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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Wang, P., Chen, X., Liu, Q., Liu, X., & Li, Y. (2021) · Nutrition · doi:10.1016/j.nut.2021.111420 · Cited by 47
Lipoprotein subfractions in patients with sarcopenia and their relevance to skeletal muscle mass and function
Gong, H., Liu, Y., Lyu, X., Dong, L., & Zhang, X. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111668 · Cited by 51
Polypharmacy and potentially inappropriate medications in stroke rehabilitation: prevalence and association with outcomes
Matsumoto, A., Yoshimura, Y., Nagano, F., Bise, T., Kido, Y., Shimazu, S., & Shiraishi, A. (2022) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-022-01416-5 · Cited by 50
“Nutritional status was assessed by trained registered dietitians using the Mini Nutritional Assessment-Short Form (MNA-SF) [23], which is a validated nutrition screening tool.”
Method
Pragmatic study designs for older adults with cancer: Report from the U13 conference
Nipp, R. D., Yao, N. A., Lowenstein, L. M., Buckner, J. C., Parker, I. R., Gajra, A., Morrison, V. A., Dale, W., & Ballman, K. V. (2016) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2016.02.005 · Cited by 47
Development and application of a scoring system to rate malnutrition screening tools used in older adults in community and healthcare settings – A MaNuEL study
Power, L., de van der Schueren, M. A. E., Leij‐Halfwerk, S., Bauer, J. M., Clarke, M., Visser, M., Volkert, D., Bardon, L. A., Gibney, E. R., & Corish, C. A. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.07.022 · Cited by 47
“TheMNA-SF-V1 [22] is themost frequently validated tool in the hospital setting, and contains parameters applicable to older adults, such as cognitive function and mobility issues.”
Background
Associations among Geriatric Nutrition Risk Index, bone mineral density, body composition and handgrip strength in patients receiving hemodialysis
Chen, S., Chung, W.-S., Wu, P.-Y., Huang, J., Chiu, Y., Chang, J., & Chen, H. (2019) · Nutrition · doi:10.1016/j.nut.2019.02.013 · Cited by 47
Lower dietary variety is a relevant factor for malnutrition in older Japanese home-care recipients: a cross-sectional study
Tsuji, T., Yamamoto, K., Yamasaki, K., Hayashi, F., Momoki, C., Yasui, Y., Ohfuji, S., Fukushima, W., & Habu, D. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1206-z · Cited by 47
Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults
Maeda, K., Ishida, Y., Nonogaki, T., Shimizu, A., Yamanaka, Y., Matsuyama, R., Kato, R., & Mori, N. (2019) · Nutrients · doi:10.3390/nu12010070 · Cited by 47
“Nutritional variables including body mass index (BMI), the Mini Nutritional Assessment Short Form (MNA-SF) [20], and amount of food intake at admission were recorded.”
Method
Cognitive Frailty in Thai Community-Dwelling Elderly: Prevalence and Its Association with Malnutrition
Seesen, M., Sirikul, W., Ruangsuriya, J., Griffiths, J., & Siviroj, P. (2021) · Nutrients · doi:10.3390/nu13124239 · Cited by 47
“Prealbumin levels were reported to be correlated with MNA-SF in geriatric population [39].”
BackgroundMethod
The geriatric minimum data set for clinical trials (GMDS)
van Kan, G. A., Sinclair, A. J., Andrieu, S., Rikkert, M. G. M. O., Gambassi, G., & Vellas, B. J. (2008) · The journal of nutrition health & aging · doi:10.1007/bf02982620 · Cited by 47
Self-citation
Clinical determinants and neural correlates of presbyphagia in community-dwelling older adults
Labeit, B., Muhle, P., von Itter, J., Slavik, J., Wollbrink, A., Sporns, P. B., Rusche, T., Ruck, T., Hüsing‐Kabar, A., Gellner, R., et al. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.912691 · Cited by 46
“The Mini Nutritional Assessment – Short Form (MNA-SF) was additionally applied as a malnutrition screening tool (Rubenstein et al., 2001).”
Method
Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity
Abdi, F. A., Zuberi, S., Blom, J.-J., Armstrong, D., & Pinto-Sánchez, M. I. (2023) · Nutrients · doi:10.3390/nu15061475 · Cited by 52
“Mini Nutritional Assessment short-form (MNA-SF) [20,23] A short version of MNA.”
Background
ESPEN practical guideline: Nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schüetz, P., Stumpf, F., Austin, P. D., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J. M., Laviano, A., Norman, K., et al. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2024.01.008 · Cited by 51
Screening for frailty in elderly subjects living at home: Validation of the modified Short Emergency Geriatric Assessment (SEGAm) instrument
Oubaya, N., Mahmoudi, R., Jolly, D., Zulfiqar, A., Quignard, É., Cunin, C., Nazeyrollas, P., Novella, J., & Dramé, M. (2014) · The journal of nutrition health & aging · doi:10.1007/s12603-014-0541-1 · Cited by 46
“Nutritional status was assessed using the Mini-Nutritional Assessment Short Form (MNA-SF) (22), with a score less than 12 defining malnutrition or risk thereof.”
Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study
Doumit, J., Nasser, R. N., & Hanna, D. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-629 · Cited by 46
“4) The Mini Nutritional Assessment (MNA) assessed the nutritional status among elderly [30,31].”
Supportive Care in Older Adults with Cancer: Across the Continuum
Koll, T. T., Pergolotti, M., Holmes, H. M., Pieters, H. C., Londen, G. J. V., Marcum, Z. A., MacKenzie, A. R., & Steer, C. (2016) · Current Oncology Reports · doi:10.1007/s11912-016-0535-8 · Cited by 46
Microwave Circuits for 24 GHz Automotive Radar in Silicon-based Technologies
Іссаков, В. (2010) · Springer eBooks · doi:10.1007/978-3-642-13598-9 · Cited by 46
Interferential current sensory stimulation, through the neck skin, improves airway defense and oral nutrition intake in patients with dysphagia: a double-blind randomized controlled trial
Maeda, K., Koga, T., & Akagi, J. (2017) · Clinical Interventions in Aging · doi:10.2147/cia.s140746 · Cited by 46
“The MNA-SF is a validated scale, ranging from 0 to 14, where scores of 0–7, 8–11, and 12–14 indicate malnutrition, risk of malnutrition, and normal nutritional status, respectively.”
Influential
Nutritional Status and Frailty in Community-Dwelling Older Korean Adults: The Korean Frailty and Aging Cohort Study
Kim, J., Lee, Y., Won, C., Lee, K., & Chon, D. (2018) · The Journal of Nutrition, Health & Aging · doi:10.1007/s12603-018-1005-9 · Cited by 51
“The Mini Nutritional Assessment Short Form (MNA-SF) was developed as a screening instrument for malnutrition in older people (7, 8), which consists of 6 items and takes only 3 minutes to complete.”
Low Hemoglobin Levels are Associated with Sarcopenia, Dysphagia, and Adverse Rehabilitation Outcomes After Stroke
Yoshimura, Y., Wakabayashi, H., Nagano, F., Bise, T., Shimazu, S., & Shiraishi, A. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105405 · Cited by 44
Potentially inappropriate prescribing according to the STOPP/START criteria for older adults
Kara, Ö., Arık, G., Kızılarslanoğlu, M. C., Kılıç, M. K., Varan, H. D., Sümer, F., Eşme, M., Altıner, S., Kuyumcu, M. E., Yeşil, Y., et al. (2015) · Aging Clinical and Experimental Research · doi:10.1007/s40520-015-0475-4 · Cited by 46
“These geriatric syndromes included multiple falls (C2 falls within the last 3 months), polypharmacy (C5 daily medications), dementia (after cognitive assessment and screening tests including the mini-mental state examination (MMSE) and clock drawing test, dementia diagnosis was made according to DSM-IV diagnostic crit…”
Method
Mealtime habits and meal provision are associated with malnutrition among elderly patients admitted to hospital
Söderström, L., Thors Adolfsson, E., Rosenblad, A., Frid, H., Saletti, A., & Bergkvist, L. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2012.07.013 · Cited by 53
Effects of frailty, geriatric syndromes, and comorbidity on mortality and quality of life in older adults with HIV
Brañas, F., Torralba, M., Antela, A., Vergas, J., Ramírez, M., Ryan, P., Dronda, F., Galindo, M. J., Machuca, I., Bustinduy, M. J., et al. (2023) · BMC Geriatrics · doi:10.1186/s12877-022-03719-8 · Cited by 45
“Risk of malnutrition was evaluated according to the Mini-Nutritional Assessment Short Form [28], considering a score lower than 11 a sign of malnutrition risk.”
