Full Mini Nutritional Assessment Research Articles

Screening for malnutrition in hospitalised older people: Comparison of the Mini Nutritional Assessment with its short‐form versions

To determine how well the Mini Nutritional Assessment (MNA) Short Form (MNA-SF) performed as a nutritional screening tool when calf circumference replaced body mass index (BMI) as the included anthropometric measurement. A total of 100 patients ≥70years were recruited from a Geriatric Evaluation and Management Unit. Mean age of patients was 85.2 (6.1)years. By the full MNA, 40% of patients were malnourished. The MNA correlated highly with both of its short-form versions (r=0.87 and r=0.90 for the BMI and calf circumference versions, respectively). Both MNA-SF versions also showed high accuracy in identifying malnutrition (auROC values >0.89). The MNA-SF is a rapid and accurate way to screen for malnutrition in hospitalised older adults. Substitution of BMI measurement with the time-efficient calf circumference measurement maintained MNA-SF accuracy. It is recommended that calf circumference measurement be used for nutritional screening by MNA-SF in a hospital setting.

Nutritional Status of Patients withAlzheimer's Disease and Their Caregivers.

Malnutrition is one of the most important conditions that negatively affects the health of elder people, particularly in patients with dementia. To provide an assessment of nutritional status of patients affected by Alzheimer's disease (AD) living at home and of their caregivers by means of Mini Nutritional Assessment (MNA), and to explore the influence of different factors on nutrition. 90 patients affected by AD living at home and 90 age- and sex-matched caregivers were enrolled. Patients and caregivers, coming from an urban-rural fringe of Southern Italy, were assessed using full MNA, Mini-Mental State Examination, Geriatric Depression Scale- short form, Activity of Daily Living, and Instrumental Activities of Daily Living scales. Malnutrition was found with high prevalence in patients affected by AD of different severity (more than 95% of patients were malnourished or at risk of malnutrition), and associated with reduced functional status. An altered nutrition was also recognized with high rate in the group of caregivers (23.3% were malnourished and 41.1% at risk of malnutrition) and the worse nutritional condition was correlated with higher age and lower functional and cognitive status and education. A positive correlation between MNA score of AD patients and caregivers was found. Corrective measures should be taken in order to early identify nutritional deficiencies and risk of malnutrition observed with high rate in both groups of AD patients and their caregivers; in these subjects a nutrition education program and intervention policies are mandatory to restore nutritional status.

How does nutritional state change during a subacute admission? Findings and implications for practice.

Nutritional status influences patients' clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics. A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup. Participants (n=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (n=132), declined for 10.3% (n=22) and improved for 27.7% (n=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169, P=0.002) and higher full MNA score at admission (OR=0.870, P=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (n=46), but there was a decline in mean fat-free mass (-1.1 kg, 95% confidence interval: -0.1 to -2.2 kg, P=0.043, n=24). Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care.

One-Year Mortality in Older Patients with Cancer: Development and External Validation of an MNA-Based Prognostic Score.

PurposeThe MNA (Mini Nutritional Assessment) is known as a prognosis factor in older population. We analyzed the prognostic value for one-year mortality of MNA items in older patients with cancer treated with chemotherapy as the basis of a simplified prognostic score.MethodsThe prospective derivation cohort included 606 patients older than 70 years with an indication of chemotherapy for cancers. The endpoint to predict was one-year mortality. The 18 items of the Full MNA, age, gender, weight loss, cancer origin, TNM, performance status and lymphocyte count were considered to construct the prognostic model. MNA items were analyzed with a backward step-by-step multivariate logistic regression and other items were added in a forward step-by-step regression. External validation was performed on an independent cohort of 229 patients.ResultsAt one year 266 deaths had occurred. Decreased dietary intake (p = 0.0002), decreased protein-rich food intake (p = 0.025), 3 or more prescribed drugs (p = 0.023), calf circumference <31cm (p = 0.0002), tumor origin (p<0.0001), metastatic status (p = 0.0007) and lymphocyte count <1500/mm3 (0.029) were found to be associated with 1-year mortality in the final model and were used to construct a prognostic score. The area under curve (AUC) of the score was 0.793, which was higher than the Full MNA AUC (0.706). The AUC of the score in validation cohort (229 subjects, 137 deaths) was 0.698.ConclusionKey predictors of one-year mortality included cancer cachexia clinical features, comorbidities, the origin and the advanced status of the tumor. The prognostic value of this model combining a subset of MNA items and cancer related items was better than the full MNA, thus providing a simple score to predict 1-year mortality in older patients with an indication of chemotherapy.

The impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe aortic stenosis before aortic valve replacement.

IntroductionSevere aortic stenosis (AS) is associated with the reduction of physical activity and muscle mass and may be associated with decreased appetite.AimTo assess the nutritional status and the impact of nutritional status and appetite on the hospital length of stay and postoperative complications in elderly patients with severe AS before aortic valve replacement.Material and methodsNinety-nine patients (55 male, 44 female; 74.3 ±5.2 years old) with severe AS and an indication for aortic valve replacement (AVR) were included. The nutritional status was assessed by different questionnaires (7-point Subjective Global Assessment Score – 7-SGA, full-Mini Nutritional Assessment – full-MNA) and anthropometric measurements (body mass index (BMI) kg/m2). Body composition was estimated using multi-frequency bioelectrical impedance analysis. Appetite was assessed by the Simplified Nutrition Assessment Questionnaire (SNAQ).ResultsThe average BMI of patients was 28.8 ±5.8 kg/m2. Results of the 7-SGA and f-MNA questionnaires revealed that 39 patients (39.4%) were at risk of malnutrition. The mean SNAQ score was 15.8 ±1.8. The average length of hospital stay was 10 ±5.8 days. There was a positive correlation of LOS with age (r = 0.26, p = 0.03) and a negative correlation with fat mass (kg) (r = –0.28, p = 0.04) and BMI (r = –0.22, p = 0.03). Postoperative complications were observed in 37 patients (37.4%). Patients who developed complications were older and had poorer nutritional status according to the results of the 7-SGA.ConclusionsDespite many patients undergoing AVR being overweight and obese, a considerable proportion displayed clinical signs of malnutrition. The results suggest that an assessment of nutritional status and appetite in this group of patients should be conducted regularly and that the 7-SGA scale could represent a reliable tool to assess malnutrition.

Validity of the portuguese version of the mini nutritional assessment in brazilian elderly.

BackgroundMalnutrition is common and affects negatively the health of the older adult. The Mini Nutritional Assessment (MNA), a nutritional assessment tool allows to identify elders malnourished and at risk of malnutrition. The aim of this study is to validate the Portuguese version of the MNA.MethodsCross-sectional study with 344 Brazilian elderly. The full version of the MNA was performed, also calf circumference (CC), mid arm circumference (MAC) and body fat (BF). Psychometric evaluation was carried out and correlation, diagnostic accuracy and ROC curves were generated.ResultsConstruct validity was supported, all four questionnaire dimensions were evidenced in the Principal Component Analysis and also significant Spearman correlation (P < 0.001) were demonstrated. Criterion validity was also evidenced with relevant sensitivity (MAC = 82.8; CI95% = 64.2-94.2) and specificity (CC = 80.0; CI95% = 74.0-85.1). In the ROC curve AUC was excellent (MAC = 0.832; CI95% =0.785-0.873).ConclusionsThe full MNA demonstrated significant results and sufficient exploratory psychometric properties that supported its validity. It seems to be valid tool to access nutritional status of Brazilian elderly.

Risk for Dysphagia and Nutritional Status in Community-dwelling Elders

Purpose: The aim of this study was to examine risk for dysphagia in community-dwelling elders and to identify the level of risk and factors influencing nutritional status. Methods: During March and April, 2013, face-to-face interviews or self-reports were conducted with 292 elders. The research tools were the Dysphagia Risk Assessment Scale and Full MNA(Mini Nutritional Assessment). Results: The risk for dysphagia had a mean score of 9.23 points and 63.7% of the participants were in the risk group. The mean score for nutritional status was 22.28. Over half of the participants (56.2%) were regarded as being in the risk group for malnutrition, whereas 8.2% were regarded as being in the malnutrition group. In terms of the factors influencing nutritional status, the most significant factor was risk for dysphagia, followed by educational level and calf circumference. Conclusion: The findings indicate that more than half of the community-dwelling elders were at risk for dysphagia or in a state of malnutrition risk. The risk for dysphagia was a major factor influencing nutritional status. Therefore, dysphagia should be considered as a major health problem in older adults and should be assessed and managed early enough to avoid malnutrition.

