University of Missouri - Saint Louis

The Graduate School


An oral examination in defense of the dissertation for the degree

Doctor of Philosophy in Nursing

Karene Goodman
MSN in Nursing, 1995, University of Missouri-Columbia
BSN in Nursing, 1990, Drury University-Springfield

Appetite and Weight in Elders Living in Long-term Care Facilities



Elders living in long-term care facilities often experience weight loss. Nutrition and appetite are recognized as important factors in weight maintenance in elders. Weight loss of 5% or more of body weight in 1 month or 10% in 6 months increases an elder’s risk of death. Existing research has identified numerous factors associated with appetite and weight loss in elders. Dementia, depression, 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 Assessment Questionnaire (SNAQ), an appetite assessment tool. In addition, the study was designed to explore other potential contributors to poor appetite and weight loss in elders living in rural Midwestern long-term care facilities. More than 50% of participants scored 14 or less on the SNAQ each month, suggesting poor appetite in this population. Most elders who lost 5% or more of their body weight each month scored 14 or less on the SNAQ. The SNAQ showed poor sensitivity for weight loss in participants of 5% or greater each month, but high specificity in this population. The present study suggests that illness is an important factor in weight loss and appetite in elders living in long-term care facilities. This study supports the use of the SNAQ as a useful tool, but additional studies are needed to further explore the low sensitivity of the SNAQ in this population.


Date: July 18, 2013

Time: 10:00 a.m. to 12:00 p.m.

Place: College of Nursing all Purpose Room


Defense of Dissertation Committee


Jean Bachman, PhD (Advisor)

Anne Fish, PhD


Kuei-Hsiang Hsueh, PhD

Margo-Lea Hurwicz, PhD