Validation of a Diet Quality Screening Tool for Use in the Oldest Old^*

Abstract

The oldest old (aged ≥80 years) are often the population subgroup at high nutritional risk due to age-related metabolic changes. We performed a validation analysis of a dietary screening tool (DST) which was developed for older adults among the oldest old. We examined dietary intakes using three 24-hour dietary recalls and the DST among 122 participants (aged 82–97) of the Geisinger Rural Aging Study. DST scores were compared with the Health Eating Index (HEI)-2015 scores, which were calculated based on three-day dietary recalls. Pearson correlations were used to characterize concurrent validity and Bland-Altman plots were used to identify potential bias. DST scores were significantly correlated with HEI scores (adjusted r = 0.68; p < 0.001) in an age- and sex-adjusted model. Those within the not-at-risk DST group had significantly higher HEI scores (adjusted means = 79.6 ± 3.68) compared with those who were in the at-risk (adjusted means = 51.2 ± 1.56) and the possibly-at-risk (adjusted means = 66.3 ± 1.79) groups (p-trend < 0.001). The DST appears to be a valid measure of diet quality in the oldest old when compared with the HEI and may be a potential tool to assess overall diet quality in this population.

Keywords:

• Diet assessment
• diet quality
• geriatric nutrition
• oldest old

Acknowledgments

The authors gratefully acknowledge the coordinating, recruiting, and screening staff from the Geisinger Obesity Research Institute (Marianne Yohn, Stephanie Ranck, Krystal Cunningham, Megan Lamotte, and Bethann Whilden) and the Penn State Diet Assessment Center (Kristen Cox).

Author contribution

XG, DCM, CW, RKB, CDS, GLJ, and YL designed research; XG, DCM, CW, RKB, CDS, GLJ, and YL conducted research; CW and YL analyzed data and performed statistical analysis; YL wrote the manuscript; all authors provided study oversight and critical reading of manuscript; XG had primary responsibility for final content. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study is funded by the United States Department of Agriculture, Agricultural Research Service agreement 8050-51530-012-01A.