Elsevier

Nutrition

Volume 15, Issue 2, February 1999, Pages 116-122
Nutrition

Applied Nutritional Investigations
The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients

https://doi.org/10.1016/S0899-9007(98)00171-3Get rights and content

Abstract

The Mini Nutritional Assessment (MNA) has recently been designed and validated to provide a single, rapid assessment of nutritional status in elderly patients in outpatient clinics, hospitals, and nursing homes. It has been translated into several languages and validated in many clinics around the world. The MNA test is composed of simple measurements and brief questions that can be completed in about 10 min. Discriminant analysis was used to compare the findings of the MNA with the nutritional status determined by physicians, using the standard extensive nutritional assessment including complete anthropometric, clinical biochemistry, and dietary parameters. The sum of the MNA score distinguishes between elderly patients with: 1) adequate nutritional status, MNA ≥ 24; 2) protein-calorie malnutrition, MNA < 17; 3) at risk of malnutrition, MNA between 17 and 23.5. With this scoring, sensitivity was found to be 96%, specificity 98%, and predictive value 97%. The MNA scale was also found to be predictive of mortality and hospital cost. Most important it is possible to identify people at risk for malnutrition, scores between 17 and 23.5, before severe changes in weight or albumin levels occur. These individuals are more likely to have a decrease in caloric intake that can be easily corrected by nutritional intervention.

Section snippets

Nutrition screening in elderly patients

The prevalence of malnutrition reaches significant levels (15–60%) in elderly patients who are hospitalized, live in nursing homes, or are in home-care programs.7, 8 This condition often goes unrecognized due to the lack of a specific, validated instrument to detect malnutrition in these frail elderly persons. In the past two decades, a number of geriatric assessment instruments have been developed to diagnose and treat high-risk elderly patients. However, too little attention has been given to

The mini nutritional assessment

The development, validation, and cross-validation of a nutritional assessment test, the MNA, was a collaborative research program between the Department of Internal Medicine and Clinical Gerontology, Toulouse University Hospital, France, the Clinical Nutrition Program, University of New Mexico, USA, and the Nestlé Research Center, Lausanne, Switzerland.1, 2, 3 The following requirements are necessary for a simple and rapid evaluation test3: reliable scale; permits definition of thresholds;

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