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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“Recently a more easily administered short form (SF) of the MNA, the MNA-SF, has been introduced (7, 8).”
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Method
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BackgroundMethod
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BackgroundInfluential
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Self-citation
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Method
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Langkamp‐Henken, B., Hudgens, J., Stechmiller, J. K., & Herrlinger‐Garcia, K. A. (2005) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2005.07.005 · Cited by 70
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“The first six items (MNA-SF) can be used for screening purposes.(8) The MNA-SF was recently proposed as a standalone tool by adapting the three-category classification of the long form to the short form.”
Method
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“Median age, years (SD) 53 (22-81) 53 (22-78) 54 (38-81) 0.”
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BackgroundMethod
Assessing the older person: is the MNA a more appropriate nutritional assessment tool than the SGA?
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“Barthel Index, median (25-75 percentile) 65 (36-85) 40 (15-72) <0.”
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“The sensitivity of the MNA-SF ranges from 86% to 100% compared with the full MNA or other nutritional parameters (Cohendy, Rubenstein, & Eledjam, 2001; Rubenstein et al., 2001; Visvanathan et al., 2004).”
Background
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“The MNA-SF consists of six questions on food intake, weight loss, BMI, mobility, psychological stress or acute disease, and neuropsychological problems [8].”
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“The short-form (SF) consisting of 6 items (A-F), first developed in 2001 [24] and revised in 2009 (range 0–14 points; 0–7 points: malnourished; 8–11 points: at risk of malnutrition and 12–14 points: normal nutritional status) [23], and the long-form (LF) or “full MNA” consisting of additional 12 items (G-R) [22, 25] (…”
Background
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Kruizenga, H. M., de Vet, H. C. W., van Marissing, C. M. E., Stassen, E. E. P. M., Strijk, J. E., de van der Schueren, M. A. E., Horman, J. C. H., Schols, J. M. G. A., van Binsbergen, J. J., Eliëns, A., et al. (2009) · The journal of nutrition health & aging · doi:10.1007/s12603-009-0147-1 · Cited by 62
Nutritional status and its effects on muscle wasting in patients with chronic heart failure: insights from Studies Investigating Co-morbidities Aggravating Heart Failure
Saitoh, M., dos Santos, M. R., Ebner, N., Emami, A., Konishi, M., Ishida, J., Valentová, M., Sandek, A., Doehner, W., Anker, S. D., et al. (2016) · Wiener klinische Wochenschrift · doi:10.1007/s00508-016-1112-8 · Cited by 62
Poor Nutritional Status among Low-Income Older Adults: Examining the Interconnection between Self-Care Capacity, Food Insecurity, and Depression
Jung, S. E., Kim, S., Bishop, A. J., & Hermann, J. (2018) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2018.04.009 · Cited by 62
Nutritional management of older adults with cognitive decline and dementia
Ogawa, S. (2014) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12252 · Cited by 63
Self-reported socio-economic status, social, physical and leisure activities and risk for malnutrition in late life: A cross-sectional population-based study
Timpini, A., Facchi, E., Cossi, S., Ghisla, M. K., Romanelli, G., & Marengoni, A. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0286-4 · Cited by 62
Web-Based Multidomain Lifestyle Programs for Brain Health: Comprehensive Overview and Meta-Analysis
Wesselman, L. M. P., Hooghiemstra, A. M., Schoonmade, L. J., de Wit, M. C., van der Flier, W. M., & Sikkes, S. A. M. (2019) · JMIR Mental Health · doi:10.2196/12104 · Cited by 60
“Montreal Cognitive Assessment (MoCA) [75], Token test [76]; Mini Nutritional Assessment Cognition: objective; Lifestyle: measurement and Body measurements — Decrease of cOgnitive decline, malnutRition and sedEntariness by elderly empowerment in lifestyle (MNA) (version not specified) [77]; BMIc, Management and social…”
Background
Cohort Profile: West China Health and Aging Trend (WCHAT)
