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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Prevalence of Long COVID-19 Symptoms After Hospital Discharge in Frail and Robust Patients
Damanti, S., Cilla, M., Cilona, M. B., Fici, A., Merolla, A., Pacioni, G., LORENZO, R. D., Martinenghi, S., Vitali, G., Magnaghi, C., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.834887 · Cited by 23
Potentially inappropriate medications are negatively associated with functional recovery in patients with sarcopenia after stroke
Matsumoto, A., Yoshimura, Y., Nagano, F., Shimazu, S., Shiraishi, A., Kido, Y., & Bise, T. (2022) · Aging Clinical and Experimental Research · doi:10.1007/s40520-022-02224-7 · Cited by 22
“Nutritional status was assessed by trained registered dietitians using the Mini Nutritional Assessment-Short Form (MNA-SF) [28], a validated nutritional screening tool.”
Method
Relationships of Fall Risk With Frailty, Sarcopenia, and Balance Disturbances in Mild-to-Moderate Alzheimer’s Disease
Güner, M., Topuz, S., Baş, A. O., Çöteli, S., Kahyaoğlu, Z., Boğa, İ., Ceylan, S., Doğu, B. B., Cankurtaran, M., & Halil, M. G. (2023) · Journal of Clinical Neurology · doi:10.3988/jcn.2022.0219 · Cited by 22
Prognostic Impact of Nutrition Measures in Patients with Heart Failure Varies with Coexisting Physical Frailty
Iida, Y., Kamiya, K., Adachi, T., Iwatsu, K., Kamisaka, K., Iritani, N., Imoto, S., Yamada, S., & collaborators, T. F. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14519 · Cited by 22
“10 A previous study highlighted the association of severe malnutrition de ﬁ ned by the MNA-SF with a four-fold greater mortality risk in outpatients with HF. 11 Due to the different subcomponents of these screening tools, their prognostic impact may depend on the patient ’ s current condition.”
Background
Ernährung im Alter
Jm, B. (2011) · Der Internist · doi:10.1007/s00108-011-2806-7 · Cited by 23
Direct and indirect effects of nutritional status, physical function and cognitive function on activities of daily living in Japanese older adults requiring long-term care
Kamo, T., & Nishida, Y. (2013) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12169 · Cited by 23
Geriatric assessment and care for older cancer inpatients admitted in acute care for elders unit
Rétornaz, F., Seux, V., Pauly, V., & Soubeyrand, J. (2008) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2008.04.001 · Cited by 22
Validez de la escala MNA como factor de riesgo nutricional en pacientes geriátricos institucionalizados con deterioro cognitivo moderado y severo
Tarazona‐Santabalbina, F. J., Belenguer‐Varea, Á., Pascual, J. R. D., Homero Gac, E., Cuesta-Peredó, D., Domínguez, L., Pérez, M. A. I. S., & Zaragoza, J. A. A. (2009) · Hispana · doi:10.3305/nh.2009.24.6.4571 · Cited by 22
Early rehospitalizations of frail elderly patients – the role of medications: a clinical, prospective, observational trial
Ekerstad, N., Bylin, K., & Karlson, B. W. (2017) · Drug Healthcare and Patient Safety · doi:10.2147/dhps.s139237 · Cited by 22
“50 Polypharmacy was defined as 10 or more drugs in one patient.”
