[Development of a Risk Prediction Model and a Simple Assessment Sheet for Screening Undernutrition Using Factors Related to Food Environment Accessibility among Older Adults Living Alone in Semi-mountainous Areas]

Objectives: In addition to an aging population, the number of single-person households is increasing in semi-mountainous areas. The nutritional status of older adults living alone has also been studied as they are prone to undernutrition. In this study, we aimed to develop a risk prediction model and a simple assessment sheet for screening undernutrition using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.

Methods: This study included 181 participants (36 men, 145 women) living alone in four semi-mountainous areas (mean age, 83.6 years). Factors related to accessibility to the food environment were measured using 30 predefined items. The Mini-Nutritional Assessment Short Form was used for the nutritional status assessment.

Results: An exploratory factor analysis was performed using 30 items of the food environment accessibility, among which, 16 items were extracted. On the basis of the results of a logistic regression analysis using 17 items including age, 10 items were selected to be included in the logistic model to predict the risk of undernutrition. The risk prediction model showed fair discrimination (area under the curve=0.722) and calibration capabilities (Hosme-Lemeshow test, p=0.822). A simple rating sheet was developed using a model to predict undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.

Conclusions: A simple assessment sheet was developed to evaluate the undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.