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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“The MNA-SF is an ordinal nutritional status scale ranging from 0 (poorest) to 14 (best).(12) Items on food modification and nutrition were removed for the MNA-SF.”
Community-Living Older Adults’ Perceptions of Body Weight, Signs of Malnutrition and Sources of Information: a Descriptive Analysis of Survey Data
Craven, D., Lovell, G. P., Pelly, F. E., & Isenring, E. A. (2017) · The journal of nutrition health & aging · doi:10.1007/s12603-017-0942-z · Cited by 27
“This was highlighted in a recent Australian study of 225 community-living older adults screened for malnutrition using the MNA-SF.”
Energy Intake at Admission for Improving Activities of Daily Living and Nutritional Status among Convalescent Stroke Patients
Nishiyama, A., Wakabayashi, H., Nishioka, S., Nagano, A., & Momosaki, R. (2019) · Neurologia medico-chirurgica · doi:10.2176/nmc.oa.2019-0002 · Cited by 27
Risk factors for postoperative delirium in elderly patients undergoing gastroenterological surgery: A single‐center retrospective study
Sugi, T., Enomoto, T., Ohara, Y., Furuya, K., Kitaguchi, D., Moue, S., Akashi, Y., Ogawa, K., Owada, Y., & Oda, T. (2023) · Annals of Gastroenterological Surgery · doi:10.1002/ags3.12676 · Cited by 26
Prognostic significance of preoperative nutritional status for postoperative acute kidney injury in older patients undergoing major abdominal surgery: a retrospective cohort study
Sun, R., Zhou, Z., Li, X., Xu, Q., Zhou, B., Yu, H., Zhang, W., Sun, Q., Zhang, X., Luo, X., et al. (2023) · International Journal of Surgery · doi:10.1097/js9.0000000000000861 · Cited by 26
“To date, a number of nutritional screening tools have been developed [34] , including the widely used Mini Nutritional Assessment-Short Form [35] , Malnutrition Universal Screening Tool (MUST) [36] , and Nutritional Risk Screening 2002 (NRS-2002) [37] .”
The mediating effect of nutrition on oral frailty and fall risk in community-dwelling elderly people
Song, H., Wei, Y., Wang, Y., & Zhang, J. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04889-3 · Cited by 26
“The Short-form mini nutritional assessment(MNA-SF) proposed by Rubenstein in 2001, based on the mini nutritional assessment (MNA), is used to assess the nutritional status of the elderly [22].”
Method
Revista Española de Geriatría y Gerontología
Santos, R. P., Torres, C. F., Martín‐Arranz, M. D., de Parga, J. M. S., & Martínez, M. A. (2016) · Cited by 26
Estrategia invasiva frente a conservadora en pacientes frágiles con IAMSEST. Diseño del ensayo clínico MOSCA-FRAIL
Sanchís, J. M., Ariza‐Solé, A., Abu‐Assi, E., Alegre, O., Alfonso, F., Barrabés, J. A., Barrabés, J. A., Carol, A., Villanueva, P. D., del Blanco, B. G., et al. (2018) · Revista Española de Cardiología · doi:10.1016/j.recesp.2018.01.028 · Cited by 26
Chinese expert consensus on the application of comprehensive geriatric assessment for the elderly
Chen, X., Yan, J., Wang, J., & Yu, P. (2018) · Aging Medicine · doi:10.1002/agm2.12019 · Cited by 26
Frailty, multimorbidity and functional status as predictors for health outcomes of acute psychiatric hospitalisation in older adults
Benraad, C. E. M., Disselhorst, L. G. M., Laurenssen, N. C. W., Hilderink, P. H., Melis, R. J. F., Spijker, J., & Rikkert, M. G. M. O. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1515888 · Cited by 28
Correlation of patient complexity with the burden for health-related professions, and differences in the burden between the professions at a Japanese regional hospital: a prospective cohort study
Yoshida, S., Matsushima, M., Wakabayashi, H., Mutai, R., Sugiyama, Y., Yodoshi, T., Horiguchi, R., Watanabe, T., & Fujinuma, Y. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025176 · Cited by 26
Association between Geriatric Nutrition Risk Index and Skeletal Muscle Mass Index with Bone Mineral Density in Post-Menopausal Women Who Have Undergone Total Thyroidectomy
Chiu, T.-H., Chen, S., Yu, H.-C., Hsu, J., Shih, M. P., Jiang, H., Hsu, W., & Lee, M. (2020) · Nutrients · doi:10.3390/nu12061683 · Cited by 27
“Several clinical tools have been introduced to evaluate nutritional status, including the Malnutrition Universal Screening Tool [13], Nutrition Risk Score 2002 [14], Malnutrition Screening Tool [15], Mini Nutritional Assessment—Short Form [16], and Geriatric Nutritional Risk Index (GNRI) [17].”
