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Nutritional Health Test for Seniors

It is all too easy to overlook the warning signs of poor nutritional health in the older person. You can use this tool to calculate a Nutritional Health Score and find out if you or someone you know is at nutritional risk.


I eat at least 3 meals per day.    Yes    No
I eat dairy products most days.    Yes    No
I eat at least 5 servings of vegetables most days.    Yes    No
I have had to change the amount and/or type of food I eat because of an illness or condition that I have.    Yes    No
I have 6 to 8 cups of fluids (eg tea, coffee, water or juice), most days.    Yes    No
I always have enough money to buy food.    Yes    No
I have 3 or more glasses of beer, wine or spirits almost every day.    Yes    No
I eat alone most of the time.    Yes    No
I have teeth, mouth or swallowing problems that make it hard for me to eat.    Yes    No
I take 3 or more different prescribed or over the counter medicines every day.    Yes    No
I am always able to shop, cook and/or feed myself.    Yes    No
I take vitamin supplements.    Yes    No
Without wanting to, I have lost or gained more than 5kg in the last 6 months.    Yes    No
 
   
 
  Your Score:    
 
53 or more   Good!
Check your nutritional score again in about 6 months.
 
49 - 52   You are at moderate nutritional risk.
See what can be done to improve your lifestyle. Your Council on Aging or health care professionals can help. Check your nutritional score again in 3 months.
 
48 or less   You are at high nutritional risk.
Bring this checklist the next time you see your doctor, dietitian or other qualified health or social service professional. Discuss any problems you may have, and ask for their help in improving your nutritional health.
 

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