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 1005
Title Turkish nursing homes and care homes nutritional status assessment project (THN-malnutrition).
Abstract Background and aim: Malnutrition is related with serious morbidity and mortality in institutionalized older adults. The aim of this study is to determine the frequency of malnutrition in nursing homes and care homes and to identify the factors associated with malnutrition in these settings. Methods: This multicenter study was conducted in 14 centers of nursing homes/care homes in three different cities. Total number of 1797 residents aged (greater-than or equal to) 65 years was enrolled. Malnutrition screening was made by Mini Nutritional Assessment Short Form (MNA-SF) and full MNA. Statistical analyses were conducted by SPSS 15.0. Results: The median age (min-max) of the study population was 78.0 (65.0-108.0) and 917 (51%) were female. MNA-SF score of the residents was 11 (0-14). According to the MNA-SF 850 (49.3%) residents had normal nutritional status, 654 (38.3%) residents were at malnutrition risk, and 204 (11.9%) had malnutrition. Number of medications, gender, duration of stay in the institution, frequency of family visits, social security status, type of nursing home (government or not), daily life activities (ADL), Geriatric Depression Scale (GDS) and MMSE scores, get up & go test, hypertension, dementia, depression, and Parkinson disease were associated with malnutrition. Regression analyses revealed that get up&go test, GDS, hypertension, and ADL were independently related to malnutrition diagnosed by MNA-SF. Conclusion: This study provides important information on the prevalence and associated factors of malnutrition in a large multicentered setting of nursing homes and care homes. It will direct the screening plans and interventions taken in order to detect, prevent, and manage malnutrition in these settings. (copyright) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society.
Publication Year 2013
Journals Eur Geriatr Med.
Link to details 1006
Title Altered levels of homocysteine and serum natural antioxidants links oxidative damage to Alzheimer's disease.
Abstract Increasing evidence supports the theory that oxidative stress plays an important role in the pathogenesis of Alzheimer's disease (AD). Homocysteine (Hcy), uric acid (UA), bilirubin, and albumin are simple laboratory parameters that are related to oxidative stress. In this study we compared serum Hcy and antioxidant levels in patients with AD and normal cognitive function. In this cross-sectional study, 143 AD patients and 1,553 patients with normal cognitive function aged 65 years and over were enrolled. Mean values of UA and albumin levels of AD patients were significantly lower than normal cognitive function subjects (p: 0.003 versus p < 0.001, respectively). Mean value of Hcy levels of AD patients was significantly higher than normal cognitive function subjects (p = 0.031). Multivariate regression analysis revealed that Mini-nutritional assessment short form (OR: 0.905, 95% CI: 0.850-0.965, p = 0.002), hypertension (OR: 1.573, 95% CI: 1.148-2.155, p = 0.005), UA (OR: 0.879, 95% CI: 0.788-0.981, p = 0.021), Hcy (OR: 1.040, 95% CI: 1.022-1.059, p < 0.001), and albumin (OR: 0.505, 95% CI: 0.339-0.753, p < 0.001) were independent variables predicting the occurrence of AD. Our study supports the hypothesis that a decrease in antioxidants and an increase in oxidative damage are linked to AD. (copyright) 2013 - IOS Press and the authors. All rights reserved.
Publication Year 2013
Journals J Alzheimer's Dis.
Link to details 1007
Title Fiziksel Tip ve Rehabilitasyon Klininullinde Yatan Yasli Hastalarda Depresyon ve Malnutrisyon Durumlarinin Incelenmesi. [Depression and malnutrition status of hospitalized elderly patients in physical medicine and rehabilitation clinic].
