Development of the Japanese version of the Council on Nutrition Appetite Questionnaire and its simplified versions, and evaluation of their reliability, validity, and reproducibility.
BACKGROUND
Because few Japanese questionnaires assess the elderly's appetite, there is an urgent need to develop an appetite questionnaire with verified reliability, validity, and reproducibility.


METHODS
We translated and back-translated the Council on Nutrition Appetite Questionnaire (CNAQ), which has eight items, into Japanese (CNAQ-J), as well as the Simplified Nutritional Appetite Questionnaire (SNAQ-J), which includes four CNAQ-J-derived items. Using structural equation modeling, we examined the CNAQ-J structure based on data of 649 Japanese elderly people in 2013, including individuals having a certain degree of cognitive impairment, and we developed the SNAQ for the Japanese elderly (SNAQ-JE) according to an exploratory factor analysis. Confirmatory factor analyses on the appetite questionnaires were conducted to probe fitting to the model. We computed Cronbach's α coefficients and criterion-referenced/-related validity figures examining associations of the three appetite battery scores with body mass index (BMI) values and with nutrition-related questionnaire values. Test-retest reproducibility of appetite tools was scrutinized over an approximately 2-week interval.


RESULTS
An exploratory factor analysis demonstrated that the CNAQ-J was constructed of one factor (appetite), yielding the SNAQ-JE, which includes four questions derived from the CNAQ-J. The three appetite instruments showed almost equivalent fitting to the model and reproducibility. The CNAQ-J and SNAQ-JE demonstrated satisfactory reliability and significant criterion-referenced/-related validity values, including BMIs, but the SNAQ-J included a low factor-loading item, exhibited less satisfactory reliability and had a non-significant relationship to BMI.


CONCLUSIONS
The CNAQ-J and SNAQ-JE may be applied to assess the appetite of Japanese elderly, including persons with some cognitive impairment.
Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan. Electronic address: tokudome@nuas.ac.jp.
Yuko
Y
Tokudome
Department of Education and Research in Family and Community Medicine, Mie University Graduate School of Medicine, Mie, Japan.
Keiko
K
Okumura
School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan.
Yoshiko
Y
Kumagai
Department of Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Hirohiko
H
Hirano
Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Hunkyung
H
Kim
Department of Oral Disease Research, National Center for Geriatrics and Gerontology, Aichi, Japan.
Shiho
S
Morishita
Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Yutaka
Y
Watanabe
D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009752:Nutritional Status; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014177:Translations
Appetite; Development of questionnaires; Japanese elderly; Reliability; Validity