Cited by 2,751Nutrition and Health in AgingBody Composition Measurement TechniquesClinical Nutrition and Gastroenterology

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Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)

Rubenstein, L. Z., Harker, J. O., Salva, A., Guigoz, Y., Vellas, B.·2001·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

DOI 10.1093/gerona/56.6.m366

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Abstract

BACKGROUND: The Mini-Nutritional Assessment (MNA) is a validated assessment instrument for nutritional problems, but its length limits its usefulness for screening. We sought to develop a screening version of this instrument, the MNA-SF, that retains good diagnostic accuracy. METHODS: We reanalyzed data from France that were used to develop the original MNA and combined these with data collected in Spain and New MEXICO: Of the 881 subjects with complete MNA data, 151 were from France, 400 were from Spain, and 330 were from New MEXICO: Independent ratings of clinical nutritional status were available for 142 of the French subjects. Overall, 73.8% were community dwelling, and mean age was 76.4 years. Items were chosen for the MNA-SF on the basis of item correlation with the total MNA score and with clinical nutritional status, internal consistency, reliability, completeness, and ease of administration. RESULTS: After testing multiple versions, we identified an optimal six-item MNA-SF total score ranging from 0 to 14. The cut-point score for MNA-SF was calculated using clinical nutritional status as the gold standard (n = 142) and using the total MNA score (n = 881). The MNA-SF was strongly correlated with the total MNA score (r = .945). Using an MNA-SF score of > or = 11 as normal, sensitivity was 97.9%, specificity was 100%, and diagnostic accuracy was 98.7% for predicting undernutrition. CONCLUSIONS: The MNA-SF can identify persons with undernutrition and can be used in a two-step screening process in which persons, identified as "at risk" on the MNA-SF, would receive additional assessment to confirm the diagnosis and plan interventions.

