Abstract
Malnutrition has many associated physiological and psychological consequences for older adults that can result in reduced quality of life, poor disease outcomes and more frequent and longer hospital stays. Early recognition of malnutrition allows for timely intervention and treatment. There are several screening tools for nutrition risk. The most common one for malnutrition developed and validated for older adults is the short-form of the Mini Nutritional Assessment (MNA-SF). It can be completed in just a few minutes and applied in all health care settings. This systematic review and meta-analysis serves to synthesise the totality of evidence regarding the diagnostic accuracy of the MNA-SF tool compared with the full-form of the Mini Nutritional Assessment (MNA-FF) in older adults for the diagnosis of malnutrition in healthcare settings. Systematic searches of five bibliographical databases will be performed and will include the Pubmed, EMBASE, Cochrane Library, CINAHL and Web of Science to identify all studies that validate the MNA-SF for malnutrition among older adults in healthcare settings. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pre-specified MNA-SF scores will be used to identify patients’ risk of malnutrition. Using data from 2x2 tables, studies will be pooled to generate summary estimates of sensitivity and specificity using a bivariate random effects model. The findings of this systematic review of diagnostic accuracy will provide evidence for healthcare professionals to make informed decisions regarding the optimum use of the MNA-SF as a nutrition risk screening tool to identify malnutrition among older people. Registration details: Prospero registration number CRD42019131847
Highlights
Malnutrition can be described as a condition resulting from a deficit in the uptake or intake of nutrition due to starvation, disease or ageing
This systematic review and meta-analysis will synthesise the totality of evidence regarding the diagnostic accuracy of the Mini Nutritional Assessment - short form (MNA-SF) in older adults when compared to the full form Mini Nutritional Assessment to identify malnutrition
The diagnostic accuracy of the revised MNA-SF17 screening tool for malnutrition will be explored. This will include studies where the MNA-SF is administered by a health professional (e.g., Dietitian, Registered Nurse or others) trained in administering the screening tool to identify older adults who are nourished, at risk of malnutrition or malnourished. It will not include studies where the MNA-SF is self-administered by the patient or carer as it has been shown that the resulting scores differ substantially from those assessed by healthcare professionals[22]
Summary
Malnutrition can be described as a condition resulting from a deficit in the uptake or intake of nutrition due to starvation, disease or ageing. This will include studies where the MNA-SF is administered by a health professional (e.g., Dietitian, Registered Nurse or others) trained in administering the screening tool to identify older adults who are nourished, at risk of malnutrition or malnourished It will not include studies where the MNA-SF is self-administered by the patient or carer as it has been shown that the resulting scores differ substantially from those assessed by healthcare professionals[22]. Extracted study information will include: patient demographics; study setting, design and sample size; patient type (medical, surgical, etc.); administrator of the MNA-SF (dietitian, clinician, registered nurse, etc.); reported clinical findings of weight loss, BMI or reduced muscle mass; number categorised as normal nutritional status, at risk of malnourishment, or malnourished; additional outcome(s) measured and times of measurement; and main conclusion. We expect that the findings of this systematic review will assist in the execution of a pilot and feasibility intervention study of early supported discharge from emergency departments with a patient and public involvement component
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