Welcome to the MNA® Literature Database. Here you will find valuable information on the extensive research that supports use of the MNA® in the elderly. Currently there are more than 1100 published research articles that reference the MNA®. Access links to abstracts of all MNA® articles and references cited on the website using the search function, e.g. select “Abstract” and enter a keyword to search abstracts.
Link to details 1188
Title Justificacion y diseno del estudio PICNIC: Programa de IntervenCion Nutricional en pacientes hospitalizados por Insuficiencia Cardiaca desnutridos. [Rationale and design of PICNIC study: Nutritional intervention program in hospitalized patients with
Abstract Introduction and objectives: Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. It is unknown whether a nutritional intervention can modify the prognosis of these patients. The aim of this study is to assess the efficacy of a nutritional intervention on morbidity and mortality in hospitalized patients with heart failure who are malnourished. Methods: PICNIC is a multicentre, randomized, controlled trial in which hospitalized patients with heart failure and malnutrition, as defined by the Mini Nutritional Assessment, are randomly assigned to conventional management of heart failure or conventional management of heart failure and an individualized nutritional intervention consisting of 3 points: optimization of diet, specific recommendations, and prescription, if deemed necessary, of nutritional supplements. A sample size of 182 patients for a maximum follow-up of 12 months has been estimated. The primary endpoint is time to death from any cause or rehospitalization because of heart failure. Analysis is by intention to treat. Conclusions: PICNIC study will determine the prognostic impact of a nutritional intervention in hospitalized patients with heart failure who are malnourished. Full English text available from: www.revespcardiol.org/en. (copyright) 2014 Sociedad Espanola de Cardiologia.
Publication Year 2014
Journals Rev Esp Cardiol.
Startpage Nov 19 [Epub ahead of print]
Doi doi:10.1016/j.recesp.2013.07.014; 10.1016/j.recesp.2013.07.014
Link to details 1189
Title Health status of UK care home residents: a cohort study.
Abstract BACKGROUND: UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. AIM: to describe in detail the health status and healthcare resource use of UK care home residentsDesign and setting: a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration.Method: Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. RESULTS: out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. CONCLUSION: residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.
Publication Year 2014
Journals Age Ageing.
Link to details 1190
Title Retinopathy, nephropathy, peripheral neuropathy and geriatric scale scores in elderly people with Type 2 diabetes.
Abstract Aims: To analyse the relationships between retinopathy, nephropathy, peripheral neuropathy and geriatric scale scores in elderly people with Type 2 diabetes. Methods: GERODIAB is the first French multi-centre, prospective, observational study designed to assess the influence of glycaemic control on mortality and morbidity through a 5-year follow-up study in people with Type 2 diabetes aged 70 years and older. In this report the relationships at baseline between retinopathy, nephropathy and peripheral neuropathy, and five geriatric scale scores in 987 people, using bivariate and multivariate analyses are analysed. Results: Retinopathy (26%) was significantly associated with impaired scores on the Mini Geriatric Depression Scale, the Mini Nutritional Assessment and the Instrumental Activities of Daily Living scale. Logistic regression showed that the duration of diabetes, BMI, Mini Geriatric Depression Scale, hypoglycaemia and HbA1c were associated with retinopathy (concordance 69.1%; P < 0.001). Nephropathy (47.4%, including 34.8% with Modification of Diet in Renal Disease < 60 ml/min) was significantly associated with impaired Activities of Daily Living and Instrumental Activities of Daily Living scale scores. Using the logistic model, the most significant factors were age, duration of diabetes, triglycerides, HDL cholesterol, hypoglycaemia, hypertension and BMI (concordance 66.3%; P < 0.001). Peripheral neuropathy (28.2%) was associated with impaired scores on the Mini Mental State Examination, Activities of Daily Living, Instrumental Activities of Daily Living and Mini Geriatric Depression Scales. In the logistic model, diastolic blood pressure, duration of diabetes and the Instrumental Activities of Daily Living, Mini Geriatric Depression Scale and Mini Mental State Examination scales were included (concordance 69.8%; P < 0.001). Conclusion: In this specific sample, classical microvascular complications of diabetes were found to be associated with impaired geriatric scale scores. This highlights the benefits of systematic assessment in elderly people with Type 2 diabetes. (copyright) 2013 Diabetes UK.
