Predictive ability of the Mini Nutritional Assessment short-form (MNA-SF) as compared to serum albumin concentration in the community dwelling elders, Meki, East Ethiopia: Cross-Sectional Validation Study

Abstract

Background: Various tools have been used to perform nutritional screening and assessment, and the Mini Nutritional Assessment [MNA] is one of the most widely used and recommended tools in the geriatric population. MNA is available in two lengths: long and short. MNA short-forms, on the other hand, have not been evaluated in Ethiopia. As a result, the purpose of this study was to validate MNA short form against serum albumin concentration in Ethiopian elders. Methods: The community based cross-sectional validation study included 176 elderly people who were recruited at random. Those who had limbs amputated, were bedridden, or had an obvious abnormality were not eligible, a known liver and/or kidney disorder. The original MNA questions were translated into Afan Oromo and Amharic. All translated and pretested MNA questionnaires were administered to each participant. Anthropometrics and albumin levels in the blood were determined. Positive predictive value [PPV] and negative predictive values [NPV] were calculated, as well as reliability, validity, sensitivity, and specificity. A receiver-operating characteristic curve [ROC-curve] study for MNA was used to calculate the area under the curve [AUC] and appropriate cut-off value for predicting malnutrition. Result: A strong association between serum albumin concentration score and MNA-short form score Spearman’s rank correlation coefficients of BMI-MNA-SF 0.526, p 0.05 and CC-MNA-SF 0.501, p 0.05. At 95 percent CI, the agreement between the long and short forms of MNA was found to be a weighted kappa of 0.404[0.288, 0.521] for BMI-MNA-SF and 0.426[0.333, 0.519] for CC-MNA-SF. These results show a moderate agreement with serum albumin concentrations. The BMI-MNA-SF and the CC-MNA-SF have a high level of agreement 0.400. [0.322, 0.478]. Furthermore, high power to distinguish two categories using serum albumin concentration as the gold standard and AUC for BMI –MNA-SF 0.789 [0.722-0.855] and 0.791 [0.726-0.857] for CC-MNA-SF at 95% CI. Diagnostic accuracy for BMI-MNA-SF showed that 37.1% sensitivity, 90.8% specificity, 58.5% PPV, and 80.5% NPV. Similarly, sensitivity 77.5%, specificity of 64.4% PPV 73.7%, and 69.0%, NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 63.64%, and 71.02% for CC-MNA-SF. Conclusion: Both types of MNA-SF have been shown to be effective screening tools as compared to serum albumin concentration levels in the elders in Meki town, East Ethiopia.