Simplifier le dépistage de la dénutrition du sujet âgé en médecine générale : test de concordance entre un outil simple, le « Malnutrition Universal Screening Tool » (« MUST ») et le « Mini Nutritional Assessment-Short Form » (« MNA-SF »)

Abstract

ObjectiveThe main goal of this study is to assess how results from two clinical tools, the Mini Nutritional Assessment-Short Form (MNA-SF) and the Malnutrition Universal Screening Tool (MUST), correlate in the framework of nutritional status evaluation of elderly under ambulatory care. Additionally, determinants of nutritional risk have been analyzed. MethodsThe evaluation of a multicentric diagnostic test has been carried out with 81 patients over 70-years-old, while consulting at their general practitioner's office, or at home. For each patient, MUST and MNA-SF scores were calculated and compared with the kappa coefficient. Subjects were classified into two groups according to the absence or presence of nutritional risk. Univariate comparative analyses were realized between MUST and MNA-SF data. ResultsRespectively, MNA-SF and MUST screened 33.3% and 18.5% of the patients at nutritional risk. Consistency between both tools was moderate: κ=0.438±0.2058. Compared with subjects at nutritional risk, patients with a good nutritional status were younger, took less drugs, their body mass index was higher (for a limit at 23), they were less lonely and tended to have a higher weight. ConclusionsMUST isn’t a satisfying screening tool of elderly malnutrition in ambulatory primary care. Thus, MNA-SF remains the gold standard.