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 994
Title Ability of different screening tools to predict positive effect on nutritional intervention among the elderly in primary health care.
Abstract Objective: Routine identification of nutritional risk screening is paramount as the first stage in nutritional treatment of the elderly. The major focus of former validation studies of screening tools has been on the ability to predict undernutrition. The aim of this study was to validate Mini Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening 2002 (NRS-2002), Body Mass Index (BMI) <24, and the Eating Validation Scheme (EVS), using published randomized controlled trials of nutritional intervention among old people in primary health care, in order to evaluate whether they were capable of distinguishing those with a positive benefit from those that showed no benefit of nutritional intervention. Methods: The methods used were a literature search; classification of participants with respect to nutritional risk according to the different nutritional screening tools; and validation (i.e., evaluation of whether the different tools were capable of distinguishing those with a positive benefit from those that showed no benefit of nutritional intervention by assessing the positive [PPV] and negative [NPV] predictive values). Results: MNA-SF, NRS-2002, BMI <24 and EVS had the highest PPV (0.75) and EVS the highest NPV (0.74) with regard to function-the primary clinical outcome. Conclusion: Overall EVS seemed most capable of distinguishing those clients and residents with a positive benefit from those that showed no benefit of nutritional intervention. The findings should be confirmed in further validation and intervention studies. (copyright) 2013 Elsevier Inc.
Publication Year 2013
Link to details 995
Title Prevalence and measures of nutritional compromise among nursing home patients: Weight loss, low body mass index, malnutrition, and feeding dependency, a systematic review of the literature.
Abstract Weight loss and poor nutrition have been important considerations in measuring quality of nursing home care since 1987. Our purpose was to examine, synthesize, and provide a systematic review of the current literature on the prevalence and definitions of nutritional problems in nursing home residents. In the fall of 2011, we performed MEDLINE searches of English-language articles published after January 1, 1990. Articles were systematically selected for inclusion if they presented prevalence data for general nursing home populations on at least one of the following: weight loss, low body mass index, Mini-Nutritional Assessment or other measure of malnutrition, poor oral intake, or dependency for feeding. Data on each study, including study author, year, setting, population, type of study (study design), measures, and results, were systematically extracted onto standard matrix tables by consensus by a team of two fellowship-trained medical school faculty geriatrician clinician-researchers with significant experience in long term care. The MEDLINE search yielded 672 studies plus 229 studies identified through related citations and reference lists. Of the 77 studies included, 11 articles provided prevalence data from the baseline data of an intervention study, and 66 articles provided prevalence data in the context of an observational study of nutrition. There is a wide range of prevalence of low body mass index, poor appetite, malnutrition, and eating disability reported among nursing home residents. Studies demonstrate a lack of standardized definitions and great variability among countries. Of all the measures, the Minimum Data Set (MDS) weight loss definition of (greater-than or equal to)5% in 1 month or (greater-than or equal to)10% in 6 months had the narrowest range of prevalence rate: 6% to 15%. Weight loss, as measured by the MDS, may be the most easily replicated indicator of nutritional problems in nursing home residents for medical directors to follow for quality-improvement purposes. Additional studies are needed, reporting the prevalence of the MDS weight loss definition among international nursing home residents. (copyright) 2013 American Medical Directors Association, Inc.
Publication Year 2013
Journals J Am Med Dir Assoc.
Link to details 996
Title Kratka baterie pro testovani fyzicke zdatnosti senioru - Pilotni studie a validizace testu u starsich osob v Ceske republice. [The "short physical performance battery" in the Czech Republic - The pilot and validation study in older persons].