Hou, L., Liu, X., Zhang, Y., Zhao, W., Xia, X., Chen, X., Lin, X., Yue, J., Ge, N., & Dong, B. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1530-1 · Cited by 60
Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward
Salvi, F., Giorgi, R., Grilli, A., Morichi, V., Espinosa, E., Spazzafumo, L., Marinozzi, M. L., & Dessı̀-Fulgheri, P. (2008) · Aging Clinical and Experimental Research · doi:10.1007/bf03324863 · Cited by 60
Treatment of Sarcopenic Dysphagia with Rehabilitation and Nutritional Support: A Comprehensive Approach
Maeda, K., & Akagi, J. (2015) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2015.09.019 · Cited by 61
Risk of Malnutrition Evaluated by Mini Nutritional Assessment and Sarcopenia in Noninstitutionalized Elderly People
Liguori, I., Curcio, F., Russo, G., Cellurale, M., Aran, L., Bulli, G., Della‐Morte, D., Gargiulo, G., Testa, G., Cacciatore, F., et al. (2018) · Nutrition in Clinical Practice · doi:10.1002/ncp.10022 · Cited by 60
Predicting chemotherapy toxicity in older adults: Comparing the predictive value of the CARG Toxicity Score with oncologists' estimates of toxicity based on clinical judgement
Moth, E. B., Kiely, B. E., Stefanic, N., Naganathan, V., Martin, A. J., Grimison, P., Stockler, M. R., Beale, P. J., & Blinman, P. L. (2018) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2018.08.010 · Cited by 63
Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission
Chatindiara, I., Allen, J. E., Popman, A., Patel, D., Richter, M., Kruger, M. C., & Wham, C. A. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0771-x · Cited by 59
“All assessments were performed per the MNA®-SF user guide [24].”
Method
Associations Between Intrinsic Capacity and Adverse Events Among Nursing Home Residents: The INCUR Study
Sánchez‐Sánchez, J. L., Rolland, Y., Cesari, M., & Barreto, P. D. S. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2021.08.035 · Cited by 59
Malnutrition and nutritional care practices in hospital wards for older people
Vanderwee, K., Clays, E., Bocquaert, I., Verhaeghe, S. T. L., Lardennois, M., Gobert, M., & Defloor, T. (2010) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2010.05531.x · Cited by 58
Potentially Inappropriate Use of Psychotropic Medications in Hospitalized Elderly Patients in France
Prudent, M., Dramé, M., Jolly, D., Trenque, T. C., Parjoie, R., Mahmoudi, R., Lang, P. O., Somme, D., Boyer, F. C., Lanièce, I., et al. (2008) · Drugs & Aging · doi:10.2165/0002512-200825110-00004 · Cited by 59
Cross-sectional study of prevalence of dementia, behavioural symptoms, mobility, pain and other health parameters in nursing homes in Austria and the Czech Republic: results from the DEMDATA project
Auer, S., Höfler, M., Linsmayer, E., Beránková, A., Prieschl, D., Ratajczak, P., Šteffl, M., & Holmerová, I. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0870-8 · Cited by 59
Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study
Madeira, T., Peixoto-Plácido, C., Sousa-Santos, N., Santos, O., Alarcão, V., Goulão, B., Mendonça, N., Nicola, P., Yngve, A., Bye, A., et al. (2018) · Public Health Nutrition · doi:10.1017/s1368980018002318 · Cited by 60
Hospital dental hygienist intervention improves activities of daily living, home discharge and mortality in post‐acute rehabilitation
Shiraishi, A., Yoshimura, Y., Wakabayashi, H., Tsuji, Y., Yamaga, M., & Koga, H. (2018) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.13583 · Cited by 59
Impact of nutritional status according to GLIM criteria on the risk of incident frailty and mortality in community-dwelling older adults
Rodríguez‐Mañas, L., Rodríguez-Sánchez, B., Carnicero, J. A. C., Rueda, R., García‐García, F. J., Pereira, S. L., & SULO, S. S. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.07.032 · Cited by 58
Assessment of malnutrition in older persons: A focus on the mini nutritional assessment
Morley, J. E. (2011) · The journal of nutrition health & aging · doi:10.1007/s12603-011-0018-4 · Cited by 58
Clinically relevant determinants of body composition, function and nutritional status as mortality predictors in lung cancer patients
Kovařík, M., Hronek, M., & Zadák, Z. (2014) · Lung Cancer · doi:10.1016/j.lungcan.2014.01.020 · Cited by 58
A self-completed nutrition screening tool for community-dwelling older adults with high reliability: A comparison study
Huhmann, M. B., Pérez, V., Alexander, D. D., & Thomas, D. R. (2013) · The journal of nutrition health & aging · doi:10.1007/s12603-013-0015-x · Cited by 57
“The Mna has been validated in international studies with a broad range of HCPs in a variety of settings (6, 8).”
