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Differences in Psychosocial and Behavioral Variables by Dietary Screening Tool Risk Category in Older Adults

Greene, Geoffrey W., Lofgren, Ingrid, Paulin, Chelsea, Greaney, Mary L., Clark, Phillip G.
Journal of the Academy of Nutrition and Dietetics 2017
cognition, data collection, elderly, equations, exercise, fruits, nutrition assessment, prediction, regression analysis, risk, self-efficacy, surveys, vegetable consumption, vegetables
The Dietary Screening Tool (DST) has been validated as a dietary screening instrument for older adults defining three categories of potential nutritional risk based on DST score cutoffs. Previous research has found that older adults classified as being "At-risk" differed from those categorized as being "Not at-risk" for a limited number of health-related variables. The relationship between risk categories and a wide variety of variables has not yet been explored. This research will contribute to an increased understanding of clustering of multiple health concerns in this population.The aim of this study was to determine if DST risk categories differed by demographic, anthropometric, cognitive, functional, psychosocial or behavioral variables in older adults.This study utilized a cross-sectional design with data collected from 9/15/2009 to 7/31/2012; participants completed an interviewer-administered survey including the DST and other measures.Community dwelling older adults (n= 255) participating in the Study of Exercise and Nutrition in Older Rhode Islanders Project were included if they met study inclusion criteria (complete DST data with depression and cognitive status scores above cutoffs).DST scores were used to classify participants’ dietary risk (“At-risk,” “Possible-risk,” “Not-at-risk”)Multiple analysis of variance and Χ2 analyses examined whether DST risk categories differed by variables. Significant predictors were entered into a logistic regression equation predicting “At-risk” compared to other risk categories combined.Participants’ mean age was 82.5±4.9 years. Nearly half (49%, n=125) were classified as being at “Possible-risk,” with the remainder 26% (n=66) “Not-at-risk” and “At-risk” 25% (n=64). “At-risk” participants were less likely to be in Action/Maintenance Stages of Change (p<0.01). There was a multivariate effect of risk category (p<0.01). “At-risk” participants had a lower intake of fruits and vegetables, fruit and vegetable self-efficacy, satisfaction with life, and resilience as well as higher Geriatric Depression Scale scores indicating greater negative affect than individuals “Not-at-risk” (p<0.05). In a logistic regression predicting “At-risk,” fruit and vegetable self-efficacy, satisfaction with life scale score, and fruit and vegetable intake were independent predictors of risk (p<0.05).Older adults classified “At-risk” indicated a greater degree of negative affect and reduced self-efficacy to consume fruits and vegetables. This study supports the use of the DST in assessment of older adults and suggests a clustering of health concerns among those classified “At-risk “.