title: Screening for Malnutrition in Community Dwelling Older Japanese: Preliminary Development and Evaluation of the Japanese Nutritional Risk Screening Tool (NRST).
abstract: BACKGROUND
  Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations.
  
  
  OBJECTIVE
  This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II.
  
  
  METHODS
  The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people.
  
  
  METHODS
  Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People.
  
  
  RESULTS
  The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST).
  
  
  CONCLUSIONS
  These results indicate that the NRST is a promising screening tool for the prediction of malnutrition and sarcopenia in community-dwelling older Japanese people. Further development of a full Japanese version of the SCREEN II is indicated.
authors.affiliation: Kazuko Ishikawa-Takata, Section of Nutritional Care and Management, Department of Nutritional Education, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, 162-8636 Tokyo, Japan; Tel: +81-3-3203-5721, Fax: +81-3-3202-3278, kazu@nih.go.jp.
authors.forename: N C
authors.initials: NC
authors.lastname: Htun
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa-Takata
authors.forename: A
authors.initials: A
authors.lastname: Kuroda
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Kikutani
authors.forename: S P
authors.initials: SP
authors.lastname: Obuchi
authors.forename: H
authors.initials: H
authors.lastname: Hirano
authors.forename: K
authors.initials: K
authors.lastname: Iijima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D007564:Japan / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012372:ROC Curve; D015203:Reproducibility of Results; D012111:Residence Characteristics; D018570:Risk Assessment; D055948:Sarcopenia / Q000453:epidemiology; D011795:Surveys and Questionnaires / Q000592:standards*
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