Cross-country differences and similarities in undernutrition prevalence and risk as measured by screen ii in community-dwelling older adults

Undernutrition is highly prevalent among community-dwelling older adults. Early identification of nutrition risk is important to prevent or treat undernutrition. This study describes the prevalence rates of nutrition risk in community-dwelling older adults (aged ≥ 65) using the same validated tool across different countries and aims to identify differences in nutritional risk factors. Cross-sectional data was obtained from three datasets including participants from the Netherlands (NL), Canada (CA) and New Zealand (NZ). Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) was used to assess nutritional risk factors and prevalence of risk. Differences between countries were tested with logistic and linear regression. Sensitivity analyses were conducted to test the influence of sampling strategy. A total of 13,340 participants were included, and 66.3% were found to be at high nutrition risk. After stratifying the data for method of data sampling, prevalence rates showed some differences across countries (NL: 61.5%, NZ: 68.2%, CA: 70.1%). Risk factor items that contributed to nutrition risk also differed among countries: NZ and CA participants scored higher for weight change, skipping meals, problems with meal preparation, use of meal replacements, problems with biting and chewing, low fluid intake and problems with doing groceries, as compared to participants in NL. Low intake of fruits and vegetables and meat were more prevalent in NL. In conclusion: nutrition risk is a worldwide, highly prevalent problem among community-dwelling older adults, but risk factors contributing to nutrition risk differ by country.