Abstract Introduction: Population ageing increases number of seniors with decline of physical capabilities and functional deficits. Targeted interventions to maintain or increase physical performance are most effective before the development of full frailty, in so-called "pre-frail" period. One of the assessment tools for evaluation of the physical performance and/or frailty in older persons is the "Short Physical Performance Battery" - SPPB. The aim of the study was to introduce the assessment battery to clinical practice in the CR and to evaluate its selected psychometric properties. Method: Original English SPPB was translated into Czech language and back translated to ensure linguistic accuracy. SPPB was applied in the selected sample of older persons and validated against other performance tools for cognition, self-care and nutrition status used in CR and selected psychometric properties evaluated. Results: We examined 145 older persons (108 women, i.e. 74.48% and 37 men, i.e. 25.52%) mean age 80.38 years (54-101 years, SD (plus or minus) 8,47). We found good physical performance in 35 (24.1%) older persons (SPPB 10-12 points), 21 (14.5%) were identified as pre-frail (SPPB 7-9 points) and 89 (61.4%) as frail in high risk of future disability or already disabled (SPPB (less-than or equal to) 6 points). We found statistically significant correlation of global SPPB score with nutritional status (MNA-Short Form), activities of daily living performance (ADL) and cognitive performance (MMSE) - (Spearman orrelation (rho) = 0.51; 0.53 and 0.38 respectively). The Cronbach's (alpha) for SPPB variables scored 0.821, which is consistent with good internal consistency of SPPB battery. When evaluating 3 age groups [(less-than or equal to) 75 years (n = 41), 76-85 (n = 62) and 86-101 years (n = 42)] the most significant correlations were found between SPPB and MNA, ADL and MMSE in the young elderly ((rho) = 0.74, 0.79 and 0.64 respectively) and they diminished with increasing age. Conclusion: We confirmed significant correlations between SPPB and self care activities, cognitive performance and nutritional status and good internal consistency of the battery. SPPB test is simple, easy to perform, with low time and cost requirements. It could be recommended for clinical practice in both community and hospitalized older patients to evaluate their overall physical performance and identify persons at risk of frailty and disability who may profit from targeted interventions.
Publication Year 2013
Journals Vnitr Lek.
Link to details 997
Title Physical performance of older people in the Czech Republic-The pilot and validation study using Short Physical Performance Battery.
Abstract Introduction.- The physical performance is the most reliable health indicator in older people. The important task for geriatric medicine is to detect older individuals in the risk of frailty. Aim and method.- The aim of the study was to translate/backtranslate the Short Physical Performance Battery (SPPB) into Czech language and perform validation and feasibility study in the sample of Czech elderly persons. Correlations of SPPB and cognitive (MMSE), nutritional (MNA) and self-care activities (ADL) were performed, internal consistency of SPPB items was calculated. Results.- The study group included 145 persons, mean age 80.4(plus or minus)8.5 years (74.5%women) in the full range of SPPB score (0-12). The distribution of fit, pre-frail and frail subjects was 24.1%, 14.5% and 61.4% respectively. Statistically significant correlations were found between SPPB scores and MNA, ADL and MMSE - (Spearman correlation (beta)= 0.51, 0.53 and 0.38 respectively, for all P < 0.001). Dividing the whole cohort into 3 age-related groups ((greater-than or equal to)75 years, 76-85 and 86-101 years of age) the most significant correlations were found between SPPB and MNA, ADL and MMSE in the youngest age group ((beta)= 0.74, 0.79 and 0.64 respectively) and diminished with increasing age. The internal consistency was high with Cronbach's (beta)= 0.821. Conclusion.- SPPB seems to be an useful test for comprehensive geriatric evaluation as it provides additional information correlated but not identical to those recommended for geriatric evaluation in the Czech Republic such as cognitive, nutritional and ADLs. It may be used for evaluation of physical performance and as a proxy measure for physical frailty.
Publication Year 2013
Journals Eur Geriatr Med.
Endpage [Poster P214, 9th Congress of the European Union Geriatric Medicine Society (EUGMS), Venice, Italy, October 2-4, 2013]
Link to details 998
Title Nutritional status according to the mini nutritional assessment (MNA(registered trademark)) and frailty in community dwelling older persons: A close relationship.
Abstract Objective: This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. Design: Cross-sectional study. Setting: Community-dwelling older adults were recruited in the region of Nurnberg, Germany. Participants: 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female. Measurements: Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (<17 points) and the risk of malnutrition (17-23.5 points) were determined by MNA(registered trademark). Results: 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p<0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05). Conclusions: These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies. (copyright) 2013 Serdi and Springer-Verlag France.
Publication Year 2013
Journals J Nutr Health Aging.
Link to details 1000
Title Serum trace elements and risk of malnutrition in institutionalised elderly.
