nutrients Article Comparing Assessment Tools as Candidates for Personalized Nutritional Evaluation of Senior Citizens in a Nursing Home Diogo Sousa-Catita 1,2,3, * , Maria Alexandra Bernardo 4 , Carla Adriana Santos 3 , Maria Leonor Silva 4 , Paulo Mascarenhas 4 , Catarina Godinho 2 and Jorge Fonseca 2,3   Citation: Sousa-Catita, D.; Bernardo, M.A.; Santos, C.A.; Silva, M.L.; Mascarenhas, P.; Godinho, C.; Fonseca, J. Comparing Assessment Tools as Candidates for Personalized Nutritional Evaluation of Senior Citizens in a Nursing Home. Nutrients 2021, 13, 4160. https:// doi.org/10.3390/nu13114160 Academic Editor: Jose Lara Received: 25 October 2021 Accepted: 18 November 2021 Published: 20 November 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Residências Montepio—Serviços de Saúde, SA, 1600-131 Lisboa, Portugal 2 Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; cgcgodinho@gmail.com (C.G.); jorgedafonseca@hotmail.com (J.F.) 3 GENE—Artificial Feeding Team, Hospital Garcia de Orta, 2805-267 Almada, Portugal; carla.adriana.santos@hotmail.com 4 Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; abernardo@egasmoniz.edu.pt (M.A.B.); lsilva@egasmoniz.edu.pt (M.L.S.); pmascarenhas@egasmoniz.edu.pt (P.M.) * Correspondence: diogo.rsc2@gmail.com; Tel.: +351-9-1893-5354 Abstract: Nutrition is an important health issue for seniors. In nursing homes, simple, inexpen- sive, fast, and validated tools to assess nutritional risk/status are indispensable. A multisurvey cross-sectional study with a convenient sample was created, comparing five nutritional screen- ing/assessment tools and the time required for each, in order to identify the most useful instrument for a nursing home setting. Nutrition risk/status was evaluated using the following tools: Subjec- tive Global Assessment (SGA), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS 2002), and calf girth (CG). The time spent completing each tool was recorded. Eighty-three subjects were included. MNA-SF and CG were the screening tools that ranked highest with regards to malnutrition identification. CG failed to identify nutritional risk/malnutrition in seniors with lower limb edema. CG was the fastest tool while SGA was the slowest. This was the first study comparing non-invasive nutritional tools with time expended as a consideration in the implementation. CG is responsive, fast, and reliable in elders without edema. MNA-SF was more efficient at detecting malnutrition cases in the elderly population. Both MNA-SF and CG are considered the most suitable for the nursing home setting. Keywords: geriatric; aging; old age; nutritional screening; mini nutritional assessment short form; calf girth 1. Introduction According to the World Health Organization (WHO), the prevalence of malnutrition risk increases with age [1]. In this context, clinical tools have been developed and validated to evaluate nutritional risk and status [2–6]. Multiple tools include clinical, biochemical, and anthropometric parameters. Some of them are especially focused on the elderly [2] while others were created to be used on the general population [3–6]. Nursing homes must deal with large numbers of senior citizens, often with a wide range of pathologic conditions and clinical status, from active aging seniors to very dependent older patients. Studies have reported that malnutrition is directly associated with the functional impairment of senior populations, and nutritional status is indirectly associated with the presence and severity of comorbidities [7,8]. Given the diversity and number of senior citizens that require assessment, nursing homes have a need to identify simple, inexpensive, and fast tools to assess nutritional risk and/or status in order to save time for health professional and reduce inconvenience to the senior population [9]. A previous study compared six Nutrients 2021, 13, 4160. https://doi.org/10.3390/nu13114160 https://www.mdpi.com/journal/nutrients