Nutrition Focused Physical Examination Components Specific to Older Adults: A Modified Delphi Study

The number of older adults will double worldwide by 2050, impacting the social system with higher healthcare personnel needs and economic costs. Registered dietitian nutritionists play a critical role in the holistic management of chronic diseases and related nutritional problems. Thereby, a comprehensive nutritional assessment should include a nutrition-focused physical examination (NFPE) to ensure early identification of nutrition-related problems. However, explicit NFPE components across different assessment categories (NFPE+) of the Nutrition Care Process for older adults are lacking.

This modified Delphi study aimed to identify NFPE+ components specific to older adults (≥ 65 years) through a literature review and to obtain consensus about the relevance and usefulness of these components among international dietitian experts in gerontology nutrition. Experts rated how useful and relevant the identified NFPE+ domains and components were using a 5-point Likert-type scale. Open-ended answers allowed the experts to suggest new components or propose adjustments to the identified components. Consensus was defined a priori at 75% agreement.

The literature review identified 30 NFPE+ components specific to older adults. The Delphi panel comprised of 15 experts from eight countries with 23.5 (±11.5) years of experience in geriatric nutrition. All 30 proposed NFPE+ components and three newly suggested components achieved consensus through two Delphi rounds. These 33 components were categorized into five NFPE+ domains in a finalized NFPE+ tool.

NFPE+ domains and components specific to older adults may significantly contribute to a focused and comprehensive nutritional assessment in older adults.