Abstract Objective:The objective of this work is to evaluate the association between Selenium (Se)-, Copper (Cu)- and Zinc (Zn)-circulating concentrations and indicators of nutritional status.Subjects/Methods:This study enroled 428 institutionalised elderly. The diagnostic tools used are a form to collect data regarding gender, age, duration of stay in nursing home, number of prescribed drugs, chronic diseases, Mini Nutritional Assessment (MNA), anthropometric measurements, albumin, transferrin and serum concentrations of Se, Cu and Zn. The collected data were analysed with descriptive assessments of the differences (chi) 2, Student's t-test and analysis of variance. Multivariate linear regression were performed to evaluate the association between the concentrations of each trace elements and the other variables.Results:The study population was represented by 327 women and 101 men, of whom 13.8% were 65-75 years old and 47.4% were older than 85 years. According to the MNA score, 58.4% were at risk of malnutrition and 21.3% were malnourished. The results show a significant reduction in the average concentrations of Se and Zn in women when the nutritional status gets worse. The same trend, although not statistically significant, is also observed in men. In both genders, the Cu concentration does not show a statistically significant association with nutritional status. Multivariate linear regression show some positive or negative associations.Conclusions:Our study seems to confirm the association between Se and nutritional status, as well as with some blood chemistry parameters. The length of institutionalisation seems to be an independent predictor of Se concentration. (copyright) 2013 Macmillan Publishers Limited All rights reserved.
Publication Year 2013
Journals Eur J Clin Nutr.
Link to details 1001
Title The transit of the food trolley'- malnutrition in older people and nurses' perception of the problem.
Abstract AIMS: To investigate how the issue of malnutrition in institutionalised older people is perceived by nurses in a Teaching Hospital in Italy and how some aspects that can prevent malnutrition are dealt with. BACKGROUND: Malnutrition in institutionalised older people is still a significant and unresolved problem. Many studies have been published on the inadequacy of nutritional care. Nurses play a strategic and key role in the prevention of malnutrition. Knowing how nurses perceive the problem of malnutrition and how they deal with aspects that can prevent malnutrition can be an important starting point for implementing strategies that will improve overall nutritional care. METHODS: A Focus Group (FGs) study was conducted in a Teaching Hospital in the north-west of Italy with 33 nurses, who were still working or had worked with older people. The FGs were audio-taped and transcribed verbatim. Data collection was stopped when we achieved saturation. Two researchers independently analysed the transcription for content analysis and negotiated the emerging categories. RESULTS: Although nurses perceived malnutrition as a significant issue, it was often considered of secondary importance compared with other aspects of care. Food choice, although available, is often limited to very few options, diets are standardised and monotonous and patients must choose 'sight unseen'. Time constraints and understaffing were the obstacles for the identification of the need for nutritional care. Organisational and managerial decision-making did not ensure the provision of high-quality nutritional care. Patients' nutritional status was often not assessed, and tools such as the Mini Nutritional Assessment were not mentioned by the participants. CONCLUSION: Our study substantially confirmed what is reported in the literature. However, it is necessary to raise nurses' awareness around poor nutritional care to prevent malnutrition in institutionalised older people.
Publication Year 2013
Journals Scand J Caring Sci.
Doi doi:10.1111/j.1471-6712.2012.01043.x; 10.1111/j.1471-6712.2012.01043.x
Link to details 1002
Title The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics.
Abstract BACKGROUND: Lebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of community dwelling elderly people, aged 65 years and above, living in a rural settings in Lebanon, in line of socioeconomic factors, health and living conditions. The present paper will describe the gender specific characteristics of the study population. METHODS: AMEL is a cross-sectional population based study conducted between April 2011 and April 2012 including 1200 elderly individuals living in the 24 rural Caza (districts) of Lebanon. People aged greater than or equal to 65 y were randomly selected through multistage cluster sampling. Subjects were interviewed at their homes by trained interviewers. The questionnaire included the following measures: socio-demographic factors, nutritional status (Mini Nutritional Assessment, MNA), health related characteristics, functional ability, cognitive status, mood and social network. RESULTS: The sample included 591 men (49.3%) and 609 women (50.8%). Mean age was 75.32 years and similar between genders. Malnutrition (MNA < 17) and risk of malnutrition (MNA between 17 and 23.5) were present in 8.0% (4.9%-11.1%) and 29.1% (24.0%-34.2%) respectively of the participants, and more frequent in women (9.1% and 35.3% respectively). Regarding socio-demographic status, among women the level of illiteracy and poor income was significantly higher than in men. Moreover, chronic diseases, poor self perceived health, frailty, functional disability, depressive symptoms and cognitive impairment were particularly high and significantly more frequent in women than in men. CONCLUSION: The present study provides unique information about nutritional status, health and living conditions of community dwelling rural residents of Lebanon. These findings may alert policy makers to plan appropriate intervention in order to improve the quality of life and increase successful aging.
