The validity of Nutrition Screening Initiative DETERMINE Checklist responses in older Georgians

The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.