Comparison of Nutritional Components of InterRAI-HC to Validated Nutrition Screening Tools

Background: Increased proportions of older adults are choosing to live independently into their advanced years and can be at risk of malnutrition. Adverse effects of malnutrition include: functional decline, an increase in inpatient stay due to prolonged wound recovery, and an overall increase in preventable hospitalisations. Therefore, accurate detection of malnutrition in the community is crucial. In New Zealand, the national implementation of the International Residential Assessment Instrument-Home Care (InterRAI-HC), a holistic home-based assessment, has been underway since 2008. InterRAI-HC aims to identify the necessary support services required by free-living elderly adults based on identified warning signs, called Clinical Assessment Proctocols (CAPs). The potential CAPs triggered by the “Oral and Nutritional status” section of InterRAI-HC include the “undernutrition”, “dehydration”, or the “feeding tube” CAPs. This section is the only nutrition-specific section and therefore the undernutrition CAP trigger rate should be similar to malnutrition detection rates of established and validated nutrition screening tools. Objective: Compare the oral and nutrition section of InterRAI-HC with validated nutrition screening tools, MNA-SF and SCREEN II. Design: An observational study of free-living older adults living in Dunedin, New Zealand recruited from retirement villages or the community. A questionnaire was developed and administered which obtained information on general socio-demographic characteristics and additional information required for risk categorisation using InterRAI-HC, SCREEN II, and the MNA-SF tools. Results: A total of 181 participants were visited in their own homes by two researchers, 91 were from the community and 90 were from two retirement villages. A SCREEN II score