Background: Pre-exercise screening is important to identify the fitness level of older adults prior to performing exercise. This study aimed to develop a screening tool for identifying older adults with poor physical fitness prior to exercising.

Method: Participants involved 2315 older adults from four states in Peninsular Malaysia. Several social and health parameters were investigated, and fitness level was assessed using hand grip strength. Receiver operating curve (ROC) analysis was chosen to determine the cut-off point, sensitivity, specificity, positive predictive value (PPV) and Youden`s Index of the screening tool.

Results: Age, sex, waist circumference, hypertension, diabetes mellitus and fasting blood sugar were selected as items of screening tool. The screening tool had sensitivity of 77%, specificity of 80.9%, PPV of 79% and Youden`s Index of 0.579.

Conclusion: This study provides significant findings on the importance of having a pre-exercise screening tool which has good sensitivity, specificity, PPV and Youden`s Index for identification of older adults with poor physical fitness.

Keywords: development; exercise; fitness; older adults; screening tool; Malaysia