Method
A comparison of the MNA-SF, MUST, and NRS-2002 nutritional tools in predicting treatment incompletion of concurrent chemoradiotherapy in patients with head and neck cancer
Hsueh, S., Lai, C.-C., Hung, C., Lin, Y., Lu, C., Yeh, K., Tsang, N., Hung, Y., Chang, P., & Chou, W. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-021-06140-w · Cited by 26
The high prevalence of Clostridioides difficile among nursing home elders associates with a dysbiotic microbiome
Haran, J. P., Ward, D. V., Bhattarai, S. K., Loew, E. B., Dutta, P., Higgins, A., McCormick, B. A., & Bucci, V. (2021) · Gut Microbes · doi:10.1080/19490976.2021.1897209 · Cited by 27
Association of the FRAIL Scale with Geriatric Syndromes and Health-Related Outcomes in Korean Older Adults
Lee, H., Chong, J., Jung, H., Baek, J. Y., Lee, E., & Jang, I. (2021) · Annals of Geriatric Medicine and Research · doi:10.4235/agmr.20.0095 · Cited by 26
Validation and implementation of telephone-administered version of the Multidimensional Prognostic Index (TELE-MPI) for remote monitoring of community-dwelling older adults
Custodero, C., Senesi, B., Pinna, A., Floris, A., Vigo, M., Fama, M., Mastropierro, V., Sabbà, C., Prete, C., & Pilotto, A. (2021) · Aging Clinical and Experimental Research · doi:10.1007/s40520-021-01871-6 · Cited by 26
“Nutritional status investigated with the MNA-SF [18].”
Method
SARC-F Predicts Mortality Risk of Older Adults during Hospitalization
Ueshima, J., Maeda, K., Ishida, Y., Shimizu, A., Inoue, T., Nonogaki, T., Matsuyama, R., Yamanaka, Y., & Mori, N. (2021) · The journal of nutrition health & aging · doi:10.1007/s12603-021-1647-x · Cited by 26
Oral function and nutritional status in non‐acute hospitalised elders
Ohta, M., Imamura, Y., Chebib, N., Schulte‐Eickhoff, R. M., Allain, S., Genton, L., Mojon, P., Graf, C. E., Ueda, T., & Müller, F. (2021) · Gerodontology · doi:10.1111/ger.12612 · Cited by 26
The prevalence and associated factors of motoric cognitive risk syndrome in multiple ethnic middle‐aged to older adults in west China: a cross‐sectional study
Sun, X., Harris, K. E., Hou, L., Xia, X., Liu, X., Ge, M., Jia, S., Zhou, L., Zhao, W., Zhang, Y., et al. (2022) · European Journal of Neurology · doi:10.1111/ene.15255 · Cited by 26
“Assessments were also conducted to evaluate malnutrition risk (Mini- Nutrition Assessment Short Form scale [MNASF]) [28], poor sleep (Pittsburgh Sleep Quality Index [PSQI]) [29], depressive symptoms (GDS15) [30] and cognition status (10item SPMSQ) [17].”
Method
Dynapenic abdominal obesity is associated with mild cognitive impairment in patients with cardiometabolic disease: a cross-sectional study
Oba, K., Tamura, Y., Ishikawa, J., Suzuki, H., Fujiwara, Y., Tachibana, A., Kodera, R., Toyoshima, K., Chiba, Y., & Araki, A. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-02948-1 · Cited by 27
“Additionally, using the MNA-SF, we assessed decreased food intake and weight loss over a 3-month period using a questionnaire on food intake and weight loss (at least 3 kg).”
MethodInfluential
Prehabilitation in older patients prior to elective cardiac procedures (PRECOVERY): study protocol of a multicenter randomized controlled trial
Steinmetz, C., Heinemann, S., Kutschka, I., Hasenfuss, G. P., Asendorf, T., Remppis, B. A., Knoglinger, E., Grefe, C., Albes, J. M., Baraki, H., et al. (2023) · Trials · doi:10.1186/s13063-023-07511-w · Cited by 26
“Frailty will be identified with the CFS [48], the Mini Nutritional Assessment [39, 40], and in a subgroup analysis by Bioelectrical Impedance Analysis [38].”