Mini Nutritional Assessment and short-form Mini Nutritional Assessment can predict the future risk of falling in older adults – Results of a national cohort study

Falling is a major issue in geriatric health. Tools that identify individuals at risk of falling can help reduce the risk of falling. The study aimed to determine whether the full and short-form Mini Nutritional Assessment (MNAs) have the ability to predict the risk of falling in older adults. Subjects were 3118 ≥ 53-year old Taiwanese who completed both the 1999 and 2003 "Taiwan Longitudinal Study on Aging" surveys. We rated these subjects with normalized versions of the MNA and applied the standard cut-offs to define under-nutrition (≤23.5 and ≤11 points, respectively). We used multivariate logistic regression analysis and receiver operating characteristics to evaluate the ability of these tools in predicting the risk of falling three years later. Older adults rated as at risk of malnutrition with the full MNA (OR = 1.87, 95% confidence interval = 1.33-2.63, p < 0.001) or the short-form (1.39, 1.07-1.80, p = 0.014) were associated with increased risk of falling three years later. Both versions significantly predicted the risk of falling and performed slightly better in ≥65-year old persons than in younger (53-64-year old) persons. The short-form performed relatively well compared to the full scale. Results suggest that the full and short-form MNAs, in addition to rating the risk of malnutrition, also predict the risk of falling in older adults. Although the short-form is slightly less effective than the full scale in predicting the future risk of falling, its simplicity, effectiveness and efficiency make it ideal as a multipurpose screening tool in clinical settings.

Full Mini Nutritional Assessment and Prognosis in Elderly Patients with Pulmonary Tuberculosis

Objective: Malnutrition is observed frequently in elderly patients with pulmonary tuberculosis (TB). Full Mini Nutritional Assessment (full MNA) is a useful method of measuring nutrition status for elderly person. The objective of this study is to examine the relationship between full MNA and the mortality of elderly patients with pulmonary TB. Methods: We evaluated 53 elderly patients with pulmonary TB. The nutrition risk assessment was carried out using full MNA. Results: A receiver operating characteristic (ROC) curve was generated for further analysis of the prognostic value of full MNA score. The area under the curve was 0.856 (95% confidence interval [CI], 0.751–0.961). We used the maximum Youden index to obtain optimal cutoff values for full MNA score for prognostic assessment in elderly patients with pulmonary TB. For predicting the risk of mortality, the optimal cutoff value for full MNA score was 13.75. Based on this cutoff value, the Cox proportional hazard model was applied to assess the ability of full MNA score < 14 to predict the prognosis of elderly patients with pulmonary TB. Multivariate analysis identified age (hazard ratio [HR] = 1.114, 95% CI, 1.018–1.219, p = 0.019) and full MNA score < 14 (HR = 9.038, 95% CI, 1.064–76.768, p = 0.044) to be significant independent prognostic factors for survival. Conclusion: Severe malnutrition, as defined by full MNA score < 14, was a predictor of high mortality.

Malnutrition in older adults on financial assistance in an urban Asian country: a mixed methods study.

The objectives of the present study were to assess the nutritional status, identify factors for malnutrition risk and evaluate barriers to adequate nutrition among recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans. Using a cross-sectional study design, we assessed PA recipients' malnutrition risk using the DETERMINE Nutritional Health checklist and the full Mini-Nutritional Assessment (MNA), as well as their nutritional knowledge, co-morbidity burden, depression risk, instrumental and basic activities of daily living (IADL and BADL), and awareness and utilization of available food services. In-depth interviews were also conducted on malnourished individuals (MNA score < 17) to understand barriers to adequate nutrition. Homes of community-living older adults and nursing homes of institutionalized older adults. All PA recipients aged ≥55 years in Central Singapore District. Four hundred and sixty-five of 511 (91·0 %) eligible PA recipients participated in the study. The prevalence of malnutrition in the study population was 2·8 %. However, 50·3 % were at risk of malnutrition. Among community-dwelling respondents, the risk of malnutrition was independently associated with age >75 years, currently unmarried, BADL impairment, depression risk and BMI < 19·0 kg/m2. Qualitative analysis revealed that financial, social and physical barriers and lack of knowledge were the main contributors to poor nutritional status. Only half were aware of subsidized food services and education increased interest in utilizing food services. Among nursing home respondents, those who were BADL impaired were more likely to be at risk of malnutrition. Among PA recipients, the prevalence of malnutrition is low but the risk of malnutrition is high. Education on adequate nutrition and food services are recommended.

