Validation of a nutrition and food insecurity scale for older adults

Background Food insecurity among older adults is influenced by financial, physical and functional barriers that may not be captured by existing screening tools. This study validated the Older Adult Food Insecurity Scale (OAFIS), a multidimensional assessment designed specifically for older adults. Methods 72 community-dwelling older adults (66–87 years) from Florida completed the U.S. Department of Agriculture’s Food Security Survey Module (FSSM) and the 22-item OAFIS. Registered dietitian nutritionists conducted comprehensive assessments to classify food security status. Internal consistency, factor structure and criterion-related validity were evaluated. Results The OAFIS demonstrated good internal consistency (Cronbach’s α=0.77) and identified four domains: mobility/physical limitations, access limitations, financial limitations and bodily function issues. OAFIS scores correlated strongly with dietitian assessments (r=0.69) and moderately with FSSM scores (r=0.57). The FSSM explained only 34% of the variance in dietitian-assigned classifications and was associated with financial and access domains but not mobility or bodily function domains. Brief 8-item and 4-item screeners were also developed. Conclusions The OAFIS provides a valid multidimensional measure of food and nutrition insecurity among older adults, capturing important physical and functional barriers overlooked by traditional screening tools. The instrument may improve identification of at-risk older adults in clinical and community settings.