Predictive ability of the Mini Nutritional Assessment Short Form (MNA-SF) in a free-living elderly population: a cross-sectional study

Abstract

BackgroundVarious scales have been used to perform a quick and first level nutritional assessment, and the MNA is one of the most used and recommended by experts in the elderly in all areas. This scale has a short form, the MNA-SF, revised and validated in 2009, which has two versions: the BMI-MNA-SF contains the first six items of the full scale including Body Mass Index while the CC-MNA-SF includes Calf Circumference instead of BMI.ObjectiveTo evaluate the predictive ability for nutritional status of the two versions of the MNA-SF against the MNA in free-living elderly in the province of Valencia.MethodsCross-sectional study of 660 free-living elderly in the province of Valencia selected in 12 community centres using stratified sampling by blocks. Inclusion criteria: being aged 65 or over, living at home, having functional autonomy, residing in the province of study for more than one year, regularly attending community centres and voluntarily wanting to take part.ResultsOf the 660 subjects studied, 319 were men (48.3%) and 341 (51.7%) women with a mean age of 74.3 years (SD = 6.6). In terms of nutritional assessment, using the BMI-MNA-SF and the CC-MNA-SF we found that 26.5% and 26.2% were at risk of malnutrition and 0.9% and 1.5% were malnourished respectively. With the full MNA, 23.3% were at risk of malnutrition. Spearman’s rank correlation coefficients indicate a high association between the full MNA score and the MNA-SFs scores (BMI-MNA-SF: ρ = 0.78p < 0.001; CC-MNA-SF: ρ = 0.78p < 0.001). In addition we obtained a very high correlation between the two MNA-SFs (ρ = 0.96p < 0.001). We evaluated the agreement between the full MNA and the MNA-SFs classification in three nutritional categories (normal nutritional status, risk of malnutrition, malnutrition) with Cohen’s kappa coefficients (BMI-MNA-SF: κ = 0.54p < 0.001; CC-MNA-SF: κ = 0.52p < 0.001). These values indicate moderate agreement with the full MNA. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF (κ = 0.88p < 0.001). In order to determine the ability of both MNA-SFs to identify subjects not requiring any nutritional intervention, we considered the dichotomised categorisation of the full MNA and the MNA-SFs as “normal nutritional status” vs. “malnutrition and risk of malnutrition” Areas under the ROC curves using MNA as the gold standard indicate moderately high prognostic accuracy (BMI-MNA-SF: AUC = 0.88p < 0.001; CC-MNA-SF: AUC = 0.87 p < 0.001). Both versions of the MNA-SF showed similar sensitivity, specificity and diagnostic effectiveness (BMI-MNA-SF: 73.4%, 86.6%, 83.5%; CC-MNA-SF 73.4%, 86.2%, 83.2%).ConclusionsIn its two versions the MNA-SF presents useful predictive ability against the MNA. The advantage of the CC-MNA-SF is that using it requires fewer resources and less time in primary care, although always the characteristics of the population must take into account to make the right decision based on the MNA-SF scales.

Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists

“…GA assesses age‐related vulnerabilities or domains that are predictive of morbidity and mortality in older adults with cancer . In our study, GA domains were assessed using validated tools and cutoffs and included comorbidity , functional status , physical performance , cognition , instrumental social support (e.g., someone to help if you were confined to bed) , polypharmacy , psychological health , and nutrition (supplemental online Table 1).…”

Clinical significance of nutritional risk screening for older adult patients with COVID-19

“…Nutrition Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI) are currently commonly used clinical nutrition screening methods [5][6][7][8]. Previous studies have validated the role of these non-disease-specific nutritional risk screening (NRS) tools to identify nutritional risks in hospitalized patients with multiple diseases [9,10]. However, little research had been reported on the use of these NRS tools for a specific disease: COVID-19, which has the potential to put patients at nutritional risk.…”

Wybrane pomiary antropometryczne i MNA (mini nutritional assessment) a niektóre czynniki predykcyjne niedożywienia osób starszych

“…An analysis was performed in correspondence with the MNA, taking into account certain initiating factors of eating disorders in the population of older people. The studies of Montejano Lozoya et al [10] were conducted among 660 seniors staying at home, with the use of a full version of the MNA scale, the MNA-SF and its 2 variations: BMI-MNA-SF and CC-MNA-SF. The average results obtained on the afore-mentioned scales proved high.…”

“…A disordered nutritional status could stem from a range of medical, psychological and social factors [1]. It also pertains to institutionalisation, hospitalisation and inhabiting rural areas, which finds confirmation in a variety of studies [1, 14, Selected anthropometric measurements and mini nutritional assessment in relation to some predictive factors of undernourishment in the elderly which CC may be applied at primary care facilities thanks to the shorter measurement time and a smaller number of devices than in the case of BMI assessment [10]. Similar associations as far as a certain degree of underestimation while using the MNA-SF-CC is concerned are made in the studies conducted by Kaiser et al [19] who assessed 675 senior citizens from various backgrounds, both those staying at rehabilitation centres or nursing homes and those staying at home.…”

“…Even when using the full version of the MNA, if undernourishment or risk of undernourishment is diagnosed, one needs to conduct further biochemical, immunological and anthropometric tests. A single parameter does not ensure accurate nourishment diagnostics [10]. One ought to take into account that the factors of undernourishment in the population of older people are very complex.…”