Nutritional status predicts preterm death in older people: A prospective cohort study

There is an association between malnutrition and mortality. However, it is uncertain whether this association is independent of confounders. The aim of the present study was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in people 65 years and older. This prospective cohort study included individuals aged ≥65 years who were admitted to hospital between March 2008 and May 2009 and followed-up after 50 months (n = 1767). Nutritional status was assessed with the MNA, and possible risk factors associated with malnutrition were recorded during participants hospital stay. Main outcome measure was overall survival. Based on the MNA definitions, 628 (35.5%) were well-nourished, 973 (55.1%) were at risk of malnutrition, and 166 (9.4%) of the participants were malnourished at baseline. During the follow-up period 655 (37.1%) participants died. At follow-up, the survival rates were 75.2% for well-nourished participants, 60.0% for those at risk of malnutrition, and 33.7% for malnourished participants (p < 0.001). After adjusting for confounders the hazard ratios (95% CI) for all-cause mortality were 1.56 (1.18-2.07) in the group at risk of malnutrition and 3.71 (2.28-6.04) in the malnourished group. Nutritional status defined according to the three categories in the full MNA independently predicts preterm death in people aged 65 years and older. These findings are clinically important and emphasise the usefulness of the MNA for screening of nutritional status.

Associations of social participation, demographic, socioeconomic and disease factors with nutritional risk in a group of older Hong Kong adults

Aims: To identify the impact of social participation, socio-demographic, socio-economic and disease factors on nutritional risk among older persons in Hong Kong. Background: Few published work has investigated the relative risks of social participation, demographic, socioeconomic and disease factors with malnutrition in community-living older people, this study is to investigate the associations of these risk factors on the nutritional status in better nutrition support for the old age group. Design: A crosssectional study. Methods: It was a secondary analysis of a database in a mobile community centre between January 2008 and December 2009. One thousand seven hundred and thirty one participants aged between 54 and 103 were collected. With 319 full Mini Nutritional Assessment (MNA) completed, the participants’ demographic, socio-economic data, diseases, and nutritional status were analyzed with relative risk and 95% confidence interval level to identify the factors that make them vulnerable to nutritional risk. Results: The prevalence of malnutrition in the community-dwelling old was 3.95% and 83.7% of the sample was at risk of malnutrition. Living on allowances, young old who was socially engaged and good relationship with family members were at less risk to malnutrition. Conclusions: Special attention should be taken to these groups as they are prone to develop malnutrition.

A comparison of the full Mini Nutritional Assessment, short-form Mini Nutritional Assessment, and Subjective Global Assessment to predict the risk of protein-energy malnutrition in patients on peritoneal dialysis: A cross-sectional study

BackgroundThe full Mini Nutritional Assessment (full-MNA) and short-form MNA (MNA-SF) are simple and effective nutrition screening scales, but their usefulness for identifying patients with peritoneal dialysis (PD) at risk of protein-calorie malnutrition (PEM) has not been investigated. ObjectivesThis study was aimed to investigate the convergent validity of the full-MNA and MNA-SF for identifying patients with PD at risk of PEM. DesignA cross-sectional study. SettingA hospital-managed dialysis center. Participants80 adult ambulatory PD patients. MethodsPatients were interviewed for personal data and rated with the full-MNA, MNA-SF and the Subjective Global Assessment (SGA) for nutritional status. The consistency among the scales was assessed with kappa coefficients. The ability of each scale to differentiate undernutrition was evaluated with external standards including serum albumin and creatinine concentrations, mid-arm and calf circumferences, and dialysis-related indicators. Statistical significance was evaluated with Wilcoxon rank-sum test. ResultsThe full-MNA and MNA-SF showed low agreements with the SGA (kappa=0.346 and 0.185, respectively). The full-MNA and MNA-SF performed better than the SGA in differentiating undernutrition according to the external standards. However, contrary to general expectation, MNA-SF rated a significantly smaller proportion of subjects at risk of undernutrition. ConclusionThe full-MNA and MNA-SF are more able than the SGA in identifying PD patients at risk of PEM. However, MNA-SF rates a smaller proportion of PD patients at risk of undernutrition than the full-MNA. The use of MNA-SF as a stand-alone unit requires further confirmation.

