Quality-of-Life Instruments and Nutrition Screening Tools: Overlaps, Opportunities, and Implications for Healthy Aging in the United States

Abstract

Background Quality of life (QoL) is critical for healthy aging - both for older adults and for healthcare providers/health systems. Eating and nutritious food are essential for older adults to remain healthy/independent and maintain good nutrition status and also provide pleasure and enhance QoL. However, research on nutrition and QoL is limited, including for building understanding of the relationship between nutrition and QoL and of the instruments and tools used to help develop a research framework and evaluate the impact of United States community nutrition programs/services on QoL. Objectives The first objective is to review overlaps/gaps in previously identified/validated QoL instruments and nutrition screening tools used in research with community-living older adults and then, second, to use these findings to suggest opportunities for further research and implications for developing US health and nutrition policies/programs supporting healthy aging. Methods Twenty validated QoL instruments were reviewed to determine if they included nutrition-related items that corresponded to 8 QoL domains (physical health, emotional state, mental health, social connection, environment, personhood, autonomy, and spiritual feeling). Sixteen validated nutrition screening tools were reviewed to determine if any of their nutrition items corresponded with these same 8 QoL domains. Results Of the 20 QoL instruments reviewed, 75% included at least 1 nutrition-related item, most commonly fitting into the autonomy (n = 11), physical health (n = 7), social connection (n = 3), environment (n = 3), emotional state (n = 2), mental health (n = 2), and personhood (n = 1) domains, with none in the spiritual feeling domain. All 16 nutrition screening tools included at least 1 nutrition-related item corresponding to a QoL domain, most commonly the physical health (n = 16) domain. Other QoL domains represented by nutrition items in nutrition screening tools were autonomy (n = 9), emotional state (n = 5), social connection (n = 5), environment (n = 4), and mental health (n = 3). Commonalities existed between QoL instruments and nutrition screening tools in types of nutrition-related items included, but there were many inconsistencies/gaps. Conclusions Nutrition items corresponding to different QoL domains are found inconsistently among validated QoL instruments and nutrition screening tools. Nutrition can be potentially modified to benefit healthy aging and QoL outcomes; findings present opportunities for further research to help increase understanding of the relationship between QoL and nutrition and the effectiveness of nutrition interventions, as well as to help advance US policy development and programs supporting healthy aging.