Publication Year 2013
Journals BMC Public Health.
Startpage 573; Jun 12 [Epub ahead of print]
Link to details 1003
Title Inventory of frailty and malnutrition within general practice.
Abstract Introduction.- Little is known about frailty and the nutritional status of frail elderly within the general population. The aim of this inventory was therefore to evaluate frailty and nutritional status among community dwelling elderly within a general practice. Material and methods.- Two general practitioners (GP) selected among all their patients aged over 75 years those who they considered as (possibly) frail. Frailty status in this GP selected group was evaluated by the Tilburg Frailty Index (TFI). (Risk of) malnutrition according to the Mini Nutritional Assessment (MNA) and the correlation between frailty and (risk of) malnutrition was assessed. Results.- Sixty-six (possibly) frail elderly (mean(plus or minus)SD) (age: 83(plus or minus)5 years) were included. Among those, 25 elderly were considered by the GPs as nullfrailnull. Frailty was confirmed by the TFI in 76% (n = 19) of these elderly. Out of the remaining 41 elderly considered as 'possibly frail' by the GP, 44% (n = 18) were frail according to TFI. (Risk of) malnutrition was present in 33% (n = 21) among the (possibly) frail elderly. However, this was recognized in only 56% of the cases by the GPs. There was a significant correlation between frailty (TFI) and (risk of) malnutrition (MNA) (P = 0.007), although the linear relation was limited (R2 = 0.35). Conclusion.- This inventory has shown that frailty is common among community dwelling elderly in general practice. Although nullfrailtynull per se was reasonably well recognized by the GP, they tended to overestimate it. In contrast, the (risk of) malnutrition remained unrecognized in almost half of by the GP selected (possibly) frail elderly.
Publication Year 2013
Journals Eur Geriatr Med.
Endpage [Poster P212, 9th Congress of the European Union Geriatric Medicine Society (EUGMS), Venice, Italy, October 2-4, 2013]
Link to details 1004
Title Validation of mini nutritional assessment scale in peritoneal dialysis patients.
Abstract Introduction: Malnutrition is a negative predictive factor for survival in end stage renal disease (ESRD) patients. Coincidence of malnutrition, inflammation and atherosclerosis (MIA syndrome) in the dialysis population is an exceptionally poor outcome event. Due to flexibility, ease of performance and reproducibility, clinical scales are of particular value in assessment of nutritional status in ESRD patients. The aim of the present study was to evaluate the clinical value of Mini Nutritional Assessment (MNA) in peritoneal dialysis (PD) patients. Material and methods: Nutritional status was assessed in 41 peritoneal dialysis patients by means of the MNA scale and malnutrition inflammation score (MIS). Some other clinical and laboratory parameters associated with nutritional status were analyzed. Patients were followed up for 30 months. Results: In the analyzed group of patients a good nutritional state was diagnosed in 22 patients (54%), risk of malnutrition in 17 (41%) and malnutrition in 2 patients (5%) based on the MNA scale. A strong correlation between MNA based nutritional status and MIS was found (r = -0.85, p < 0.01, ANOVA, p < 0.01). Differences in time on dialysis, body mass index, concentration of albumin, cholesterol and triglycerides were noted between at risk/malnourished and well-nourished (according to MNA) patients. Statistically significant factors determining survival of patients by Cox proportional hazard analysis were age (HR 1.07), being at risk/malnourished according to MNA (HR 5.7), MIS (HR 1.2), and albumin (HR 0.13). Conclusions: The MNA scale is a valuable, clinically suitable tool for assessment of nutritional status in peritoneal dialysis patients. Risk of malnutrition and malnutrition diagnosed by MNA identifies patients at high mortality risk. Copyright (copyright) 2013 Termedia & Banach.
Publication Year 2013
Journals Arch Med Sci.