An operationalized version of the Mini-Nutritional Assessment Short Form using comprehensive geriatric assessment

Abstract

We sought to operationalize some of the items of the Mini-Nutritional Assessment Short Form (MNA-SF) according to Barthel Index (BI), Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS) scores among older hospitalized patients in order to optimize the concordance of aforementioned tools. In addition, we assessed comparability and interchangeability of operationalized MNA-SF and standard MNA-SF which have not been performed so far. 358 older participants (250 women) aged ≥60 years who were consecutively admitted at geriatric hospital ward were included in this retrospective cross-sectional study. According to MNA-SFstandard, in total study population, the prevalence of the patients at risk of malnutrition and malnourished subjects were 48.6% and 48.9%, respectively. A substantial agreement between MNA-SFstandard and MNA-SFoperationalized, which is based on the items mobility of BI and MMSE score, was observed (k=0.74, P<0.001) whereas including the GDS into model did not show a significant impact on overall agreement in this population (k=0.73, P<0.001). According to the MNA-SFoperationalized, 50.2% and 49.2% were categorized as malnourished and being at risk of malnutrition, respectively. The false positive rate and the false negative rate of the MNA-SFoperationalized vs. MNA-SFstandard was 10% and 12% of the entire population. The MNA-SFoperationalized, which is operationalized with the items mobility of BI and MMSE-score, emerged as a comparable and feasible tool in older hospitalized patients. It identified the high proportion of malnourished or being at risk of malnutrition and revealed a substantial agreement with the MNA-SFstandard.