Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Jean Bachman, PhD


Anne Fish

Kuei-Hsiang Hsueh

Margo-Lea Hurwicz


Abstract Elders living in long-term care facilities often experience weight loss. Weight loss in elders has been shown to increase their risk of death. Existing research has identified numerous factors associated with appetite and weight loss in elders. Dementia, depression, acute and chronic illness, and medications have all been identified as potential causes of decreased appetite and weight loss in elders. Only a few nutritional and appetite assessment tools exist, and these tools are not widely used in long-term care facilities. The purpose of this descriptive study was to validate the Simplified Nutritional Appetite Questionnaire (SNAQ), an appetite assessment tool in long-term care facilities. In addition, the study was designed to explore other potential contributors to poor appetite and weight loss in elders. Included in the study were 92 elders living in four Midwestern long-term care facilities. Participants were weighed and appetite was assessed using the SNAQ monthly. More than 50% of participants scored ≤14 on the SNAQ each month, suggesting poor appetite in this population. Most elders who lost ≥5% of their body weight each month scored ≤14 on the SNAQ. The SNAQ showed poor sensitivity for weight loss ≥5% each month and over 6 months, but high specificity in this population. Initial and sixth month data indicated that Cronbach’s alpha coefficients for the SNAQ would improve from 0.51 to 0.57 and 0.56 to 0.78, respectively, when question 4 was removed. Construct validity was supported by significant correlations with number of diagnoses (r = –.343, p = .001) and dementia (r = .313, p = .01). The present study suggests that illness and medications are important factors in appetite and weight loss in elders living in long-term care facilities. This study supports the SNAQ as a useful tool, but additional studies are needed to further explore the low sensitivity of the SNAQ in this population.

OCLC Number


Included in

Nursing Commons