Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward

Salvi, F.; Giorgi, Raffaella; Grilli, Annalisa; Morichi, Valeria; Espinosa, Emma; Spazzafumo, Liana; Marinozzi, Maria; Dessı̀-Fulgheri, Paolo

doi:10.1007/bf03324863

Cited by 44 publications

(34 citation statements)

References 26 publications

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“…Poor ADL and IADL status has been found to be correlated with poor nutritional status rated with the MNA in community-living (23) , institutionalised (6,31) and hospitalised elderly (32) . In several studies involving hospitalised or institutionalised elderly, the MNA has also been observed to have a functional status-predictive ability (7,23,24,33) . Cereda et al (33) have shown that the MNA is suitable for grading functional status of institutionalised elderly.…”

Section: Predicting Functional Dependency and Declinementioning

confidence: 98%

Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

Lee

Tsai

2011

Br J Nutr

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Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional statuspredictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the 'Survey of Health and Living Status of the Elderly in Taiwan', a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects ($ 65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes.

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Section: Predicting Functional Dependency and Declinementioning

confidence: 98%

Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

Lee

Tsai

2011

Br J Nutr

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“…Increased risk is associated with cognitive impairment, hospitalisation, poly-pharmacy, older age, history of fractures, malnutrition, low physical activity, lower strength, and depression [41][42][43][44][45][46][47][48][49].Musculoskeletal conditions have long been recognised as a major cause of functional impairment and disability. The total number of disability adjusted life years associated with musculoskeletal conditions worldwide has been estimated as over 30,000,000, and they remain one of the ten leading causes of disability worldwide [50].…”

Section: Functional Decline and Its Role In Frailtymentioning

confidence: 99%

Musculoskeletal health, frailty and functional decline

Milte

Crotty

2014

Best Practice & Research Clinical Rheumatology

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Frailty in older people is associated with a vulnerability to adverse events. While ageing is associated with a loss of physiological reserves identifying those with the syndrome of frailty has the potential to assist clinicians tailor treatments to those at risk of future decline into disability with increased risk of complications, morbidity and mortality. Sarcopenia is a key component of the frailty syndrome and on its own puts older people at risk of fragility fractures however the clinical syndrome of frailty affects musculoskeletal and non musculoskeletal systems. Hip fractures are becoming a prototype condition in the study of frailty. Following a hip fracture many of the interventions are focused on limiting mobility disability and restoring independence with activities of daily living but there are multiple factors to be addressed including osteoporosis, sarcopenia, delirium, weight loss. Established techniques of geriatric evaluation and management allow systematic assessment and intervention on multiple components by multidisciplinary teams and deliver the best outcomes. Using the concept of frailty to identify older people with musculoskeletal problems as at risk of a poor outcome assists in treatment planning and is likely to become more important as effective pharmacological treatments for sarcopenia emerge. This review will focus on the concept of frailty and its relationship with functional decline, as well as describing its causes, prevalence, risk factors and potential clinical applications and treatment strategies. Key wordsFragility fracture, frailty, functional decline, screening, older adult, exercise therapy, dietary therapy Word count 9,401 words (word limit=9,400)

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“…Malnutrition is a common but under-diagnosed condition in older adults that is associated with physical and cognitive decline, 1,2 decreased quality of life, 3 and mortality. 4 Malnutrition disproportionately affects older adults, 5,6 and results from a combination of changes related to aging, comorbidities, medications, and environmental factors influencing the availability and desirability of food and the ability to eat and absorb nutrients.…”

Section: Introductionmentioning

confidence: 99%

Malnutrition Among Cognitively Intact, Noncritically Ill Older Adults in the Emergency Department

Pereira¹,

Bulik

Weaver

et al. 2015

Annals of Emergency Medicine

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Objectives We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk. Methods We conducted a cross-sectional study with random time block sampling of cognitively intact patients aged 65 years and older. Nutrition was assessed using the Mini Nutritional Assessment Short-Form (0–14 scale) with malnutrition defined as a score of 7 or less and at-risk for malnutrition defined as a score of 8–11. The presence of depressive symptoms was defined as a Center for Epidemiological Studies Depression-10 score of 4 or more (0–10 scale). Results Among 138 older adults, 16% (95% Confidence Interval [CI], 10%–22%) were malnourished and 60% (95% CI, 52%–69%) were either malnourished or at-risk for malnutrition. Seventeen of the 22 malnourished patients (77%) denied previously being diagnosed with malnutrition. The prevalence of malnutrition was not appreciably different between males and females, across levels of patient education, or between those living in urban and rural areas. However, the prevalence of malnutrition was higher among patients with depressive symptoms 52%, those residing in assisted living 50%, those with difficulty eating 38%, and those reporting difficulty buying groceries 33%. Conclusion Among a random sample of cognitively intact older ED patients, more than half were malnourished or at-risk for malnutrition, and the majority of malnourished patients had not previously been diagnosed. Higher rates of malnutrition among those with depression, difficulty eating, and difficulty buying groceries suggest the need to explore multifaceted interventions.

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Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward

Abstract: The MNA-SF is a useful screening tool for hospitalized elders at risk of malnutrition. It is associated with poor clinical outcomes and is able to predict functional decline. Together with hypoalbuminemia, it better identifies patients with true protein-energy malnutrition.

Cited by 44 publications

References 26 publications

Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

Musculoskeletal health, frailty and functional decline

Malnutrition Among Cognitively Intact, Noncritically Ill Older Adults in the Emergency Department

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