Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

Abstract

Objectives: To evaluate the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) with regard to validity using a combination of anthropometric and serum-protein measurements as standard criteria to assess protein-energy malnutrition (PEM). Design: Cross-sectional study with consecutive selection of residents aged ! 65 y. Setting: A municipality in the south of Sweden. Subjects: During a year, starting in October 1996, 148 females and 113 males, aged ! 65 -104 y of age, newly admitted to special types of housing for the elderly, were included in the study. Results: According to SGA, 53% were assessed as malnourished or moderately malnourished on admission. The corresponding figure from MNA was 79% malnourished or at risk of malnutrition. Both tools indicated that anthropometric values and serum proteins were significantly lower in residents classified as being malnourished (P < 0.05). Sensitivity in detecting PEM was in SGA 0.93 and in MNA 0.96 and specificity was 0.61 and 0.26, respectively. Using regression analysis, weight index and serum albumin were the best objective nutritional parameters in predicting the SGA-and MNA classifications. Item 'muscle wasting' in SGA and 'self-experienced health status' in MNA showed most predictive power concerning the odds of being assessed as malnourished. Conclusions: SGA was shown to be the more useful tool in detecting residents with established malnutrition and MNA in detecting residents who need preventive nutritional measures.

Nutritional assessment interpretation on 22 007 Spanish community-dwelling elders through the Mini Nutritional Assessment test

“…Skin problems, fluid consumption, protein intake and fruits or vegetables intake showed the weakest correlations with the total MNA score. Earlier findings reported similar results, with these items among the questions with the lower correlations (18,36,37) .…”

Malnutrition and associated factors among aged residents in all nursing homes in Helsinki

“…In various institutional settings, the proportion of the resident population suffering from malnutrition has varied between 15 and 71% and the proportion at risk of malnutrition has been between 40 and 60% (Lauque et al, 2000;Van Nes et al, 2001;Christensson et al, 2002;Gerber et al, 2003). In a Swedish study, 33% of the aged residents living in old people's homes that correspond to our nursing homes suffered from malnutrition (Saletti et al, 2000).…”

“…Several studies have shown that aged residents living in institutions suffer from malnutrition (Abbasi & Rudman, 1994;Lamy et al, 1999;Lauque et al, 2000;Van Nes et al, 2001;Christensson et al, 2002;Gerber et al, 2003). In Sweden, one-third of aged residents living in old people's homes were malnourished (Saletti et al, 2000).…”

Nutritional status, well-being and functional ability in frail elderly service flat residents

“…MNA has been developed especially for the elderly (Guigoz et al, 1997), and it was recently reported that MNA classification of geriatric patients was related to anthropometric, body composition and functional measurements (Persson et al, 2002). In a comparison between MNA and SGA, MNA was suggested to be most useful in identifying subjects who need preventive nutritional measures, whereas SGA appeared to be better at detecting residents with established malnutrition (Christensson et al, 2002).…”