Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes.

ABSTRACT

OBJECTIVES: Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. DESIGN: Longitudinal observational with follow-up at six months. SETTING: Female acute Medicine for Older People wards at a University hospital in England. PARTICIPANTS: 179 female inpatients. MEASUREMENTS Age, weight, Body Mass Index (BMI), grip strength, SNAQ, Barthel Index Score, Mini Mental State Examination (MMSE), Geriatric Depression Scale Short Form (GDS-SF), Malnutrition Universal Screening Tool (MUST), category of domicile and receipt of care were measured soon after admission and repeated at six month follow-up. The length of hospital stay (LOS), hospital acquired infection, readmissions and deaths by follow-up were recorded. RESULTS: 179 female participants mean age 87 (SD 4.7) years were recruited. 42% of participants had a low SNAQ score (<14, indicating poor appetite). A low SNAQ score was associated with an increased risk of hospital acquired infection (OR 3.53; 95% CI 1.48, 8.41; p=0.004) and with risk of death (HR 2.29; 95% CI 1.12, 4.68; p = 0.023) by follow-up. CONCLUSION: Poor appetite was common among the older hospitalised women studied, and was associated with higher risk of poor healthcare outcomes.