Abstract
Background
The Dietary Screening Tool (DST) has been validated as a dietary screening instrument
for older adults defining three categories of potential nutritional risk based on
DST score cutoffs. Previous research has found that older adults classified as being
“at risk” differed from those categorized as being “not at risk” for a limited number
of health-related variables. The relationship between risk categories and a wide variety
of variables has not yet been explored. This research will contribute to an increased
understanding of clustering of multiple health concerns in this population.
Objective
The aim of this study was to determine whether DST risk categories differed by demographic,
anthropometric, cognitive, functional, psychosocial, or behavioral variables in older
adults.
Design
This study utilized a cross-sectional design with data collected from September 15,
2009 to July 31, 2012. Participants completed an interviewer-administered survey including
the DST and other measures.
Participants/setting
Community-dwelling older adults (n=255) participating in the Study of Exercise and
Nutrition in Older Rhode Islanders Project were included if they met study inclusion
criteria (complete DST data with depression and cognitive status scores above cutoffs).
Main outcome measures
DST scores were used to classify participants’ dietary risk (at risk, possible risk,
and not at risk).
Statistical analyses performed
Multiple analysis of variance and χ2 analyses examined whether DST risk categories differed by variables. Significant
predictors were entered into a logistic regression equation predicting at-risk compared
to other risk categories combined.
Results
Participants’ mean age was 82.5±4.9 years. Nearly half (49%, n=125) were classified
as being at possible risk, with the remainder 26% (n=66) not at risk and at risk 25%
(n=64). At-risk participants were less likely to be in the Action/Maintenance Stages
of Change (P<0.01). There was a multivariate effect of risk category (P<0.01). At-risk participants had a lower intake of fruits and vegetables, fruit and
vegetable self-efficacy, satisfaction with life, and resilience, as well as higher
Geriatric Depression Scale scores, indicating greater negative affect than individuals
not at risk (P<0.05). In a logistic regression predicting at risk, fruit and vegetable self-efficacy,
Satisfaction with Life Scale score, and fruit and vegetable intake were independent
predictors of risk (P<0.05).
Conclusions
Older adults classified as at risk indicated a greater degree of negative affect and
reduced self-efficacy to consume fruits and vegetables. This study supports the use
of the DST in assessment of older adults and suggests a clustering of health concerns
among those classified as at risk.
Keywords
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Biography
G. W. Greene is a professor and dietetic internship director, Department of Nutrition and Food Sciences, University of Rhode Island, Kingston.
Biography
I. Lofgren is an associate professor, Department of Nutrition and Food Sciences, University of Rhode Island, Kingston.
Biography
C. Paulin is coordinator, Online MS Dietetics Program, Department of Nutrition and Food Sciences, University of Rhode Island, Kingston.
Biography
M. L. Greaney is an associate professor, Health Studies and Department of Kinesiology, University of Rhode Island, Kingston.
Biography
P. G. Clark is a professor and director, Program in Gerontology and Rhode Island Geriatric Education Center, University of Rhode Island, Kingston.
Article info
Publication history
Published online: August 17, 2017
Accepted:
June 27,
2017
Received:
September 7,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This investigation is funded by grant no. 5RO1CA126448 from the National Cancer Institute (NCI) and the National Institute on Aging (NIA), National Institutes of Health. Neither NCI nor NIA had any direct involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit this paper for publication.
Identification
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© 2018 by the Academy of Nutrition and Dietetics.
