BSN Tracker

Assessment Tool: DETERMINE Nutritional Health Checklist

Read each item to the patient or have them complete it themselves. Check each item that applies and add the points to find the total nutritional health score. Higher scores indicate greater nutritional risk requiring follow-up action.

DETERMINE Checklist

A 9-item nutritional health checklist for older adults living in the community. Developed by the Nutrition Screening Initiative (1991). The acronym DETERMINE highlights warning signs of poor nutritional health. Total score 0–21; higher scores indicate greater nutritional risk.

Risk interpretation

0–2

Good nutritional health

3–5

Moderate nutritional risk

6+

High nutritional risk

Read each statement to the patient (or have them complete it themselves). Circle the number for each item that applies. Add the circled numbers together to find the total nutritional score.

D – Disease: Do you have an illness or condition that made you change the kind and/or amount of food you eat?

Points if applicable: 2

E – Eating poorly: Do you eat fewer than 2 meals per day?

Points if applicable: 3

T – Tooth loss / mouth pain: Do you have tooth or mouth problems that make it hard for you to eat?

Points if applicable: 2

E – Economic hardship: Do you always have enough money to buy the food you need?

Score 4 if answer is NO

Points if applicable: 4

R – Reduced social contact: Do you eat alone most of the time?

Points if applicable: 1

M – Multiple medicines: Do you take 3 or more different prescribed or over-the-counter drugs per day?

Points if applicable: 1

I – Involuntary weight loss/gain: Have you lost or gained 10 pounds (4.5 kg) or more without wanting to in the last 6 months?

Points if applicable: 2

N – Needs assistance in self-care: Are you not always physically able to shop, cook, and/or feed yourself?

Points if applicable: 2

E – Elder years above age 80: Are you 80 years of age or older?

Points if applicable: 1