Nutritional Literacy Assessment In Older Adults: A Scoping Review Of Measurement Tools - Info and Reading Options

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The phenomenon of global population aging has become a prominent challenge of mutual interest . The ageing trend is pervasive, irreversible, and anticipated to prevail for the next two to three decades. According to the predictions made by the World Health Organization (WHO), the number of individuals aged 80 and above from 2020 to 2050 was estimated to be 426 million . With the aging of populations, the importance of nutritional health management in the context of elderly care is set to increase. Research has demonstrated that over 70% of chronic disease etiology is associated with inadequate dietary intake and lifestyle behaviors . Nutritional literacy has been identified as a pivotal factor in the development of disparate dietary patterns and habits . Nutritional literacy is a multidimensional concept that expands upon the concept of health literacy within the sphere of nutrition and wellness. It encompasses the capacity of individuals in accessing and evaluating essential nutritional information and resources, along with their competence in utilizing nutritional knowledge to make informed choices aimed at preserving health, mitigating the risk of conditions such as diabetes and cardiovascular disease, and facilitating the management of chronic ailments . Extensive research has identified a direct correlation between elevated nutritional literacy and the management of diet-related chronic diseases, including obesity, diabetes, and cardiovascular disease . Nutritional literacy has emerged as a key determinant of healthy dietary practices, exerting a positive and distinctive influence on their development . These healthful eating habits not only address nutritional and health requirements but also facilitate social interaction. Conversely, unhealthy eating behaviors, characterized by insufficient intake of vegetables and fruits, and excessive consumption of high-fat, high-sugar and high-energy foods, can adversely impact food selection and intake, potentially leading to various forms of malnutrition, encompassing undernutrition, obesity, and deficiencies in essential vitamins or minerals, and in severe cases, the onset of eating disorders . Surveys have highlighted the notable risk and prevalence of malnutrition among the elderly, closely linked to inappropriate dietary habits . These factors have the potential to contribute to a decline in both physical and psychological functioning in older individuals, significantly impacting disease prognosis. Notably, the presence of nutritional deficiencies among elderly hospitalized individuals has been linked to heightened risks of infection and mortality, prolonged hospitalization, diminished response to pharmaceutical therapy, elevated rates of re-hospitalization and increased healthcare expenditure, thereby placing notable burdens on family members . Japan and the United States have previously directed attention towards the nutritional literacy of older adults, achieving advancements in exploring influencing factors and crafting assessment instruments . However, investigations into nutritional literacy among the elderly in nations like China and Nepal are still nascent. The extant research on the formulation and status of nutritional literacy assessment tools for older populations is insufficient, lacking systematic aggregation and scrutiny. Aziz et al. conducted a systematic review focusing on the utilization of various nutritional assessment instruments, including the MNA, SGA, and GNRI, within the Asian context, with particular emphasis on Malaysia . The researchers evaluated the strengths and weaknesses of each tool. However, the study encompassed a restricted array of tools, the tool analysis was not exhaustive, and the geographical scope was confined to Malaysia, thereby constraining the generalizability of the results. Additionally, Chin et al. conducted a scoping review focusing on assessment tools for general nutrition knowledge among older adults and their caregivers across all care settings. The search was limited to studies or NKAT in English language only. Due to inclusion criteria restrictions, only tools assessing general nutrition knowledge were included. Tools related to other nutrition areas (e.g., nutrition or health literacy, food label understanding, nutrition attitudes, beliefs, and behaviors) and specific topics (e.g., heart disease or protein-energy malnutrition) were excluded. As a result, the scope of the study was relatively narrow. Given the recent emergence of publications on assessment tools related to nutritional literacy, it is imperative to update the reviews of assessment tools in a timely manner. A scoping review was conducted to systematically characterize research in the field and identify existing knowledge gaps. Serving as an evolving research approach, a scoping review can provide a comprehensive picture of the breadth and depth of a particular research area, aiding in the identification of lacunae in current research and guiding future directions . The primary aim of this study was to conduct a scoping review to identify existing evidence from the literature on assessment tools for nutrient literacy among elderly individuals. The review was designed to be exhaustive and methodical, encompassing the retrieval and synthesis of extant studies pertaining to the creation and validation of assessment instruments linked to nutritional literacy in older adults. It aimed to construct a comprehensive knowledge repository on assessment tools for nutrient literacy among elderly individuals by comparing their fundamental attributes, relevance to the target population, and practical utility. This review was intended to provide a reference point for future research.

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