Bioelectrical impedance vector analysis, phase-angle assessment and relationship with malnutrition risk in a cohort of frail older hospital patients in the United Kingdom
Slee, A., Birch, D., & Stokoe, D. (2014) · Nutrition · doi:10.1016/j.nut.2014.06.002 · Cited by 57
Senior Alert
Edvinsson, J., Rahm, M., Trinks, A., & Höglund, P. J. (2015) · Quality Management in Health Care · doi:10.1097/qmh.0000000000000058 · Cited by 57
Impact of Frailty on the Risk of Exacerbations and All-Cause Mortality in Elderly Patients with Stable Chronic Obstructive Pulmonary Disease
Luo, J., Zhang, D., Tang, W., Dou, L., & Sun, Y. (2021) · Clinical Interventions in Aging · doi:10.2147/cia.s303852 · Cited by 56
“MNA-SF, median (IQR) 12 (9, 14) 13 (12, 14) 10 (8, 12) <0.”
Relationship between Nutritional Status and Clinical Outcome in Patients Treated for Lung Cancer
Polański, J., Chabowski, M., Świątoniowska-Lonc, N., Dudek, K. D., Jankowska‐Polańska, B., Zabierowski, J., & Mazur, G. J. (2021) · Nutrients · doi:10.3390/nu13103332 · Cited by 56
Is it time to include older adults in inflammatory bowel disease trials? A call for action
Vieujean, S., Caron, B., Jairath, V., Bénétos, A., Danese, S., Louis, E. J., & Peyrin‐Biroulet, L. (2022) · The Lancet Healthy Longevity · doi:10.1016/s2666-7568(22)00060-5 · Cited by 58
Obese Japanese Patients with Stroke Have Higher Functional Recovery in Convalescent Rehabilitation Wards: A Retrospective Cohort Study
Nishioka, S., Wakabayashi, H., Yoshida, T., Mori, N., Watanabe, R., & Nishioka, E. (2015) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2015.08.029 · Cited by 56
Malnutrition in an Elderly Population without Cognitive Impairment Living in Nursing Homes in Spain: Study of Prevalence Using the Mini Nutritional Assessment Test
Serrano-Urrea, R., & Garcı́a-Meseguer, M. J. (2013) · Gerontology · doi:10.1159/000351763 · Cited by 56
A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: study protocol for a randomised controlled trial
Bjerk, M., Brovold, T., Skelton, D. A., & Bergland, A. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2516-5 · Cited by 56
Better preoperative physical performance reduces the odds of complication severity and discharge to care facility after abdominal cancer resection in people over the age of 70 – A prospective cohort study
Karlsson, E., Egenvall, M., Farahnak, P., Bergenmar, M., Nygren‐Bonnier, M., Franzén, E., & Rydwik, E. (2018) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2018.08.011 · Cited by 56
The relationship between existing nutritional indicators and Global Leadership Initiative on Malnutrition (GLIM) criteria: A one-institution cross-sectional analysis
Matsumoto, Y., Iwai, K., Namikawa, N., Matsuda, S., Wakano, C., Heya, H., & Yamanaka, M. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.01.016 · Cited by 56
Calf circumference value for sarcopenia screening among older adults with stroke
Inoue, T., Maeda, K., Shimizu, A., Nagano, A., Ueshima, J., Sato, K., & Murotani, K. (2020) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2020.104290 · Cited by 57
Nutrition and its Relation to Mealtime Preparation, Eating, Fatigue and Mood Among Stroke Survivors After Discharge from Hospital - A Pilot Study