Publication Year 2014
Journals Diabet Med.
Link to details 1191
Title Psychosocial correlates of nutritional status of family caregivers of persons with dementia.
Abstract ABSTRACT Background: This exploratory study investigated the associations of individual characteristics of both persons with dementia and family caregivers with the nutritional status of caregivers. Methods: This cross-sectional study was conducted at home by psychogerontologist within the frame of a community gerontological center in rural areas of south west France. The study participants comprised 56 community-dwelling persons with dementia (mean 80.7 years, SD 6.5) and 56 family caregivers (mean 70.9 years, SD 11.0). Persons with dementia were assessed with Mini-Mental State Examination (MMSE), Basic Activities Of Daily Living (ADL), Instrumental ADL (IADL), and NeuroPsychiatric Inventory (NPI), and family caregivers with the Burden Interview (Zarit scale), the State-Trait Anxiety Inventory (STAI Y-B), the Center for Epidemiologic Studies Depression Scale (CES-D), the emotional impact measure of NPI and the Autonomy, Gerontology and Group Resources scale (AGGIR scale). For both, nutritional status was evaluated using the Mini Nutritional Assessment (MNA(R)). Results: Among family caregivers, 32.1% were at risk of malnutrition and 5.4% were malnourished, and among people with dementia, 58.9% and 23.2%, respectively. NPI severity score of apathy of persons with dementia (Beta = -0.342, p = 0.001), dependency on AGGIR scale (Beta = -0.336, p = 0.002), and CES-D score of caregivers (Beta = -0.365, p = 0.001) were associated with caregivers' MNA score (Adjusted R 2 = 0.480, p < 0.001). Conclusion: These preliminary findings emphasize the need for routine assessment of depressive symptoms, functional and nutritional status in dementia family caregivers, and confirm the value of investigating caregivers' nutritional risk through an integrative view including psychosocial approach.
Publication Year 2014
Journals Int Psychogeriatr.
Doi doi:10.1017/S1041610213001579; 10.1017/S1041610213001579
Link to details 1171
Title Is screening for malnutrition useful in older patients with aggressive haematological malignancies?
Abstract Introduction.- Malnutrition is frequent after the age of 70. It is a common feature in many types of cancer and responsible not only for a poor quality of life and poor treatment response but also for a shorter survival time. Early detection is important to allow targeted interventions. Patients with haematological malignancies have specific challenges associated with eating and nutrition because of the intensive treatments they endure. However, studies focusing on this aspect are scarce. We aimed to establish the usefulness of malnutrition screening in older patients considered for intensive chemotherapy. Methods.- Patients(greater-than or equal to)70 years, with an aggressive haematological malignancy were enrolled. Before the start of therapy a geriatric assessment was completed for each patient. To screen for malnutrition, we used the Mini Nutritional Assessment Short Form (MNA SF). Results.- Fifty patients were included, median age 76 years (range 70-87). Sixteen percent of the patients (n = 8) were malnourished and 66% (n = 33) were at risk. Of the malnourished patients, 50% (n = 4) had a BMI > 23. Apart from their haematological diagnosis, recent weight loss and declined food intake were the main MNA SF parameters predicting (risk of) malnutrition. For 12 patients (29%), (risk of) malnutrition was the only impairment detected by CGA. Conclusion.- Prevalence of (risk for) malnutrition in older patients with aggressive haematological malignancies is high and will further increase once chemotherapy has started. Instead of screening for malnutrition, nutritional assessment by a dietician, individualized dietary advice and follow up during treatment, should become a fundamental item in the treatment plan. [Poster P165, 9th Congress of the European Union Geriatric Medicine Society (EUGMS), Venice, Italy, October 2-4, 2013]
Publication Year 2013
Journals Eur Geriatr Med.