Method
Concurrent and Predictive Validity of Composite Methods to Assess Nutritional Status in Older Adults on Hemodialysis
Santin, F. G. D. O., Bigogno, F. G., Rodrigues, J., Cuppari, L., & Avesani, C. M. (2015) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2015.07.002 · Cited by 45
Head lifting strength is associated with dysphagia and malnutrition in frail older adults
Wakabayashi, H., Sashika, H., & Matsushima, M. (2014) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12283 · Cited by 45
Impact of Frailty and Other Geriatric Syndromes on Clinical Management and Outcomes in Elderly Patients With Non–ST‐Segment Elevation Acute Coronary Syndromes: Rationale and Design of the LONGEVO‐SCA Registry
Alegre, O., Ariza‐Solé, A., Vidán, M. T., Formiga, F., Martínez‐Sellés, M., Bueno, H., Sanchís, J. M., López‐Palop, R., Abu‐Assi, E., & Cequier, A. R. (2016) · Clinical Cardiology · doi:10.1002/clc.22550 · Cited by 45
High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital
Popman, A., Richter, M., Allen, J. E., & Wham, C. A. (2017) · Nutrition & Dietetics · doi:10.1111/1747-0080.12385 · Cited by 45
Nutritional status change and activities of daily living in elderly pneumonia patients admitted to acute care hospital: A retrospective cohort study from the Japan Rehabilitation Nutrition Database
Uno, C., Maeda, K., Wakabayashi, H., Nishioka, S., Ogawa, N., Okamoto, T., Hoyano, K., & Momosaki, R. (2019) · Nutrition · doi:10.1016/j.nut.2019.110613 · Cited by 45
Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls
Tavenier, J., Rasmussen, L. J. H., Andersen, A. L., Houlind, M. B., Langkilde, A., Andersen, O., Petersen, J., & Nehlin, J. O. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab011 · Cited by 47
Association between swallowing function, malnutrition and frailty in community dwelling older people
Weiss, O. S. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.06.028 · Cited by 47
Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial
Liang, C.-K., Lee, W.-J., Hwang, A.-C., Lin, C.-S., Chou, M.-Y., Peng, L.-N., Lin, M.-H., & Chen, L.-K. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104392 · Cited by 45
Characteristics of sarcopenia by European consensuses and a phenotype score
Jang, I., Lee, E., Lee, H., Park, H., Kim, S. Y., Kim, K., Jung, H., & Kim, D. H. (2019) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12507 · Cited by 43
“We defined the risk for malnutrition if the Mini-Nutritional Assessment Short Form score was ≤ 11.(32) Polypharmacy was defined as regularly taking five or more prescription medications.”
Method
De-Training Effects Following Leucine-Enriched Whey Protein Supplementation and Resistance Training in Older Adults with Sarcopenia: A Randomized Controlled Trial with 24 Weeks of Follow-Up
Mori, H., & Tokuda, Y. (2022) · The journal of nutrition health & aging · doi:10.1007/s12603-022-1853-1 · Cited by 49
“Nutritional status was assessed using the Mini Nutritional Assessment®-Short Form (MNA-SF) (27).”
Method
Growth and differentiation factor-15: A link between inflammaging and cardiovascular disease
Nyárády, B. B., Kiss, L. Z., Bagyura, Z., Merkely, B. P., Dósa, E., Láng, O., Kőhidai, L., & Pállinger, É. (2024) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2024.116475 · Cited by 44
Association Between Comorbidity Burden and Rapid Cognitive Decline in Individuals with Mild to Moderate Alzheimer's Disease
Aubert, L., Pichierri, S., Hommet, C., Camus, V., Berrut, G., & de Decker, L. (2015) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13314 · Cited by 44
“Risk of malnutrition was evaluated using the Mini Nutritional Assessment—Short Form (MNA-SF) and was defined as a score of less than 12.(20) The risk of depression was assessed using the 4-item Geriatric Depression Scale (GDS-4)(21) and was defined as a score greater than 0.”
Method
Predictors of long-term survival in nonagenarians: the NonaSantfeliu study
Formiga, F., Ferrer, A., Chivite, D., Rubio‐Rivas, M., Cuerpo, S., & Pujol, R. (2010) · Age and Ageing · doi:10.1093/ageing/afq127 · Cited by 44
Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología
Martín, M. A. C., Silleras, B. D. M., Malafarina, V., López-Mongil, R., Niño-Martín, V., López-Trigo, J. A., & Redondo-del-Río, M. P. (2015) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2015.07.007 · Cited by 44
The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition
Roller, R., Eglseer, D., Eisenberger, A., & Wirnsberger, G. (2015) · British Journal of Nutrition · doi:10.1017/s0007114515004924 · Cited by 41
“Assessment-short form (MNA-sf), which is recommended for malnutrition risk screening for people older than 65 years((23,24)).”
Background
Geriatric assessment as a predictor of postoperative complications in elderly patients with hepatocellular carcinoma
Kaibori, M., Ishizaki, M., Matsui, K., Iida, H., Inoue, K., Nagashima, F., & Kon, M. (2016) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-016-1388-1 · Cited by 44
“Nutritional status was assessed using the Mini Nutritional Assessment (MNA)-Short Form [18]; if the score was less than 12, a complete MNAwas performed [19].”
Method
Factors associated with activities of daily living among the disabled elders with stroke
Li, P., Zang, X., Wang, Y., Chai, Q., Wang, J., Sun, C.-Y., & Zhang, Q. (2016) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2016.01.002 · Cited by 44

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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