Nutrition Focused Physical Examination Components Specific to Older Adults: A Modified Delphi Study

ABSTRACT

Background

The number of older adults will double worldwide by 2050, impacting the social system with higher healthcare personnel needs and economic costs. Registered dietitian nutritionists play a critical role in the holistic management of chronic diseases and related nutritional problems. Thereby, a comprehensive nutritional assessment should include a nutrition-focused physical examination (NFPE) to ensure early identification of nutrition-related problems. However, explicit NFPE components across different assessment categories (NFPE+) of the Nutrition Care Process for older adults are lacking.

Methods

This modified Delphi study aimed to identify NFPE+ components specific to older adults (≥ 65 years) through a literature review and to obtain consensus about the relevance and usefulness of these components among international dietitian experts in gerontology nutrition. Experts rated how useful and relevant the identified NFPE+ domains and components were using a 5-point Likert-type scale. Open-ended answers allowed the experts to suggest new components or propose adjustments to the identified components. Consensus was defined a priori at 75% agreement.

Results

The literature review identified 30 NFPE+ components specific to older adults. The Delphi panel comprised of 15 experts from eight countries with 23.5 (±11.5) years of experience in geriatric nutrition. All 30 proposed NFPE+ components and three newly suggested components achieved consensus through two Delphi rounds. These 33 components were categorized into five NFPE+ domains in a finalized NFPE+ tool.

Conclusions

NFPE+ domains and components specific to older adults may significantly contribute to a focused and comprehensive nutritional assessment in older adults.

​Journal of Human Nutrition and Dietetics, Volume 38, Issue 4, August 2025. Read More

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