Predictive factors of hospital stay, mortality and functional recovery after surgery for hip fracture in elderly patients
Sierra, T. P., Bartolomé-Martín, I., Solis, J. R., Goitiandia, L. B., de Suso, M. T. G., Sanz, M. D. M., & Calvo, M. (2017) · Revista Española de Cirugía Ortopédica y Traumatología · doi:10.1016/j.recote.2017.10.007 · Cited by 22
Feasibility and Effectiveness of Nutritional Telemonitoring for Home Care Clients: A Pilot Study
Atten, M. N. V. D.-V., Haveman‐Nies, A., Heery, D., de Vries, J. H. M., & de Groot, C. P. G. M. (2018) · The Gerontologist · doi:10.1093/geront/gny059 · Cited by 23
Associations between vitamin D deficiency, musculoskeletal health, and cardiometabolic risk among community-living people in Taiwan
Chen, C., Liu, L.-K., Chen, M.-J., Lee, W., Lin, M.-H., Peng, L., & Chen, L. (2018) · Medicine · doi:10.1097/md.0000000000013886 · Cited by 22
Association between simple evaluation of eating and swallowing function and mortality among patients with advanced dementia in nursing homes: 1-year prospective cohort study
Hoshino, D., Watanabe, Y., Edahiro, A., Kugimiya, Y., Igarashi, K., Motokawa, K., Ohara, Y., Hirano, H., Myers, M., Hironaka, S., et al. (2019) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2019.103969 · Cited by 22
Malnutrition according to GLIM criteria in stable renal transplant recipients: Reduced muscle mass as predominant phenotypic criterion.
Boslooper-Meulenbelt, K., van Vliet, I. V., Gomes-Neto, A., de Jong, M. D., Bakker, S., Jager-Wittenaar, H., & Navis, G. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.11.034 · Cited by 18
Risk Stratification of Patients Undergoing Percutaneous Repair of Mitral and Tricuspid Valves Using a Multidimensional Geriatric Assessment
Schäfer, M., Körber, M. I., Vimalathasan, R., Mauri, V., Iliadis, C., Metze, C., ten Freyhaus, H., Baldus, S. E., Polidori, M. C., & Pfister, R. (2021) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.120.007624 · Cited by 22
“Affiliations Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.) and Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne (M.C.P.) and Cologne Excellence Clust…”
Influential
Different Functional Outcomes in Patients with Delirium and Subsyndromal Delirium One Month after Hospital Discharge
Martínez‐Velilla, N., Bouzón, C. A., Cambra, K., Ibáñez, B., Herrero, Á. C., & Alonso‐Renedo, J. (2012) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000345609 · Cited by 22
Optimal Nutritional Support Strategy Based on the Association between Modified NUTRIC Score and 28-Day Mortality in Critically Ill Patients: A Prospective Study
Park, S., Park, S. H., Kim, Y., Lee, G. H., Kim, H.-S., Lim, S. Y., & Choi, S. A. (2023) · Nutrients · doi:10.3390/nu15112465 · Cited by 22
“Most nutritional screening tools have been developed in outpatient or inpatient settings and do not include variables depending on the time of application [6,7].”
Background
Profiles of physical frailty, social frailty, and cognitive impairment among older adults in rural areas of China: a latent profile analysis
Dong, Q., Bu, X., Wang, T., Liu, M., Zhong, F., & Liu, C. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1424791 · Cited by 21
Oropharyngeal dysphagia: a narrative review towards an integrated neurogeriatric perspective.
