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Cited by 24Nutrition and Health in AgingClinical Nutrition and GastroenterologyBody Composition Measurement Techniques

Which are the most efficient items of mini nutritional assessment in multimorbid patients?

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Hengstermann, S., Nieczaj, R., Steinhagen-Thiessen, E., Schulz, R.-J.·2008·The Journal of nutrition, health and aging
DOI 10.1007/bf02982563PMC PMC12892625
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Abstract

OBJECTIVE: The aim of the study was to identify the most significant MNA-items to accelerate the determination of nutritional risk of elderly patients in routine clinical practice in a geriatric hospital. Since MNA requires 10-15 min it is hardly applicable to clinical routine. DESIGN: The study was a cross-sectional study. SETTING: The study centre was an acute geriatric hospital. PARTICIPANTS: In total 808 multimorbid elderly patients were recruited. METHODS: We applied the MNA in 808 (528 f/280 m) geriatric multimorbid patients (78.5+/-8.7f / 74.6+/-9 m yrs) without cognitive impairment 48 h after hospital admission. Admission diagnoses covered orthopaedical (40%), internal (34%) and cerebrovascular (24%) diseases. According to analysis of reliability the consistency of the MNA scale for multimorbid patients has been verified. In preparation for scale reduction a factor analysis was applied. A reduced scale with selected cutoffs was configured and compared with MNA. RESULTS: According to MNA, 15% of patients were well-nourished, 65% at risk of malnutrition and 20% were malnourished. The reliability analyses showed a Cronbach's Alpha of 0.60 that represented a satisfactory result. By means of factor analysis the MNA-items were reduced from 18 to 7 items (weight loss, mobility, BMI, number of full meals, fluid consumption, mode of feeding, health status). with new cutoffs (12.5-15 well-nourished, 9-12 at risk of malnutrition, <9 malnourished). According to the modified MNA (m-MNA) 21.7% of the patients were well-nourished, 54.5% at risk of malnutrition and 21.7% were malnourished. The score of the MNA and m-MNA correlated with r=0.910. Furthermore, there was a strong correlation between MNA and m- MNA group classification of 83%. CONCLUSION: The m-MNA enables a rapid (3 min) and efficient screening of malnutrition in multimorbid geriatric patients. The m-MNA is easy to apply and may also be suitable in multimorbid patients with cognitive dysfunction. Due to the variety of items the m-MNA seems to be superior to other screening tools.

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  • NRS 2002 and MNA-SF are rapid, easily undertaken and show a high degree of content validity and reliability, making them suitable in polymorbid medical inpatients including those with cognitive dysfunction.

    “Both of these tools are rapid, easily undertaken and show a high degree of content validity and reliability, thereby making them suitable in polymorbid medical inpatients including those patients with cognitive dysfunction [26,27].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [26]

    The Discussion (page not provided) says MNA-SF takes under five minutes and preserves diagnostic accuracy. It does not establish high content validity or reliability for MNA-SF, and its conclusion about suitability for patients with cognitive dysfunction concerns the different m-MNA. The paper does not address NRS 2002. (LLM, conf=0.88)

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Cited by

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Authors
Hengstermann, S., Nieczaj, R., Steinhagen-Thiessen, E., & Schulz, R.-J.
Affiliations
Charité – Universitätsmedizin Berlin (DE)
Corresponding author
Schulz, R.-J.
ORCID
Schulz, R.-J.
Venue
The Journal of nutrition, health and aging
Publisher
Elsevier BV
Published
2008-02
Volume
12
Issue
2
Pages
117-122
ISSN
1279-7707 (ISSN-L)
DOI
10.1007/bf02982563
PMC
PMC12892625
OpenAlex
W2050911144
Cited by
24
References
2
Citations by year
2024: 1 · 2023: 2 · 2020: 3 · 2019: 1 · 2017: 1 · 2016: 2 · 2015: 3 · 2013: 1 · 2012: 4
FWCI
1.13
Type
journal article
Language
en
Open access
Licence
Locations
  • The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
Mini Nutritional Assessment, malnutrition screening, multimorbidity, elderly patients, geriatric hospital, scale reduction, factor analysis, nutritional risk, weight loss, mobility (physical function), body mass index, fluid intake, feeding mode, cognitive impairment, screening efficiency, reliability statistics, orthopedic patients, internal medicine patients
MeSH terms
Aged, Cross-Sectional Studies, Factor Analysis, Statistical, Female, Health Status Indicators, Humans, Male, Nutritional Status, Time Factors, Weight Loss, Geriatric Assessment, Nutrition Assessment, Risk Assessment, Malnutrition

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