Link to details 1172
Title Malnutrition and associated factors in nursing home residents: A cross-sectional, multi-centre study.
Abstract Background & aims: Malnutrition is a common problem in the elderly living in nursing homes. A clear understanding of associated factors is missing. The aim of this study was to evaluate prevalence of malnutrition and to determine factors independently associated with malnutrition in this setting. Methods: A cross-sectional, multi-centre study was conducted in 23 nursing homes in Flanders, Belgium. The nutritional status was assessed using the Mini Nutritional Assessment (MNA). Data on possible associated factors were collected using validated scales. Results: The study included 1188 elderly residents; 38.7% were at risk for malnutrition and 19.4% were malnourished. The presence of a wound/pressure ulcer, a recent hospitalization (<3 months ago), being involved in a tailored nutritional intervention, and suffering from a lower cognitive state were significantly associated with malnutrition. Receiving additional meals provided by family members was negatively associated with malnutrition. Conclusion: Malnutrition is a prevalent problem in nursing homes in Flanders. Systematic screening and well-defined tailored interventions should be further developed and evaluated in this population at risk. (copyright) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
Publication Year 2013
Journals Clin Nutr.
Link to details 1173
Title Nutritional status in patients with chronic pancreatitis.
Abstract Objective:Chronic pancreatitis (CP) patients have an increased risk of malnutrition. Information about nutritional status of CP outpatients is scarce, and simple, sensitive methods to identify patients at risk are lacking. This explorative cross-sectional study was performed to survey the nutritional status of CP outpatients.Subjects:Fifty patients with chronic or recurrent acute pancreatitis (RAP) had a nutritional assessment performed. Scores on nutritional screening tools and a quality of life questionnaire were assessed. General observations and relations between parameters were described. Results:Thirty-nine patients had CP and eleven patients had RAP. According to the nutritional screening tools, 28-50% of the patients had a moderate or high risk of malnutrition. All domains of the Short Form Health Survey were significantly lowered in CP patients (all P(less-than or equal to)0.001) compared with the Dutch norm values. A considerable number of patients scored below the 5th percentile on anthropometric measures. Mini Nutritional Assessment could not identify all patients with very low anthropometric scores. Substantial weight loss was not a sensitive indicator for functional impairment. Conclusion:CP outpatients are at risk of malnutrition. Currently used screening methods (for example, weight loss) are likely to be not sensitive enough to identify all patients with impaired body composition and restricted function. Therefore, some patients with objective decline in nutritional status will remain unidentified. An extended nutritional assessment is recommendable in CP patients.European Journal of Clinical Nutrition advance online publication, 16 October 2013; doi:10.1038/ejcn.2013.199.
Publication Year 2013
Journals Eur J Clin Nutr.
Link to details 1174
Title Body mass index as a predictor of all-cause mortality in nursing home residents during a 5-year follow-up.
Abstract Background: Body mass index (BMI) is considered a short-term mortality predictor, but a consensus has not been reached on its role and that of other nutritional parameters in predicting long-term mortality in nursing home residents. Objectives: To correlate BMI, Mini Nutritional Assessment scores, and serum albumin levels with the 5-year mortality rate in institutionalized elderly subjects. Methods: A total of 181 nursing home residents aged (greater-than or equal to)70 years were included in a 5-year longitudinal study. Data were collected on all participants' nutritional, health, cognitive, and functional status by means of a comprehensive geriatric assessment. Data on the participants' vital status were obtained 5 years after beginning the study, and a survival analysis was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models. Results: The 5-year mortality rate was 63%. The deceased subjects (n = 115) had a lower BMI (24.7 (plus or minus) 4.6 vs 26.6 (plus or minus) 5.0 kg/m2; P = .03) and Mini Nutritional Assessment score (18.6 (plus or minus) 3.7 vs 20.1 (plus or minus) 3.6; P = .02) than those still alive. Serum albumin levels did not differ between the two groups. Among the three indicators of nutritional status considered in this study, only BMI (greater-than or equal to) 30 kg/m2 was significantly associated with a lower mortality risk at 5 years (hazard ratio = 0.432; 95% CI 0.20-0.70; P = .04), the risk for death being greater the lower the BMI class (log-rank test: P < .001). Conclusions: Our findings suggest that BMI is the best of the three parameters considered as a nutritional predictor of nursing home residents' mortality in the longer term, and indicate that a lower mortality risk coincides with a higher BMI. (copyright) 2013 American Medical Directors Association, Inc.