Westergren, A. (2008) · The Open Nursing Journal · doi:10.2174/1874434600802010015 · Cited by 56
Multidimensional Geriatric Assessment
Rubenstein, L. Z., & Stuck, A. E. (2012) · Pathy's Principles and Practice of Geriatric Medicine · doi:10.1002/9781119952930.ch112 · Cited by 56
Self-citation
Remote Home Monitoring of Older Surgical Cancer Patients: Perspective on Study Implementation and Feasibility
Jonker, L. T., Plas, M., de Bock, G. H., Buskens, E., van Leeuwen, B. L., & Lahr, M. M. H. (2020) · Annals of Surgical Oncology · doi:10.1245/s10434-020-08705-1 · Cited by 54
Fall predictors in older cancer patients: a multicenter prospective study
Walle, N. V., Kenis, C., Heeren, P., Puyvelde, K. V., Decoster, L., Beyer, I., Conings, G., Flamaing, J., Lobelle, J., Wildiers, H. P. M. W., et al. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-135 · Cited by 55
“Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) (≤11 is abnormal) [25,26].”
Method
A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients
Slee, A., Birch, D., & Stokoe, D. (2014) · Clinical Nutrition · doi:10.1016/j.clnu.2014.04.013 · Cited by 55
Frailty and one-year mortality in major intra-abdominal operations
Li, J. L., Henderson, M. A., Revenig, L. M., Sweeney, J. F., Kooby, D. A., Maithel, S. K., Master, V. A., & Ogan, K. (2016) · Journal of Surgical Research · doi:10.1016/j.jss.2016.03.007 · Cited by 56
Using a multidimensional prognostic index (MPI) based on comprehensive geriatric assessment (CGA) to predict mortality in elderly undergoing transcatheter aortic valve implantation
Bureau, M.-L., Liuu, É., Christiaens, L. P., Pilotto, A., Mergy, J., Bellarbre, F., Ingrand, P., Paccalin, M., Cruz-Jentoft, A. J., Maggi, S., et al. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.02.048 · Cited by 56
Controlling nutritional status score predicts postoperative complications after hip fracture surgery
Yagi, T., Oshita, Y., Okano, I., Kuroda, T., Ishikawa, K., Nagai, T., & Inagaki, K. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01643-3 · Cited by 55
“Fourth, there were no direct comparisons with other nutritional indicators such as SGA, MNA-SF, or MST, because of the retrospective nature of this study.”
ResultInfluential
Impact of Frailty and Functional Status on Outcomes in Elderly Patients With ST ‐Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Rationale and Design of the IFFANIAM Study
Ariza‐Solé, A., Formiga, F., Vidán, M. T., Bueno, H., Curós, A., Aboal, J., Llibre, C., Rueda, F., Bernal, E., & Cequier, A. R. (2013) · Clinical Cardiology · doi:10.1002/clc.22182 · Cited by 54
Chair-Stand Exercise Improves Sarcopenia in Rehabilitation Patients after Stroke
Yoshimura, Y., Wakabayashi, H., Nagano, F., Bise, T., Shimazu, S., Shiraishi, A., Kido, Y., & Matsumoto, A. (2022) · Nutrients · doi:10.3390/nu14030461 · Cited by 56
“Nutrients 2022, 14, 461 6 of 14 Nutrients 2022, 14, 461 7 of 14 BMI, body mass index; BRS, Brunnstrom Recovery Stage; CCI, Charlson’s Comorbidity Index; FILS, Food Intake Level Scale; FIM, Functional Independence Measure; FM, fat mass; FMI, fat mass index; HGS, handgrip strength; MNA-SF, Mini Nutritional Assessment-Sh…”
Method

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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