Labeit, B., Lapa, S., Lueg, G., Joebges, R., Hofacker, J., Muhle, P., Suntrup-Krueger, S., Werner, C. J., Schreiber, S., Wirth, R., et al. (2025) · The Lancet Healthy Longevity · doi:10.1016/j.lanhl.2025.100794 · Cited by 21
Signs for Early Detection of Dysphagia in Older Adults with Severe Alzheimer's Disease
Simões, A. L. S., Filho, A. O., & Hebling, E. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1382-8 · Cited by 21
A prospective nutritional assessment using Mini Nutritional Assessment-short form among patients with head and neck cancer receiving concurrent chemoradiotherapy
Hung, C., Hsueh, S., Lu, C., Chang, P., Chen, P., Yeh, K., Wang, H., Tsang, N., Huang, P., Hung, Y., et al. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05634-3 · Cited by 21
Mortality Risk and Its Association with Geriatric Domain Deficits in Older Outpatients: The Amsterdam Ageing Cohort
Rhodius‐Meester, H. F. M., van de Schraaf, S. A. J., Peters, M. J. L., Kleipool, E. E. F., Trappenburg, M. C., & Muller, M. (2021) · Gerontology · doi:10.1159/000512048 · Cited by 21
The complexities of approaching nutrition in inflammatory bowel disease: current recommendations and future directions
Russell, L. A., Balart, M. T., Serrano, P. E., Armstrong, D., & Pinto-Sánchez, M. I. (2021) · Nutrition Reviews · doi:10.1093/nutrit/nuab015 · Cited by 21
“The most widely used nutritional assessment tools are the Subjective Global Assessment (SGA)(25) and the Mini-Nutritional Assessment–Short form.(26) Because the SGA is lengthy and time consuming, modified versions of the SGA, such as the Abridged Scored Patient–Generated Subjective Global Assessment,(27) have been dev…”
Method
Optimization of Nutrition And Medication (OptiNAM) for acutely admitted older patients: protocol for a randomized single-blinded controlled trial
Andersen, A. L., Houlind, M. B., Nielsen, R. L., Jørgensen, L. M., Treldal, C., Damgaard, M., Bengaard, A. K., Juul‐Larsen, H. G., Laursen, L. B., Iversen, E., et al. (2021) · Trials · doi:10.1186/s13063-021-05456-6 · Cited by 24
Chronic pain in the frail elderly mediates sleep disorders and influences falls
Honda, H., Ashizawa, R., Kiriyama, K., Take, K., Hirase, T., Arizono, S., & Yoshimoto, Y. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104582 · Cited by 23
Comparison of three malnutrition risk screening tools in identifying malnutrition according to Global Leadership Initiative on Malnutrition criteria in gastrointestinal cancer
Huang, Y., Chen, Y., Wei, L., Hu, Y. P., & Huang, L. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.959038 · Cited by 21
Social and Health Determinants of Quality of Life of Community-Dwelling Older Adults in Malaysia
Lim, S., Chan, Y., & Gan, W.-Y. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20053977 · Cited by 23
Evaluation of different screening tools for detection of malnutrition in hospitalised patients
Cortes, R., Yáñez, A. M., Capitán-Moyano, L., Millán-Pons, A., & Bennasar-Veny, M. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.17170 · Cited by 18
“However, for patients older than 65 years, we found that the MNA-SF had the highest sensitivity (94%).”
Influential
Assessment of the nutritional status among residents in a Danish nursing home – health effects of a formulated food and meal policy
Kuosma, K., Hjerrild, J., Pedersen, P. U., & Hundrup, Y. A. (2008) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2007.02203.x · Cited by 21
Undernutrition in community dwelling elderly
Arvanitakis, M., Vandewoude, M., Perkisas, S., & Gossum, A. V. (2013) · e-SPEN Journal · doi:10.1016/j.clnme.2013.06.005 · Cited by 21
Nutrition in the elderly
Morley, J. E. (2002) · Current Opinion in Gastroenterology · doi:10.1097/00001574-200203000-00015 · Cited by 21
Long-term mortality in older patients discharged after acute decompensated heart failure: a prospective cohort study
Natella, P.-A., Corvoisier, P. L., Paillaud, É., Renaud, B., Mahé, I., Bergmann, J., Perchet, H., Mottier, D., Montagne, O., & Bastuji‐Garin, S. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0419-2 · Cited by 21