Publication Year 2013
Journals J Am Med Dir Assoc.
Link to details 1175
Title Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: A cross-sectional study.
Abstract BACKGROUND: Frailty and sarcopenia are frequent conditions in the elderly and are related to inactivity and functionality. However, little is known about the influence of the sarcopenia indicators on the frailty profile or their functional implications. OBJECTIVE: To evaluate whether the indirect indicators of sarcopenia and functionality influence the frailty profile in elderly subjects. METHOD: This was a cross-sectional study with 53 elderly subjects recruited by an active search in a secondary health care service. The indirect indicators of sarcopenia were body mass index (BMI), gait speed, Mini-Nutritional Assessment (MNA), Human Activity Profile (HAP), and handgrip strength. Frailty was characterized according to Fried's Frailty Phenotype. Functional capacity was assessed according to the Short Physical Performance Battery (SPPB). Physical activity level was assessed by HAP. Data were analyzed by analysis of variance (ANOVA) and multiple regression. RESULTS: Overall, 75.5% of the subjects were women, with a mean age of 76.72 (+/-5.89) years; 15.1% were frail and 54.7% pre-frail; and the level of physical activity was the most prevalent indicator of sarcopenia. Significant differences (p<0.05) were observed in both the physical activity level and gait speed between the non-frail and pre-frail groups and between the non-frail and frail groups. In addition, some sarcopenia indicators were associated with functional capacity and geriatric depression score. CONCLUSION: The level of physical activity and gait speed appeared to be the most relevant factors in the development of frailty in the study sample, which may have functional implications.
Publication Year 2013
Journals Braz J Phys Ther.
Doi doi:10.1590/S1413-35552012005000102; 10.1590/S1413-35552012005000102
Link to details 1176
Title Predictive and prognostic value of LPS-stimulated cytokine secretion in metastatic non-small cell lung cancer.
Abstract Objective: Cancer patients usually develop malnutrition which may alter their innate immune system integrity. The aim of this study was to investigate the clinical relevance of chemokine response after lipopolysaccharide (LPS)- stimulation in metastatic non-small cell lung cancer (NSCLC). Methods: Blood samples from metastatic NSCLC patients were incubated with LPS before the onset of systemic therapy. Interleukin (IL)-6 and IL-8 levels at baseline and after LPS-stimulation were measured and the fold change compared to baseline levels was evaluated as the stimulation index for each cytokine per patient. Results were correlated with sex, age, smoking status, histologic subtype, performance status (PS), albumin, Mini Nutritional Assessment (MNA) status and clinical outcomes. Results: Totally 103 patients were evaluated. Mean ((plus or minus)SD) stimulation index was 37.6 ((plus or minus)57.8) for IL-6 and 76.7 ((plus or minus)133.4) for IL-8. The disease control rate after firstline chemotherapy was 44/80 (55 %) and the mean ((plus or minus)SD) progression-free survival (PFS) and overall survival (OS) were 4.2 ((plus or minus)3.9) and 9.2 ((plus or minus)1.1) months, respectively. MNA, PS, albumin, IL-6 and IL-8 stimulation indices were univariately associated with PFS and OS. IL-8 stimulation index emerged as an independent predictor of both PFS and OS, along with PS, and albumin levels. Conclusion: The extent of IL-6 and IL-8 stimulation after ex vivo induction with LPS is an important predictor of clinical outcome in metastatic NSCLC patients. (copyright) Federacion de Sociedades Espanolas de Oncologia (FESEO) 2013.
Publication Year 2013
Journals Clin Transl Oncol.