SCREEN-II: upstream identification of nutritional risks and its determinants among older adults in primary care in Singapore.

Abstract:

Introduction and objective: Malnutrition is common among the elderly and is a growing public health concern. Identification and subsequent intervention for malnutrition begin with screening. Community screening presents a key opportunity for early identification and intervention for at-risk groups. We aimed to examine the prevalence of nutritional risk and risk factors among Singapore's community-dwelling older adults.

Design: Cross-sectional study.

Setting and participants: Patients from public primary care polyclinics (n=404) were administered locally adapted English and Mandarin Chinese versions of SCREEN-II to determine the prevalence of nutritional risk (score<50). Stepwise logistic regression and latent class analysis (LCA) were performed to examine predictors of low scores.

Results: The overall prevalence of nutritional risk was 67.3% (95% CI 62.5% to 71.9%) affecting 60.2% males and 75.5% females in the sample. On stepwise logistic regression, being female (adjusted aOR (aOR) 1.89, 95% CI 1.21 to 2.95), having multimorbidity (aOR 2.48, 95% CI 1.56 to 3.92) and staying in lower-end housing (aOR 2.30, 95% CI 1.37 to 3.88) were risk factors for malnutrition. LCA two-cluster solution further identified Malay race (aOR 7.29, 95% CI 2.44 to 21.79, p<0.001) and secondary school education (aOR 1.75, 95% CI 1.16 to 2.63, p=0.007) as risk factors.

Conclusions: Findings suggest that nutritional risk is significant among Singapore's older adults and support the identification of higher risk subgroups. Further studies would be worthwhile to direct limited resources towards these at-risk groups in the face of the rapidly ageing population.