Method
Nutrition in Surgery: An Orthopaedic Perspective
Zink, T. M., Kent, S. E., Choudhary, A. N., & Kavolus, J. J. (2023) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.23.00259 · Cited by 26
Roles of Baseline Intrinsic Capacity and its Subdomains on the Overall Efficacy of Multidomain Intervention in Promoting Healthy Aging among Community-Dwelling Older Adults: Analysis from a Nationwide Cluster-Randomized Controlled Trial
Liang, C.-K., Lee, W.-J., Chou, M.-Y., Hwang, A.-C., Lin, C.-S., Peng, L.-N., Hsiao, F., Loh, C.-H., & Chen, L.-K. (2024) · The Journal of Prevention of Alzheimer s Disease · doi:10.14283/jpad.2024.20 · Cited by 27
Assessment of risk factors and test performance on malnutrition prevalence at admission using four different screening tools.
Olivares, J., Ayala, L., Salas-Salvadó, J., Muniz, J., Gamundí, A., Martínez-Indart, L., & Masmiquel, L. (2014) · Nutrición Hospitalaria · doi:10.3305/nh.2014.29.3.7120 · Cited by 28
Asociación entre el Mini Nutritional Assessment y el índice de fragilidad de Fried en las personas mayores que viven en la comunidad
Jürschik, P., Botigué, T., Nuín, C., & Lavedán, A. (2014) · Medicina Clínica · doi:10.1016/j.medcli.2013.08.009 · Cited by 26
Long‐term effect of ghrelin on nutritional status and functional capacity in the elderly: a population‐based cohort study
Serra‐Prat, M., Palomera, E., Pellicer-Roca, M., Puig‐Domingo, M., & The Mataró Ageing Study Group (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03730.x · Cited by 26
Nutritional assessment of elderly patients on dialysis: pitfalls and potentials for practice
Rodrigues, J., Cuppari, L., Campbell, K. L., & Avesani, C. M. (2017) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfw471 · Cited by 26
Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument
Oubaya, N., Dramé, M., Novella, J., Quignard, É., Cunin, C., Jolly, D., & Mahmoudi, R. (2017) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2017.07.026 · Cited by 26
Prevalence of Risk Factors for the Refeeding Syndrome in Older Hospitalized Patients
Pourhassan, M., Cuvelier, I., Gehrke, I., Marburger, C., Modreker, M. K., Volkert, D., Willschrei, H. P., & Wirth, R. (2018) · The Journal of nutrition, health and aging · doi:10.1007/s12603-017-0917-0 · Cited by 27
“In addition, Mini Nutritional Assessment Short Form (MNA®-SF) was used to identify patients at risk of malnutrition (27).”
Relative Validity of a Short 15-Item Food Frequency Questionnaire Measuring Dietary Quality, by the Diet History Method
Rothenberg, E. M., Strandhagen, E., Samuelsson, J., Ahlner, F., Sterner, T. R., Skoog, I. G., & Lundberg, C. E. (2021) · Nutrients · doi:10.3390/nu13113754 · Cited by 33
“The common methods for malnutrition screening are the SGA (subjective global assessment) [27] and MNA (minimal nutrition assessment) [28,29].”
Method
Impact of age-friendly living environment and intrinsic capacity on functional ability in older adults: a cross-sectional study
Jiang, Y.-S., Shi, H., Kang, Y., Shen, J., Li, J., Cui, J., Pang, J., Zhang, C., & Zhang, J. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04089-5 · Cited by 25
The relationship between cognitive frailty, physical frailty and malnutrition in Turkish older adults
Koçyiğit, S. E., Bulut, E. A., Aydın, A. E., Dost, F. S., Kaya, D., & Işık, A. T. (2024) · Nutrition · doi:10.1016/j.nut.2024.112504 · Cited by 26
A Questionnaire Study to Assess the Value of the Vulnerable Elders Survey, G8, and Predictors of Toxicity as Screening Tools for Frailty and Toxicity in Geriatric Cancer Patients
Hentschel, L., Rentsch, A., Lenz, F., Hornemann, B., Schmitt, J. M., Baumann, M. A., Ehninger, G., & Schuler, M. K. (2016) · Oncology Research and Treatment · doi:10.1159/000445365 · Cited by 25
National survey of the Portuguese elderly nutritional status: study protocol
Madeira, T., Peixoto-Plácido, C., Goulão, B., Mendonça, N., Alarcão, V., Santos, N. C., de Oliveira, R. M., Yngve, A., Bye, A., Bergland, A., et al. (2016) · BMC Geriatrics · doi:10.1186/s12877-016-0299-x · Cited by 34
“The cut-off of below 24 points is used to identify individuals at-risk and to predict poor outcomes in the elderly [43–45].”