Abstract Objective: In our country, the elderly population is rapidly increasing every year. Mental health and nutritional status of elderly individuals may be related to each other. The aim of this study is to evaluate the depression and malnutrition among the patients aged 65 years and over, who were admitted to the physical medicine and rehabilitation clinic. Materials-Methods: 41 inpatients aged 65 and over in the Istanbul Faculty of Medicine, Deparment of Physical Medicine and Rehabilitation clinic were evaluated. Geriatric Depression Scale (GDS) and Mini Nutritional Assessment (MNA) were used to the determinate the nutritional and depression status. Results: The mean age of 41 patients was 72.14(plus or minus)5.61 (min: 65, max: 90) years. 33 (80.5%) patients were female and 8 (19.5%) were male. 58.5% of the patients, were married, 4.9% were single, 36,6% of the patients lost their husband or wife. 78.2 % of the patients, had three or more children (min: 3, max: 7). In all patients, the median value of GDS was 11 and above, so the patients were evaluated as a possible depression and depressive. According to MNA score, 7.3% of patients had malnutrition, 34.1% had a risk of malnutrition. There was no statistically significant correlation between GDS and MNA scores. Conclusion: The depression and nutritional disorders are often seen together in elderly, but it was determined that they don't affect each other mutually.
Publication Year 2013
Journals Turk Fiz Tip Rehab Derg [Turkish Journal of Physical and Rehabilitative Medicine].
Endpage [Abstract P210, 24th National Physical Medicine & Rehabilitation Congress/Ulusal Fiziksel T?p ve Rehabilitasyon Kongresi, Antalya, Turkey, March 27, 31, 2013]
Link to details 1008
Title Malnutrition as a complication of oropharyngeal dysphagia in specific clinical situations.
Abstract Introduction: Malnutrition is one of the major complications of oropharyngeal dysphagia (OD) but little is known about the characteristics of malnutrition in specific clinical settings. Aim: To compare the nutritional and hydration status of elderly patients with chronic OD and patients with OD and acute complications (pneumonia). Materials and Methods: 3 groups of elderly patients (>70 years) with OD according to the volume viscosity swallow test (V-VST) were studied with an elderly control group without OD (Group D). Group A, with history of aspiration pneumonia (AP); Group (less-than or equal to), without AP history and Group C with acute pneumonia. Screening for malnutrition was performed with the Mini Nutritional Assessment test (MNA(registered trademark)) and assessment with anthropometric characteristics and body composition with bioimpedance (BIA 101). Biochemical markers of malnutrition were also collected. Results: 59 patients were studied, 15 patients in each group (Group C, n = 14). The group of patient with acute pneumonia presented: (a) higher rates of malnutrition according to the MNA (21.4 %) (Group A, 13.3 %; Group (less-than or equal to), 6.7 %; Group D, 0 % (p>0.05); (b) lower albumin and cholesterol levels (p<0.001) and higher PCR (p<0.001); (c) lower BMI (25.4 kg/m2) (p = 0.01); (d) a reduction in basal metabolism (p = 0.04), in muscle mass (p = 0.06) and in fat mass (p = 0.05) and (e) a reduction in intracellular water (p = 0.04). Discussion: Patients with OD are at risk for malnutrition, which is increased in acute conditions such as pneumonia. Screening for malnutrition should be performed on all patients with OD, particularly during an acute infection.
Publication Year 2013
Endpage [Abstract, Oral Presentation 05.03, 2nd Congress of the European Society for Swallowing Disorders (ESSD), Barcelona, Spain, Oct 25-27, 2012]
Link to details 1009
Title Introduction of a tailored enhanced recovery protocol to reduce short-term complications following radical cystectomy and intestinal urinary diversion with vescica ileale padovana (VIP) neobladder.