Frailty and Nutrition: What We Have Learned from Research and Clinical Practice on the Mini Nutritional Assessment.

In this short communication, we review the relationship between frailty and malnutrition risk in the elderly. Frailty is a term used for elderly at increased risk of adverse outcomes, including disability, falls, hospitalization, need for long-term care, and mortality. The Mini Nutritional Assessment (MNA) was designed and validated in a series of studies to assess nutritional status of elderly, as integral part of the comprehensive geriatric assessment, with a 2-steps screening process; when the MNA-SF classify a person at risk, the full MNA should be completed. The MNA and MNA-SF are sensitive, specific, and accurate in identifying nutrition risk. Increased risk of malnutrition, a common condition in the elderly, is closely associated with many potential contributors of frailty. The maintenance of optimal physical and cognitive performances depends on the early screening of critical conditions to develop preventive targeted interventions; the MNA supports such preventive action.

P-462 - Nutritional status of the hospitalized elderly dementia patients and it’s relation with calf circumference

Dementia is a neurological disease mainly characterized by clinically significant cognitive deficit which includes memory. Behavioral changes may occur and lead to an autonomy loss and a decreased capacity to perform daily professional and social activities. Disease-related undernutrition leads to an increased number of clinical complications as with a negative outcome in the physical and psychological status. Hospitalization can worsen the status. The Full Mini Nutritional Assessment (MNA) ® is the golden standard for nutritional status evaluation and it is validated for Alzheimer Disease (AD). Undernutrition in AD patients has been also related to significant weakness, depression, increased susceptibility to other illness. Evaluate the Nutritional Status of the hospitalized elderly dementia patients in the Geriatric Ward - Hospital de Magalhães Lemos and it‘s relation with calf circumference. Cross-sectional study made between February to May of 2011. Full MNA ® was applied. Furthermore, the patients were subjected to weight, height, calf circumference and mid-arm circumference measurements and the body mass index was calculated. 22 patients were evaluated of which 31.8% were male and 68.2% female.Mean age was 74.9 (8.2) years.Full MNA ® revealed that 45.5% of the elderly dementia people were at risk of malnutrition, 4.5% did not show nutritional risk and 50% was malnourished.The calf circumference equal or superior to 31 cm showed to be more representative with 54.5%, while inferior to 31 cm showed 45.5%. This study revealed the major importance of assessing the nutritional status and the need to use the calf circumference as a parameter for that evaluation.

Suitability of the short-form Mini Nutritional Assessment in free-living elderly people in the northwest of Spain.

To evaluate the Mini Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) as screening tools for malnutrition risk and malnutrition in the free-living elderly of northwestern Spain. transversal study. free-living elderly people of northwestern Spain. 728 participants (36.4% men and 63.6% women), the average of age for both genders was 80.7 ± 7.4. according to MNA screening 12.5% subjects were classified as undernutrition (MNA < 17) and 57.5% were at risk for undernutrition (17 ≤ MNA ≤ 23.5). Significant correlations were found between MNA-SF and the full version (r=0.916; p < 0.000). The sensibility and specificity of the MNA-SF for the full MNA version were 81.4% and 92.7%, respectively. The regression analyses showed that weight loss had more influence on the MNA score, followed by the Body Mass Index (BMI), acute illness or psychological stress, mobility, self-perceived health status and neuropsychological problems. These data showed a high prevalence of undernutrition risk among the free-living elderly people in northwestern Spain using the MNA test in two steps. The high sensitivity and specificity of MNA-SF might be sufficient for medical practice to identify patients at undernutrition risk or undernutrition. Generally, the full MNA confirmed the diagnosis for persons identified at risk by the MNA-SF, and planning was needed for nutritional interventions.

Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment

To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA). Retrospective pooled analysis of previously published datasets. Hospital, rehabilitation, nursing home, community. Four thousand five hundred seven people (75.2% female) with a mean age of 82.3. The prevalence of malnutrition in the combined database and in the four settings was examined. Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, 50.5%; hospital, 38.7%; nursing home, 13.8%; community, 5.8%). In the combined database, the "at risk" group had a prevalence of 46.2%. Consequently, approximately two-thirds of study participants were at nutritional risk or malnourished. The MNA has gained worldwide acceptance and shows a high prevalence of malnutrition in different settings, except for the community. Because of its specific geriatric focus, the MNA should be recommended as the basis for nutritional evaluation in older people.

Clinical study of mini-nutritional assessment for older Chinese inpatients.

Malnutrition is a common problem in older patients. Early detection of malnutrition is an important task in clinical practice. The MNA has become an extensively used tool to evaluate nutritional status in European countries and the United States. We evaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) test as screening tools for malnutrition in older Chinese inpatients and focused on finding an optimal cutoff point for MNA total score and MNA-SF score. One hundred eighty-four older Chinese inpatients were enrolled in this study from July to August 2006. Nutritional assessment included MNA, anthropometric measurements, and biochemical markers. According to the original cutoff point of the full MNA, 19.6% of those assessed were malnourished, 53.2% were at risk of malnutrition and 27.2% were well nourished. Correlations were found between MNA, MNA-SF and body mass index, triceps skinfold thickness, serum albumin, lymphocyte count, hemoglobin, lymphocyte ratio. With the most proper cutoff point lower than 19 indicating malnutrition, when using serum albumin (< 35.0 g/L) as the indicator, the sensitivity and specificity of the MNA total score were 0.6286 and 0.7466; when using BMI (< 18.5 kg/m2) as the indicator, the sensitivity and specificity were 0.8636 and 0.7469. The incidence rate of malnutrition was 32.6%. The most proper cutoff point of MNA-SF was lower than 12. The MNA and MNA-SF were useful tools to identify older Chinese inpatients with malnutrition. However, the cutoff point of the MNA should be modulated for this population.

Nutritional assessment interpretation on 22 007 Spanish community-dwelling elders through the Mini Nutritional Assessment test

To evaluate the prevalence of undernutrition among community-dwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region. Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test. Pharmacy offices across the whole country (Spain) were enrolled to recruit participants. A total of 22 007 participants (8014 men and 13 993 women), aged >or=65 years, assessed during the last two months of 2005. According to MNA screening, 4.3 % subjects were classified as undernourished (MNA score <17) and 25.4 % were at risk of undernutrition (MNA score >or=17 to <or=23.5). The MNA short form correlated strongly with the full MNA version (r = 0.85). MNA total score was significantly higher in men than in women (25.4 (sd 3.7) v. 24.6 (sd 3.9); P < 0.001) and lower in the oldest than in the youngest subjects (P < 0.001) in both genders. According to regional distribution, the best nutritional status was found in elderly from the north of Spain excluding the north-west area. Female gender, older age and living in the south half or north-west of the country were associated with higher rates of undernutrition among community-dwelling elderly persons in Spain.

Impact of global and subjective mini nutritional assessment (MNA) questions on the evaluation of the nutritional status: The role of gender and age

Undernutrition is a quite common condition in the elderly, often identified using the mini nutritional assessment (MNA) test. The aim of this research was to study the independent value of the global and the subjective MNA questions to predict undernutrition according to the full MNA score, and to analyze the influence of gender and age on such items. A total of 22,007 Spanish people 65 years of age or older were evaluated using the MNA test. These data were obtained by trained community pharmacists. The subjective assessment was further evaluated on the basis of their sensitivity and specificity, by using receiver operating characteristic (ROC) curves. About 4.3% of the studied population were classified as undernourished according to the full MNA test. The subjective subscore (two questions) presented better predictive value than the global one (six questions). Indeed, 99.5% of subjects detected as well nourished using the MNA test were also correctly classified using only the two subjective questions. In the present study, it was identified that the two subjective MNA questions can be an efficient tool for a quick screening to rule out non undernourished subjects.