Clinical Medicine & Physiology
SNAQ Score Calculator: Simplified Nutritional Appetite Questionnaire (Wilson 4-Item)
Screen older adults for anorexia of aging and 6-month involuntary weight loss (>= 5% and >= 10%) using Margaret-Mary G. Wilson et al.’s (2005) 4-item Simplified Nutritional Appetite Questionnaire (SNAQ, 4–20 points; <= 14 risk cutoff).
Catch Anorexia of Aging BEFORE weight loss occurs — in four 1-to-5 Likert questions!
Weight-based screens (like BMI or past weight loss) only fire AFTER lean muscle mass has already been lost! Derived by Margaret-Mary G. Wilson et al. (2005, Am J Clin Nutr, Council on Nutrition Appetite Questionnaire workgroup), the 4-item Simplified Nutritional Appetite Questionnaire (SNAQ) scores each item from 1 (A, worst) to 5 (E, best): (1) My appetite is [1 Very poor .. 5 Very good], (2) When I eat [1 I feel full after only a few mouthfuls .. 5 I hardly ever feel full], (3) Food tastes [1 Very bad .. 5 Very good], and (4) Normally I eat [1 Less than one meal a day .. 5 More than three meals a day].
Summing the 4 items yields a 4-to-20 score where SNAQ <= 14 prospectively predicts >= 5% unintentional body-weight loss within 6 months with ~81.5% sensitivity and ~76.4% specificity (and >= 10% weight loss with ~88.2% sensitivity and ~83.5% specificity in older community/long-term care adults)!
| SNAQ 4-Item Total Score (4 to 20) | Prospective 6-Month Weight-Loss Risk | Clinical Action |
|---|---|---|
| 15 to 20 Points | Low Risk of Weight Loss | Routine periodic appetite & weight monitoring |
| <= 14 Points (Anorexia of Aging Cutoff) | Elevated Risk of >= 5% Weight Loss in 6 Months | Medication review, dental/dysphagia screen, high-density meals |
| <= 12 Points (Severe Appetite Loss) | High Risk of >= 10% Weight Loss in 6 Months | Urgent dietitian intervention & reversible-cause workup |
Total 4-Item Wilson SNAQ Appetite Score (4 to 20 Points)
Validates that all 4 questionnaire responses B2:B5 are integers in 1..5 and returns SUM(B2:B5).
=IF(OR(MIN(B2:B5) < 1, MAX(B2:B5) > 5, INT(B2) <> B2, INT(B3) <> B3, INT(B4) <> B4, INT(B5) <> B5), "Each SNAQ Item Must Be Integer 1 (A) to 5 (E)", SUM(B2:B5))SNAQ 6-Month Involuntary Weight-Loss Risk Stratification (<= 14 Cutoff)
Flags SNAQ <= 14 as Significant Risk of >= 5% 6-Month Weight Loss (noting severe risk when <= 12).
=IF(OR(MIN(B2:B5) < 1, MAX(B2:B5) > 5, INT(B2) <> B2, INT(B3) <> B3, INT(B4) <> B4, INT(B5) <> B5), "Each SNAQ Item Must Be Integer 1 (A) to 5 (E)", IF(SUM(B2:B5) <= 14, "SNAQ <= 14: Significant Risk of >= 5% Weight Loss Within 6 Months", "SNAQ >= 15: Normal Appetite — Low 6-Month Weight-Loss Risk"))Try the example
Use the original values or change them to test your understanding.