The relationship between the DETERMINE checklist, social factors, and nutritional risk in rural, community-dwelling, elderly women
Using a stratified sample of 249 older, rural, community-dwelling women grouped into three age cohorts (65--74 years, 75--84, and 85+ years), this research evaluated the ability of the DETERMINE checklist and social factors to identify those with at-risk nutritional status. A modified DETERMINE checklist found 7% and 42% of the sample to be at high and moderate risk, respectively. Anthropometric measures identified approximately 10% of the sample to be at-risk; however, at-risk measures were more prevalent among the oldest-old (aged 85+). At-risk energy intake was identified in half the women, with a larger percentage of young-old (aged 65--74) compared to the old-old (aged 75--84) and oldest-old found with at-risk energy intake. At-risk protein intake was present in 9% of the women. Assessing inadequate nutrient intake as <75% of recommended levels for nine nutrients, cumulative risk totals showed that 33% of the women consumed ≥ 4 nutrients at inadequate levels, but this percentage dropped to 13% for ≥ 5 nutrients. Overall, at-risk energy and protein intakes were predictive of anthropometric measures;Overall, the DETERMINE checklist was a poor predictor of at-risk nutritional status. A score of ≥ 6 on the DETERMINE checklist only identified those with an at-risk mid-arm circumference and was not predictive of cumulative at-risk nutrient intake. Four questions predicted at-risk anthropometric measures: having an illness; eating few fruits, vegetables, or dairy products; involuntary weight change; and inability to shop, cook, and feed oneself. Three questions predicted cumulative at-risk nutrient intake: eating few fruits, vegetables, or dairy products; eating alone; and involuntary weight change;Cohort differences were evident. For the oldest-old, having an illness, a ten pound weight change, or a score of ≥ 6 on the DETERMINE checklist identified those who were more likely to have at-risk anthropometric measures. In the young-old group, eating alone predicted at-risk triceps skinfold measures;Social factors did little to help predict nutritional risk overall. For the young-old, attendance at a senior center, having contact with others besides family, and living with someone reduced the likelihood of at-risk protein and energy intake.