Abstract INTRODUCTION AND AIM OF THE STUDY: Different fast track programs for patients undergoing radical cystectomy (RC) can be found in the current literature. With the aim at reducing short term complications of radical cystectomy (RC) and intestinal urinary diversion with Vescica Ileale Padovana (VIP) neobladder we described and assessed a tailored enhanced recovery protocol (ERP) in a series of consecutive patients. MATERIALS AND METHODS: After an exhaustive literature research an ERPwas introduced in our institution on December 2010 focusing: on reduced bowel preparation, standardized feeding and analgesic regimens. We analysed the impact of our ERP and report the outcomes with all patients consecutively undergoing RC and VIP neobladder fromDecember 2010 to July 2012 at our Urologic Unit, who met the following inclusion criteria: ASA score (less-than or equal to)T3; absence of malnutrition according to the Mini Nutritional Assessment Short Form (MNA-SF) criteria; absence of inflammatory bowel diseases. RESULTS: The literature search rendered a total of 712 articles related to fast-track surgery, 10655 to enhanced recovery, and 8805 to cystectomy. Combining the search strings we retrieved only 2 cohort studies, and a German review article, used to develop our VIP-neobladder tailored ERP, showed in Table 1. thirty-one consecutive patients undergoing RC and VIP neobladderwith curative intentwere recruited to undergo our ERP. Mean age of patients was 62.16 years with 19.35% of patients older than age 70 years. The mean operating time was 247.10 minutes (range 200-360 minutes). The mean estimated intraoperative blood loss was 633.87 mL (150-2000). No patients died due to surgical complications. Overall 9 of 31 patients experienced complications (29.03%) (table 2), none requiring surgical intervention. We did no record major medical complications. According to Clavien grading, all complications were grade (less-than or equal to)2. Overall, 11 patients (35,4%) obtained normal bowel movements on POD 1, 12 (38.7%) on POD2, and 8 (25.8%) on POD. Bowel functionwas comparable in patients with and without use of chewing gum (table 3). A limitation of our case series is the small number of patients recruited, needing larger and specific case series and randomised controlled trials for finding validation. INTERPRETATION OF RESULTS: To date, fast track programs employed in urological procedures have been rather limited. Moreover comparative data are difficult to find, as many studies are based in the USA, applied different enhanced recovery protocols and are addressed to patients with distinct kinds of urinary diversion, such as with ileal conduit or modified Indiana. Moreover, many studies don't used a standardized classification for complications recording. Our study has the drawback that the analysed patient cohort was too small to assess some perioperative factors predicting the success of a ERP and early postoperative complications. Successful employment of a fast track program applied to our patients undergoing radical cystectomy and VIP neobladder justify the need to designed larger and specific case series and randomised controlled trials to corroborated these preliminary results. CONCLUSIONS: The introduction of our ERP has been proven to be feasible and effective in the management of patients undergoing RC and intestinal urinary diversion with VIP neobladder. The quality of the postoperative course was enhanced by the absence of the nasogastric tube, the control of nausea and vomiting and early postoperative feeding. Postoperative pain relief was managed with well results, making possible an earlymobilization. All these findings led to a more rapid recovery of the bowel function without the occurrence of significant complications. Our protocol was well tolerated. (Table presented).
Publication Year 2013
Journals Neurourol Urodyn.
Endpage S18 [Abstract 20 from the 37th Annual Congress of the Italian Urodynamic Society (Continence, Neuro-Urology, Pelvic Floor) Palazzo della Cultura, Latina, Italy, June 20–22, 2013]
Link to details 1010
Title A high prevalence of malnutrition in acute geriatric patients predicts adverse clinical outcomes and mortality within 12 months.
Abstract Background & aims: Older malnourished patients experience increased length of hospital stay and greater morbidity compared to their well nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 12 months follow-up. Methods: Secondary data analysis of 2602 consecutive patient admissions to an acute tertiary hospital in New South Wales, Australia on or before 1st June 2009. Twelve-month data was analysed in a sub-sample of 774 patients. Nutritional status was determined within 72hof admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records included hospital readmission rate, total length of stay (LOS), change in level of care at discharge, and in-hospital mortality. Results: A third (34%) of patients were malnourished and 55% at risk of malnutrition. Using a Cox proportional hazards regression model, controlling for underlying illness and age, patients at risk of malnutrition were 2.46 (95% CI: 1.36, 4.45; p = 0.003) times more likely to have a poor clinical outcome (mortality/discharge to higher level of care), while malnourished patients had a 3.57 (95% CI: 1.94, 6.59; p = 0.000) times higher risk. Conclusions: A poor nutritional status carries a substantially greater risk of death and/or loss of dependency in older adults. Interventions to improve the nutritional status of patients during their hospital stay, and following discharge back to the community, are needed to lower the risk of adverse outcomes. (copyright) 2013 European Society for Clinical Nutrition and Metabolism.
