nutrients Article Accuracy of the Simpliﬁed Nutritional Appetite Questionnaire for Malnutrition and Sarcopenia Screening among Older Patients Requiring Rehabilitation Akio Shimizu 1,2,3 , Ichiro Fujishima 4 , Keisuke Maeda 2,3, * , Kenta Murotani 5 , Tatsuro Inoue 3,6 , Tomohisa Ohno 7 , Akiko Nomoto 7 , Junko Ueshima 2,8 , Yuria Ishida 2,9 , Ayano Nagano 2,10 , Jun Kayashita 11 and Naoharu Mori 2   Citation: Shimizu, A.; Fujishima, I.; Maeda, K.; Murotani, K.; Inoue, T.; Ohno, T.; Nomoto, A.; Ueshima, J.; Ishida, Y.; Nagano, A.; et al. Accuracy of the Simpliﬁed Nutritional Appetite Questionnaire for Malnutrition and Sarcopenia Screening among Older Patients Requiring Rehabilitation. Nutrients 2021, 13, 2738. https:// doi.org/10.3390/nu13082738 Academic Editors: Giuseppe Sergi and Andrea P. Rossi Received: 23 June 2021 Accepted: 5 August 2021 Published: 10 August 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 Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan; a.shimizu.diet@gmail.com 2 Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan; j.ueshima@gmail.com (J.U.); okuda.yuria.785@mail.aichi-med-u.ac.jp (Y.I.); aya.k.nagano@gmail.com (A.N.); nmori@aichi-med-u.ac.jp (N.M.) 3 Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; tatsuro-inoue@nuhw.ac.jp 4 Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan; ifujishima@sis.seirei.or.jp 5 Biostatistics Center, Kurume University, Kurume 830-0011, Japan; kmurotani@med.kurume-u.ac.jp 6 Department of Physical Therapy, Niigata University of Health and Welfare, Niigata 950-3198, Japan 7 Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8127, Japan; tomohisa@zd5.so-net.ne.jp (T.O.); n.akiko-dent@sis.seirei.or.jp (A.N.) 8 Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Tokyo 141-8625, Japan 9 Department of Nutrition, Aichi Medical University, Nagakute 480-1195, Japan 10 Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya 663-8211, Japan 11 Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima 734-8558, Japan; kayashita@pu-hiroshima.ac.jp * Correspondence: kskmaeda1701@gmail.com; Tel.: +81-561-62-3311; Fax: +81-561-78-6364 Abstract: This cross-sectional study aimed to examine the accuracy of the Simpliﬁed Nutritional Appetite Questionnaire (SNAQ) and the SNAQ for Japanese Elderly (SNAQ-JE) for the Global Leadership Initiative on Malnutrition (GLIM)-deﬁned malnutrition and sarcopenia screening in older persons. We included 380 inpatients aged ≥65 years (mean age, 79.3 ± 7.9; 60.0% women) and admitted to rehabilitation units. Undernutrition and sarcopenia were diagnosed based on GLIM criteria and the Asian Working Group for Sarcopenia, respectively, using bioimpedance analysis. Poor appetite was deﬁned as an SNAQ score of <14 points and an SNAQ-JE score of ≤14 points. The sensitivity, speciﬁcity, and accuracy of these tools for detecting poor appetite for GLIM-deﬁned malnutrition and sarcopenia were assessed. The rates of GLIM-deﬁned malnutrition and sarcopenia were 56.8% and 59.2%, respectively. The number of patients with poor appetite was 94 (24.7%) for the SNAQ and 234 (61.6%) for the SNAQ-JE. The sensitivity and speciﬁcity of the SNAQ measured against GLIM-deﬁned malnutrition were 32.9% and 73.1%, respectively, and against sarcopenia were 29.8% and 70.2%, respectively. The sensitivity and speciﬁcity of the SNAQ-JE measured against GLIM-deﬁned malnutrition were 82.6% and 51.0%, respectively, and against sarcopenia were 86.0% and 53.7%, respectively. The SNAQ-JE showed fair accuracy for GLIM-deﬁned malnutrition and sarcopenia in older patients admitted to rehabilitation units. Keywords: older adults; sarcopenia; malnutrition; poor appetite 1. Introduction Poor appetite in older adults is recognized as a part of geriatric syndromes [1]. Its causes are multifactorial and include age-related physiological changes, morbidity, and Nutrients 2021, 13, 2738. https://doi.org/10.3390/nu13082738 https://www.mdpi.com/journal/nutrients