Method
Muscle wasting in heart failure
Saitoh, M., dos Santos, M. R., & von Haehling, S. (2016) · Wiener klinische Wochenschrift · doi:10.1007/s00508-016-1100-z · Cited by 25
“tional Risk Screening 2002 (NRS-2002) for the detection of undernutrition and the risk of its development in hospital settings [76], and Mini-Nutritional Assessment Short Form (MNA-SF) for elderly patients in home-care programs, nursing homes, and hospitals ([77]; Table 2).”
Background
Correlation among sarcopenia, malnutrition and activities of daily living in patients with vertebral compression fractures: a comparison based on admission and discharge parameters evaluating these conditions
Takahashi, K., Akira, K. U. B. O., Ishimura, K., Fukui, T., & Tamura, T. (2018) · Journal of Physical Therapy Science · doi:10.1589/jpts.30.1401 · Cited by 25
Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment
Doroudi, T., Alizadeh-Khoei, M., Kazemi, H., Hormozi, S., Taati, F., Ebrahimi, M., Koulivand, P., Fakhrzadeh, H., Davoudi, I., & Sharifi, F. (2019) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_132_18 · Cited by 25
“[2] In a study MNA‐SF had high sensitivity and specificity, and great clinical nutrition diagnostic accuracy as good as full‐MNA in predicting by serum albumin.[23] Since in aging process, there might be a decreased in serum albumin level;[18,23] therefore, serum albumin cutoff point <3.”
BackgroundResultInfluential
Validation and reliability assessment of the mini-nutritional assessment–short form questionnaire among older adults in South India
Krishnamoorthy, Y., Vijayageetha, M., & Saya, G. K. (2021) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_208_20 · Cited by 25
“This short form (SF) was introduced initially in 2001 for detecting the older adults who are at risk of malnutrition and those at risk will be further assessed using the original version for malnutrition.[7] However, it will help to describe that the current version categorizes individuals as “normal nutritional statu…”
Background
Can an individualized adherence education program delivered by nurses improve therapeutic adherence in elderly people with acute myocardial infarction?: A randomized controlled study
Calvo, E., Izquierdo, S., Castillo, R., César, E., Domene, G., Gómez, A. B., Guerrero, C., Andreu‐Periz, L., & Ariza‐Solé, A. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103975 · Cited by 26
Echo intensity is more useful in predicting hospital-associated complications than conventional sarcopenia-related parameters in acute hospitalized older patients
Nagae, M., Umegaki, H., Yoshiko, A., Fujita, K., Komiya, H., Watanabe, K., Yamada, Y., & Kuzuya, M. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111397 · Cited by 26
Associations between pretreatment nutritional assessments and treatment complications in patients with stage I-III non-small cell lung cancer: A systematic review
Voorn, M. J. J., Beukers, K., Trepels, C. M. M., Bootsma, G. P., Bongers, B. C., & Janssen-Heijnen, M. L. G. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.12.026 · Cited by 25
Comprehensive geriatric assessment
Schippinger, W. (2022) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-021-00905-y · Cited by 25
“For this purpose, the short form of the Mini Nutritional Assessment (MNA®) can be used [19, 20].”
Method
Evaluation of Muscle Mass and Stiffness with Limb Ultrasound in COVID-19 Survivors
Damanti, S., Cilla, M., Tuscano, B., LORENZO, R. D., Manganaro, G., Merolla, A., Pacioni, G., Pomaranzi, C., Tiraferri, V., Martinenghi, S., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.801133 · Cited by 26
Combined Vision and Hearing Impairment is Associated with Frailty in Older Adults: Results from the West China Health and Aging Trend Study
Zhao, Y., Ding, Q., Lin, T., Shu, X., Xie, D., Gao, L., & Yue, J. (2022) · Clinical Interventions in Aging · doi:10.2147/cia.s362191 · Cited by 25
Nutritional Status According to the GLIM Criteria in Patients with Chronic Heart Failure: Association with Prognosis
Joaquín, C., Alonso, N., Lupón, J., Gastelurrutia, P., de, A. P.-M., Domingo, M., Zamora, E., Socias, G., Ramos, A., Bayés‐Genís, A., et al. (2022) · Nutrients · doi:10.3390/nu14112244 · Cited by 25
“Nutritional status was screened at baseline with the Spanish version of the MNA short form (MNA-SF) [13], and also evaluated in all subjects by MNA questionnaire [14].”
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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