Publication details

Title
Screening for malnutrition among nursing home residents - A comparative analysis of the Mini Nutritional Assessment, the Nutritional Risk Screening, and the Malnutrition Universal Screening Tool.
Authors
Diekmann,R.;Winning,K.;Uter,W.;Kaiser,M. J.;Sieber,C. C.;Volkert,D.;Bauer,J. M.
Publication Year
2013
Abstract
Background: The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA(registered trademark)), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. Aim: The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. Method: MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Results: Among 200 residents (mean age 85.5 (plus or minus)7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. Conclusion: The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home population, this tool currently appears to be the most suitable one in this setting. (copyright) 2013 Serdi and Springer-Verlag France.
Journals
J Nutr Health Aging.
Volume
17
Issue
4
Startpage
326-
Endpage
331
Booktitle
Editors
City
Publisher
Issnisbn
1279-7077
Reflist
0
Doi
doi:10.1007/s12603-012-0396-2
Pmid
PMID: 23538654
Keywords
aged;article;comparative study;female;follow up;Germany;hazard ratio;hospitalization;human;infection;major clinical study;male;malnutrition;nursing home;nursing home patient;nutritional assessment;nutritional status;predictive value;priority journal;resid????
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