Development and validation of a new tool for simultaneous screening of malnutrition, sarcopenia and cachexia in older adults

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INTRODUCTION: The high prevalence of malnutrition, sarcopenia and cachexia among older adults presents a significant health care challenge, underscoring the need for effective screening tools. Given the frequent overlap of these conditions, a tool capable of simultaneously screening for all three conditions is imperative. METHODS: The development process included an extensive review of existing assessment instruments and data on risk factors, clinical presentations, and consequences of the three conditions. The tool underwent rigorous testing to evaluate its reliability and validity in a sample of 300 older adults. It was compared against standard diagnostic criteria and assessed alongside other screening tools, including the Mini Nutritional Assessment-Short Form, the Short Nutritional Assessment Questionnaire and the Simple Questionnaire to Rapidly Diagnose Sarcopenia. RESULTS: Eighteen percent (n = 54) of participants were diagnosed with an overlap of the three conditions, 10% (n = 30) of cases presented with sarcopenia alone and 3% (n = 10) were diagnosed with malnutrition only. The new tool demonstrated Cronbach's alpha of 0.818 and high construct validity. The newly developed tool and Mini Nutritional Assessment-Short Form had the highest diagnostic accuracy for predicting the malnutrition and sarcopenia. The Short Nutritional Assessment Questionnaire had the highest diagnostic accuracy for predicting cachexia, whereas the Simple Questionnaire to Rapidly Diagnose Sarcopenia exhibited the lowest diagnostic accuracy across all conditions. The retention criteria for items were deemed valid for the 19 items included in the finalized version of the new tool. CONCLUSIONS: Screening for malnutrition, sarcopenia and cachexia in older adults using a single tool was feasible. The new tool was easy to use and did not require anthropometric measurements or physical performance tasks. Geriatr Gerontol Int 2025; 25: 511-519.

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