Publication Year 2013
Journals e-SPEN J.
Link to details 1011
Title It could probably help someone else but not me: A feasibility study of a snack programme offered to meals on wheels clients.
Abstract Objectives: Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia. Participants: A convenience sample of 12 MOW clients. Intervention: Participants received snacks five times a week, in addition to their usual MOW order, for four weeks. Measurements: Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified. Results: Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477)/day) and protein (+7.2 ((plus or minus)14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P <0.05). Mean body weight increased from 67.1 ((plus or minus)14.3) to 67.8 ((plus or minus)14.8) (P= 0.008), while Body Mass Index (BMI) increased by a mean of 0.78 ((plus or minus)1.16) kg/m2 (P = 0.039). Only half of participants indicated interest in continuing with the program. Reasons included the role of snacks serving as a reminder to eat, as well as their perceived nutritional value. Identified barriers included perceived lack of need for additional food, ability to self-provide such items, and a perceived adequate health status. Conclusion: Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them. (copyright) 2013 Serdi and Springer-Verlag France.
Publication Year 2013
Journals J Nutr Health Aging.
Link to details 1012
Title Relationship of serum homocysteine level with nutritional status and HbA1c level in elderly inpatients.
Abstract Background: Hyperhomocysteinemia is a risk factor for vascular diseases. This study aimed to investigate the serum total homocysteine (tHcy) level and nutritional status in elderly inpatients and determine the relationship between tHcy level and nutritional status. Methods: This cross sectional study was carried out in the Tongji hospital, and 142 subjects were consecutively recruited. Fasting blood was collected, and the liver and kidney function, blood glucose, glycosylated hemoglobin (HbA1c), plasma protein, lipid profile, folic acid, vitamin B12 and serum total tHcy were measured. Anthropometric measurements, grip strength and the shortened MNA form (MNA-SF) were used to assess the nutritional status. Results: Undernutrition was common in this population. Based on MNA-SF scores, 34.2% of subjects were at risk of malnutrition, and malnourished subjects accounted for 4.9%. The mean tHcy was 14.10(plus or minus)5.46 (mu)mol/l, and the prevalence of hyperhomocysteinemia was 32.4% (46/142). Hyperhomocysteinemia was a risk factor of cerebral infarction (RR=1.636, 95% CI: 1.169-2.288); Serum tHcy was negatively correlated with serum folic acid, vitamin B12 and MNA-SF score (r=-0.348, P=0.000; r=-0.236, P=0.005; r=-0.208, P=0.014), and positively with BMI within normal range (18.5-23.9; r=0.232, P=0.044). Serum tHcy was negatively correlated with HbA1c, (r=-0.196, P=0.021) and positively with serum creatinine (r=0.327, P=0.000), but unrelated to fasting blood glucose (r=-0.098, P=0.250). Multivariate stepwise regression analysis showed serum folic acid, serum creatinine, MNA-SF score and HbA1c were independent determinants of serum tHcy. Conclusion: Elderly subjects have higher serum tHcy level. Compromised renal function, poor nutritional status and lower blood glucose are likely to influence the serum tHcy level.
Publication Year 2013
Journals Int J Clin Exp Med.
Link to details 1013
Title Factors related to high plasma homocysteine level at one year post-stroke in Korean patients with ischemic stroke.
