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Cited by 226Nutrition and Health in AgingClinical Nutrition and GastroenterologyBody Composition Measurement Techniques

A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study

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Power, Lauren, Mullally, Deirdre, Gibney, Eileen R., Clarke, Michelle, Visser, Marjolein, Volkert, Dorothee, Bardon, Laura, de van der Schueren, Marian A.E. +1 more·2018·Clinical Nutrition ESPEN
DOI 10.1016/j.clnesp.2018.02.005
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Abstract

Background Older adults are at increased risk of malnutrition compared to their younger counterparts. Malnutrition screening should be conducted using a valid malnutrition screening tool. An aim of the Healthy Diet for a Healthy Life (HDHL) Joint Programming Initiative (JPI) 'Malnutrition in the Elderly Knowledge Hub' (MaNuEL) was to review the reported validity of existing malnutrition screening tools used in older adults. Methods A literature search was conducted to identify validation studies of malnutrition screening tools in older populations in community, rehabilitation, residential care and hospital settings. A database of screening tools was created containing information on how each tool was validated. Results Seventy-four articles containing 119 validation studies of 34 malnutrition screening tools used in older adults were identified across the settings. Twenty-three of these tools were designed for older adults. Sensitivity and specificity ranged from 6 to 100% and 12-100% respectively. Seventeen different reference standards were used in criterion validation studies. Acceptable reference standards were used in 68 studies; 38 compared the tool against the Mini Nutritional Assessment-Full Form (MNA-FF), 16 used clinical assessment by a nutrition-trained professional and 14 used the Subjective Global Assessment (SGA). Twenty-five studies used inappropriate reference standards. Predictive validity was measured in 14 studies and was weak across all settings. Conclusions Validation results differed significantly between tools, and also between studies using the same tool in different settings. Many studies have not been appropriately conducted, leaving the true validity of some tools unclear. Certain tools appear to be more valid for use in specific settings.

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  • Many validated screening tools are now available, with most focusing on identification of individuals who already have signs of malnutrition, whereas others identify risk factors for developing malnutrition.

    “Many validated screening tools are now available, 31 , 32 with most focusing on the identification of individuals who already have signs of malnutrition, whereas others identify risk factors for developing malnutrition. 33 , 34 , 35 , 36”

    From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [33]

    The Overall findings section reports that 34 malnutrition screening tools have been tested for validity in older adults. The What is malnutrition screening? section says tools address both indicators of malnutrition and risk factors, but it does not establish that most focus on existing signs while others focus on future risk. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Authors
Power, L., Mullally, D., Gibney, E. R., Clarke, M., Visser, M., Volkert, D., Bardon, L., de van der Schueren, M. A. E., & Corish, C. A.
Affiliations
  • University College Dublin (IE)
  • Amsterdam Public Health (NL)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
Corresponding author
  • Power, Lauren
  • Mullally, Deirdre
  • Gibney, Eileen R.
  • Clarke, Michelle
  • Visser, Marjolein
  • Volkert, Dorothee
  • Bardon, Laura
  • Corish, Clare A.
ORCID
Venue
Clinical Nutrition ESPEN
Publisher
Elsevier BV
Published
2018-04
Volume
24
Pages
1-13
ISSN
2405-4577 (ISSN-L)
DOI
10.1016/j.clnesp.2018.02.005
OpenAlex
W2791352350
Cited by
226
References
3
Citations by year
2026: 14 · 2025: 29 · 2024: 28 · 2023: 26 · 2022: 26 · 2021: 35 · 2020: 32 · 2019: 28 · 2018: 8
FWCI
3.38
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Nutrition ESPEN (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • University College Dublin
  • European Society for Clinical Nutrition and Metabolism
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
malnutrition screening, older adults, screening instrument validity, validation studies, sensitivity and specificity, reference materials, Subjective Global Assessment, predictive validity, community settings, residential care, hospital settings, rehabilitation settings
MeSH terms
Aged, Humans, Mass Screening, Predictive Value of Tests, Risk Factors, Reproducibility of Results, Geriatric Assessment, Nutrition Assessment, Risk Assessment, Malnutrition, Validation Studies as Topic

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