Prevalence of Undernutrition in Community-Dwelling Older Adults in The Netherlands: Application of the SNAQ⁶⁵⁺ Screening Tool and GLIM Consensus Criteria

The aim of this study was to provide recent data on the prevalence of undernutrition based on screening and diagnosis in Dutch community-dwelling older adults. The data from the 2021 to 2022 examination wave from the Longitudinal Aging Study Amsterdam (n = 1138) and the Dutch National Food Consumption Survey 2019-2021 (n = 607) on community-dwelling men and women aged 65 years and older were used. The prevalence of undernutrition was based on a positive score on the Short Nutritional Assessment Questionnaire 65+ (SNAQ⁶⁵⁺) screening tool, a positive diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria and their combination. Of the combined sample (n = 1745), the mean age was 74 (SD 6) years, where 16.7% were aged 80 years or older, 50.5% was female, 56.9% had a high education level, and 30.3% lived alone. The prevalence of undernutrition based on the SNAQ⁶⁵⁺ screening in the combined sample was 8.5% (95% CI 7.3-9.9%). In the subgroup of LASA participants with complete data on all GLIM criteria (n = 700), the prevalence of undernutrition was 5.4% based on SNAQ⁶⁵⁺ and 7.1% based on GLIM. A positive SNAQ⁶⁵⁺ screening followed by a positive GLIM diagnosis resulted in a lower prevalence (3.1%). Being female, older, living alone, receiving formal home care, and having poor self-rated health, poor appetite, or mobility limitations, they were all associated with a higher prevalence, with more than two-fold higher prevalence rates in some subgroups. The results show that currently one out of twelve community-dwelling adults aged 65 years and older is undernourished based on the SNAQ65+ screening, and one out of fourteen is undernourished based on the GLIM diagnosis criteria. Awareness is needed to increase early recognition and treatment in community and primary care, especially among the more vulnerable groups.