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“Malnutrition was assessed by Mini Nutritional Assessment Short Form (MNA-SF), detailed information on drug use was collected.”
MethodInfluential
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Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis
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“Scores range from 0 to 14 points; scores 12 indicate ‘normal nutritional status’, scores 8–11 indicate ‘at risk for malnutrition’, and scores 0–7 indicate ‘malnourishment’ [17,18].”
Background
Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status
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Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) is a valid screening tool in chemotherapy outpatients
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“[7–9]; however, it is the Malnutrition Screening Tool (MST) [7] that is considered the most widely used within the Australian oncology setting.”
Method
How to Try This
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“9 Invalid measurement, n (%) 18 (19) Charlson’s comorbidity index score 2 (1–5) Mini-Mental State Examination score 14 (1–26) Reason for admission, n (%) Respiratory infection 22 (23) Urinary tract infection 1 (1) Gastrointestinal tract disease 28 (29) Liver and pancreas disease 12 (13) Cancer: Non-surgery 9 (10) Canc…”
Influential
Randomized Placebo-Controlled Trial of Nabilone for Agitation in Alzheimer's Disease
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Malnutrition Predicts Infectious and Wound Complications Following Posterior Lumbar Spinal Fusion
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Anorexia and Weight Loss in Older Persons
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Characteristics of the Mini-Nutritional Assessment in elderly home-care patients
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Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults
Ülger, Z., Halil, M. G., Sarı, I. K., Doğu, B. B., Cankurtaran, M., Güngör, A. E., & Arıoğul, S. (2010) · Clinical Nutrition · doi:10.1016/j.clnu.2010.01.006 · Cited by 163
Nutritional assessment interpretation on 22 007 Spanish community-dwelling elders through the Mini Nutritional Assessment test
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The validity of Geriatric Nutrition Risk Index: Simple tool for prediction of nutritional-related complication of hospitalized elderly patients. Comparison with Mini Nutritional Assessment
Abd‐El‐Gawad, W. M., Abou-Hashem, R. M., Maraghy, M. O. E., & Amin, G. E. E.-D. (2014) · Clinical Nutrition · doi:10.1016/j.clnu.2013.12.005 · Cited by 162
Association of modified NUTRIC score with 28-day mortality in critically ill patients
Mukhopadhyay, A., Henry, C. J., Ong, V., Leong, C. S.-F., Teh, A. L., van Dam, R. M., & Kowitlawakul, Y. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2016.08.004 · Cited by 166
The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults
Marshall, S., Bauer, J. D., & Isenring, E. A. (2013) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12167 · Cited by 159
“Similarly, the risk of/malnutrition measured by both the MNA (P = 0.001) and MNA-SF (P = 0.009) was associated with a decreased quality of life, via the Assessment of Quality of Life Instrument, 90 days post-discharge (Neumann et al., 2005).”
Influential
Defining malnutrition: Mission or mission impossible?
Meijers, J. M. M., de van der Schueren, M. A. E., Schols, J. M. G. A., Soeters, P. B., & Halfens, R. J. G. (2009) · Nutrition · doi:10.1016/j.nut.2009.06.012 · Cited by 155
The value of instrumental gait analysis in elderly healthy, MCI or Alzheimer's disease subjects and a comparison with other clinical tests used in single and dual-task conditions
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The role of diet in multiple sclerosis: A review
Esposito, S., Bonavita, S., Sparaco, M., Gallo, A., & Tedeschi, G. (2017) · Nutritional Neuroscience · doi:10.1080/1028415x.2017.1303016 · Cited by 158
Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
Espinosa-Val, M. C., Martín, A., Graupera, M. Y., Arias, O., Elvira, A., Cabré, M., Palomera, E., Bolívar-Prados, M., Clavé, P., & Ortega, O. (2020) · Nutrients · doi:10.3390/nu12030863 · Cited by 164
“On discharge, families and caregivers were given recommendations and advice on fluid adaptation according to the results of the V-VST, a clinical assessment tool that uses three volumes and viscosities in a progression of increased difficulty to assess signs of impaired safety and efficacy of swallow, texture-modified…”
Method
Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients: Implications for oral sarcopenia
Shiraishi, A., Yoshimura, Y., Wakabayashi, H., & Tsuji, Y. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2016.12.002 · Cited by 149
Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients
Poisson, P., Laffond, T., Campos, S. M. S., Dupuis, V., & Bourdel‐Marchasson, I. (2014) · Gerodontology · doi:10.1111/ger.12123 · Cited by 146
Association of Bioelectrical Impedance Analysis–Derived Phase Angle and Sarcopenia in Older Adults
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Differences in Nutrient Intake and Biochemical Nutrient Status Between Sarcopenic and Nonsarcopenic Older Adults—Results From the Maastricht Sarcopenia Study
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Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review
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“• Mean body weight and BMI increased by mean of 0.75 ± 0.80 kg and 0.78 ± 1.16 kg/m2, respectively • Increased mean energy (+415 ± 1477 kJ /day) and protein (+7.2 ± 14.06 g/day) intakes Frailty Cameron et al., 2013 [139] RCT 216 adults meeting FFP criteria (83.3 ± 5.9 years; 32% male) recruited from 16 organisations c…”
Influential
Supplementing Breakfast with a Vitamin D and Leucine–Enriched Whey Protein Medical Nutrition Drink Enhances Postprandial Muscle Protein Synthesis and Muscle Mass in Healthy Older Men
Chanet, A., Verlaan, S., Salles, J., Giraudet, C., Patrac, V., Pidou, V., Pouyet, C., Hafnaoui, N., Blot, A., Cano, N., et al. (2017) · Journal of Nutrition · doi:10.3945/jn.117.252510 · Cited by 149
“Nutritional status was measured using the Mini Nutritional Assessment Short-Form (26).”
Method
Sarcopenia in Korean Community-Dwelling Adults Aged 70 Years and Older: Application of Screening and Diagnostic Tools From the Asian Working Group for Sarcopenia 2019 Update
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Malnutrition and associated factors in nursing home residents: A cross-sectional, multi-centre study
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Association Between Oral Frailty and Nutritional Status Among Community-Dwelling Older Adults: The Takashimadaira Study
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Malnutrition in community-dwelling adults with dementia (Nutrialz Trial)
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Self-citation
Ultrasonography to Measure Swallowing Muscle Mass and Quality in Older Patients With Sarcopenic Dysphagia
Ogawa, N., Mori, T., Fujishima, I., Wakabayashi, H., Itoda, M., Kunieda, K., Shigematsu, T., Nishioka, S., Tohara, H., Yamada, M., et al. (2017) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.11.007 · Cited by 132

Authors: Rubenstein, L. Z., Harker, J. O., Salva, A., Guigoz, Y., & Vellas, B.
Affiliations: University of California, Los Angeles (US)
VA Sepulveda Ambulatory Care Center (US)
Nestlé (Switzerland) (CH)
Corresponding author: Rubenstein, L. Z.
ORCID: Rubenstein, L. Z.
Vellas, B.
Venue: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher: Oxford University Press (OUP)
Published: 2001-06-01
Volume: 56
Issue: 6
Pages: M366-M372
ISSN: 1079-5006 (ISSN-L)
1758-535X
DOI: 10.1093/gerona/56.6.m366
OpenAlex: W2122613011
Cited by: 2,751
References: 14
Citations by year: 2026: 252 · 2025: 266 · 2024: 265 · 2023: 239 · 2022: 252 · 2021: 263 · 2020: 179 · 2019: 143 · 2018: 112 · 2017: 112 · 2016: 109 · 2015: 93 · 2014: 79 · 2013: 61 · 2012: 76
FWCI: 5.19
Type: journal article
Language: en
Open access: closed
Locations: The Journals of Gerontology Series A (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Geriatric Research Education and Clinical Center
VA Greater Los Angeles Healthcare System
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords: Mini Nutritional Assessment, undernutrition screening, nutritional assessment, older adults, elderly nutrition, screening tool development, diagnostic accuracy, two-stage screening
MeSH terms: Aged, Female, Geriatrics, Humans, Male, Mass Screening, Nutrition Disorders, Professional Practice, Nutrition Assessment, Discriminant Analysis

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Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)

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