictors of survival time.


RESULTS
During the 18-month follow-up there were 27 deaths (approximately 7%). Using the abbreviated tool, nutritional risk was common (42.2%). This low rate of death limited the modeling to only a few key covariates, which were based on bivariate analyses. Nutritional risk was significantly associated with time to death. Gender was also associated with time to death, with men more likely to die sooner than women. Increasing age was also significantly associated with shorter survival times.


CONCLUSIONS
Nutritional risk as measured by SCREEN was predictive of time to death. This simple tool may be useful for future epidemiological research on health outcomes of seniors. Further work should confirm these results, as the low event rate influenced the modeling strategy.
Keller
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Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
Østbye
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D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009026:Mortality; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors