The SCREEN I (Seniors in the Community: Risk Evaluation for Eating and Nutrition) index adequately represents nutritional risk.

OBJECTIVE: Nutrition risk is a difficult and complex construct to define and measure. Exploratory factor analysis has been completed on SCREEN I, a nutrition risk screening index for community-living seniors. This analysis was completed to confirm this structure and further validate the index as a plausible measure of nutritional risk.

STUDY DESIGN AND SETTING: As part of the Bringing Nutrition Screening to Seniors demonstration project, 1,218 seniors completed SCREEN I. Using structural equation modeling (Amos version 5 software), the original and alternative two-, three-, and four-factor structures were modeled and compared.

RESULTS: The best-fitting model was a four-factor structure based on the original exploratory model. Unlike the original model, however, several SCREEN I items cross-loaded on more than one factor, demonstrating the complexity of the construct 'nutritional risk.'

CONCLUSION: SCREEN I appears to represent adequately the construct 'nutritional risk' with four factors: Food Intake, Physiologic, Adaptation, and Functional. Further work should be conducted to further elucidate the complex nature of 'nutritional risk' by identifying indirect and direct relationships among the screen items and this construct.