“Table 2 Comparison of survivors and non-survivors using age-adjusted Cox proportional hazards regression models (Continued) Function and mobility Number of impaired ADL items (n = 201/226)e 1 [0–4] 2 [0–5] 1.10 [1.05–1.17] <0.01 ADL score <12, (n = 201/226) 106 (52.7) 162 (71.7) 1.61 [1.20–2.16] <0.01 Timed get-up-and…”
MethodInfluential
The New European Society for Clinical Nutrition and Metabolism Definition of Malnutrition: Application for Nutrition Assessment and Prediction of Morbimortality in an Emergency Service
Fink, J. D. S., Marcadenti, A., Rabito, E., & Silva, F. M. (2017) · JPEN - Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607117695248 · Cited by 21
Cognitive impairment has no impact on hospital‐associated dysphagia in aspiration pneumonia patients
Maeda, K., Wakabayashi, H., Shamoto, H., & Akagi, J. (2017) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.13164 · Cited by 20
Validity of four nutritional screening tools against subjective global assessment for inpatient adults in a low-middle income country in Asia
Tran, Q. C., Banks, M., Hannan-Jones, M. T., Do, T. N. D., & Gallegos, D. (2018) · European Journal of Clinical Nutrition · doi:10.1038/s41430-018-0217-8 · Cited by 21
Prevalence and risk factors of constipation and pollakisuria among older home‐care patients
Komiya, H., Umegaki, H., Asai, A., Kanda, S., Maeda, K., Nomura, H., & Kuzuya, M. (2019) · Geriatrics & Gerontology International · doi:10.1111/ggi.13610 · Cited by 21
Risk of malnutrition and associated factors in institutionalized elderly persons
Damo, C. C., Doring, M., Alves, A. L. S., & Portella, M. R. (2018) · Revista Brasileira de Geriatria e Gerontologia · doi:10.1590/1981-22562018021.180152 · Cited by 21
“Ciência & Saúde Coletiva 2014;19(8):3513-20.”
Validity and Reliability of Korean Version of Simplified Nutritional Appetite Questionnaire in Patients with Advanced Cancer: A Multicenter, Longitudinal Study
Oh, S. Y., Koh, S., Baek, J. Y., Kwon, K. A., Jeung, H., Lee, K. H., Won, Y., & Lee, H. J. (2019) · Cancer Research and Treatment · doi:10.4143/crt.2018.505 · Cited by 21
Underrepresentation of vulnerable older patients with cancer in phase II and III oncology registration trials: A case-control study
Tack, L., Lefebvre, T., Lycke, M., Pottel, L., Cool, L., Ketelaars, L., Zutter, J. D., Martens, E., Pottel, H., Stellamans, K., et al. (2019) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2019.09.003 · Cited by 21
Single-arm phase II trial to evaluate efficacy and tolerance of regorafenib monotherapy in patients over 70 with previously treated metastatic colorectal adenocarcinoma FFCD 1404 – REGOLD
Aparicio, T., Darut‐Jouve, A., Akouz, F. K., Montérymard, C., Artru, P., Cany, L., Romano, O., Valenza, B., Foll, C. L., Delbaldo, C., et al. (2020) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2020.04.001 · Cited by 21
Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review
Avola, M., Mangano, G. R. A., Testa, G., Mangano, S., Vescio, A., Pavone, V., & Vecchio, M. M. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103115 · Cited by 25
“All patients received Physical therapy Various type of hip fracture 107 patients aged 65 years and over (mean age 85.4 ± 6.3, 74% female) Body composition, Hand grip strength (HGS), Mini Nutritional Assessment—Short Form (MNA-SF), Barthel index (BI), Functional Ambulation Categories (FAC) score BMI and lean mass were…”
MethodInfluential
Muscle strength in the Mataró aging study participants and its relationship to successful aging
Mataró Aging Study Group, Puig‐Domingo, M., Serra‐Prat, M., Merino, M. J. L., Pubill, M., Burdoy, E., & Papiol, M. (2008) · Aging Clinical and Experimental Research · doi:10.1007/bf03325150 · Cited by 23
Risk Factors for Functional Decline in Nonagenarians: A One-Year Follow-Up
Formiga, F., Ferrer, A., Garrote, J. M. P.-C., Olmedo, C., & Pujol, R. (2007) · Gerontology · doi:10.1159/000100780 · Cited by 21
An Iceberg Phenomenon in Dementia: Pain
Ağıt, A., Balcı, C., Doğu, B. B., Cankurtaran, E. Ş., Kuyumcu, M. E., Halil, M. G., Arıoğul, S., & Cankurtaran, M. (2018) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988718785765 · Cited by 21

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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