Abstract Background : Despite reports of correlation between homocysteine(Hcy) and 2ndary stroke incidence, many stroke patients still have elevated plasma Hcy post-stroke. This study investigates the changes of Hcy over one year and the related factors to high Hcy including nutrient intakes in stroke patients. Methods: A total of 203 patients with ischemic stroke admitted to the Asan Medical Center were enrolled. Blood samples were collected for Hcy and other biochemical measurements at admission and 1 year post stroke. Personal interview was performed to obtain socio-demographic data. Nutritional status was determined by mini nutritional assessment (MNA). Dietary intakes of the subjects were obtained by 24 hour dietary recall method and were analyzed with CAN pro (3.0 version). Results: The patients with high Hcy (> 15(mu)mol/L) at admission and one year post-stroke were 47(23.2%) and 59(29.1%), respectively. Among the patients with normal Hcy at admission, 36 (23.1%) patients had high Hcy one year post-stroke. The factors related to high plasma Hcy level at admission were male (p=0.048). The factors related to high Hcy one year post-stroke were low plasma folate level (p=0.002), and Vit B12 level (p=0.011), old age (p=0.025), male (p=0.006), and poor nutritional status (p=0.045). Administration of Vitamin and folate (1mg per day) were not related to Hcy level. The patients with elevated Hcy as compared to the patients with normal Hcy one year post- stroke although they all had normal Hcy at admission had low plasma Vit B12 (p=0.009), folate level(p=0.003), and poor nutritional status(p=0.031). And old age (p=0.049), male (p=0.021), and dietary Vit B6 intake (p=.032) were also significantly related to high Hcy one year post-stroke. However, administration of folate (1mg per day), smoking, and exercise were not related to high Hcy. Conclusions: Hyperhomocysteinemia is common in Korean stroke patients 1 year after stroke. Many patients with high Hcy at admission still have elevated Hcy regardless of folate administration. The strategies to decrease Hcy after stroke should include nutritional modifications, particularly so in the male patients with old age.
Publication Year 2013
Endpage [Abstract WP367, Nursing Posters I, International Stroke Conference, Honolulu, Hawai'i, Feb 6-8, 2013]
Link to details 1014
Title Correlation of comprehensive geriatric assessment (CGA) with mortality in elderly patients with lung cancer: A single institution cohort analysis.
Abstract Background: In the last 60 years, >65 y population in Brazil has increased more than eigth-fold, from 1.6 million to more than 13 million people. This shift in demographics has a huge impact in healthcare, specially in oncology. Nevertheless, so far there is no national innitiative focusing oncologic geriatric patients. This study is part of an innitiative to improve oncologic care in geriatric patients in a single institution in Sao Paulo, Brazil. Material and Methods: Since March/12, all patients >70 y admitted at AC Camargo Cancer Center have been submitted to CGA tools: Katz, Lawton, Nutritional Status (Mini nutritional assessment), Depression scales (GDS), comorbidities and polypharmacy analysis. The aims of the study were to assess if CGA could be feasible in daily practice and if it could be useful as a tool in treatment decision making. Statistical analysis used chi-square or Fisher exact tests, when indicated. Survival analysis was performed by Kapplan-Meier curve and group's comparison by the logrank test and Mantel-Cox test. The results here presented refer only to lung cancer patients. Results: From Mar/12 to Feb/13, 73 lung cancer pts were analyzed. Median age at admission was 75 y, 53% male, 47% female. Histology distribution was 57% adenocarcinoma, 22% squamous cell, 12% other non small cell and 9% small cell. Staging distribution was I (10%), II (8%), III (24%), IV (58%). There was an association between mortality and Katz (A vs B/C; p = 0.004), Lawton (27 vs 2; p = 0.44), polypharmacy (<5 vs (greater-than or equal to)5; p = 0.73), age (<79 vs (greater-than or equal to)80; p = 0.95) and sex (male vs female; p = 0.52). Conclusion: In this cohort, the incorporation of CGA tools in daily practice was feasible, able to predict mortality and could be useful in the treatment planning in elderly patients with lung cancer. (Table presented).
Publication Year 2013
Journals Eur J Cancer.
Endpage S341 [Poster 1559, Poster Session: Cancer in the Older Patient, 2013 European Cancer Congress, Amsterdam, The Netherlands, Sept 27-Oct 1, 2013]