Response to: Letter to the Editor: comment on “Body mass index and Mini Nutritional Assessment-Short Form as predictors of in-geriatric hospital mortality in older adults with COVID-19” (by Café Balcı, MD, Hacettepe University Faculty of Medicine Department of Internal Medicine Division of Geriatric Medicine)

Older adults are at risk of protein-energy malnutrition (PEM). PEM detrimentally impacts on health, cognitive and physical functioning and quality of life. Given these negative health outcomes in the context of an ageing global population, the Healthy Diet for a Healthy Life Joint Programming Initiative Malnutrition in the Elderly (MaNuEL) sought to create a knowledge hub on malnutrition in older adults. This review summarises the findings related to the screening and determinants of malnutrition. Based on a scoring system that incorporated validity, parameters used and practicability, recommendations on setting-specific screening tools for use with older adults were made. These are: DETERMINE your health checklist for the community, Nutritional Form for the Elderly for rehabilitation, Short Nutritional Assessment Questionnaire-Residential Care for residential care and Malnutrition Screening Tool or Mini Nutritional Assessment-Short Form for hospitals. A meta-analysis was conducted on six longitudinal studies from MaNuEL partner countries to identify the determinants of malnutrition. Increasing age, unmarried/separated/divorced status (vs.married but not widowed), difficulties walking 100 m or climbing stairs and hospitalisation in the year prior to baseline or during follow-up predicted malnutrition. The sex-specific predictors of malnutrition were explored within The Irish Longitudinal Study of Ageing dataset. For females, cognitive impairment or receiving social support predicted malnutrition. The predictors for males were falling in the previous 2 years, hospitalisation in the past year and self-reported difficulties in climbing stairs. Incorporation of these findings into public health policy and clinical practice would support the early identification and management of malnutrition.

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Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2015.04.006 ◽

2015 ◽

Vol 61 (1) ◽

pp. 56-60 ◽

Cited By ~ 30

Author(s):

Derya Sarikaya ◽

Meltem Halil ◽

Mehmet Emin Kuyumcu ◽

Mustafa Kemal Kilic ◽

Yusuf Yesil ◽

...

Keyword(s):

Older Adults ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Screening Tools

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Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033661 ◽

2020 ◽

Vol 10 (6) ◽

pp. e033661 ◽

Cited By ~ 2

Author(s):

Ana Rita Sousa-Santos ◽

Cláudia Afonso ◽

Nuno Borges ◽

Alejandro Santos ◽

Patrícia Padrão ◽

...

Keyword(s):

Older Adults ◽

Nutritional Assessment ◽

Multinomial Logistic Regression ◽

Short Form ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Secondary Outcome ◽

Physical Frailty ◽

Cross Sectional ◽

European Working

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

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PP169-MON: Is Evaluation of Calf Circumference on the Mini Nutritional Assessment – Short form (MNA-SF) Appropriate for Japanese as Compared with BODY MASS INDEX (BMI)?

Clinical Nutrition ◽

10.1016/s0261-5614(14)50503-1 ◽

2014 ◽

Vol 33 ◽

pp. S192

Author(s):

Y. Shibata

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Calf Circumference ◽

Is Evaluation

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Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

PLoS ONE ◽

10.1371/journal.pone.0242152 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242152

Author(s):

Sonia Hammami ◽

Imen Ghzaiel ◽

Souha Hammouda ◽

Nabil Sakly ◽

Mohamed Hammami ◽

...

Keyword(s):

Older Adults ◽

Inflammatory Cytokines ◽

Geriatric Assessment ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Serum Levels ◽

Enzyme Linked Immunosorbent Assay ◽

Tnf Α ◽

Pro Inflammatory Cytokines

The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58–0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.

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Diagnostic accuracy of the Mini Nutritional Assessment – Short Form to identify malnutrition among older adults: protocol for a systematic review and meta-analysis

HRB Open Research ◽

10.12688/hrbopenres.13358.1 ◽

2021 ◽

Vol 4 ◽

pp. 83

Author(s):

Anne Griffin ◽

Sorcha McGarry ◽

Caoimhe Moloney ◽

Rose Galvin

Keyword(s):

Systematic Review ◽

Older Adults ◽

Diagnostic Accuracy ◽

Nutritional Assessment ◽

Short Form ◽

Meta Analysis ◽

Mini Nutritional Assessment ◽

Cochrane Library ◽

Nutrition Risk ◽

Healthcare Settings

Malnutrition has many associated physiological and psychological consequences for older adults that can result in reduced quality of life, poor disease outcomes and more frequent and longer hospital stays. Early recognition of malnutrition allows for timely intervention and treatment. There are several screening tools for nutrition risk. The most common one for malnutrition developed and validated for older adults is the short-form of the Mini Nutritional Assessment (MNA-SF). It can be completed in just a few minutes and applied in all health care settings. This systematic review and meta-analysis serves to synthesise the totality of evidence regarding the diagnostic accuracy of the MNA-SF tool compared with the full-form of the Mini Nutritional Assessment (MNA-FF) in older adults for the diagnosis of malnutrition in healthcare settings. Systematic searches of five bibliographical databases will be performed and will include the Pubmed, EMBASE, Cochrane Library, CINAHL and Web of Science to identify all studies that validate the MNA-SF for malnutrition among older adults in healthcare settings. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pre-specified MNA-SF scores will be used to identify patients’ risk of malnutrition. Using data from 2x2 tables, studies will be pooled to generate summary estimates of sensitivity and specificity using a bivariate random effects model. The findings of this systematic review of diagnostic accuracy will provide evidence for healthcare professionals to make informed decisions regarding the optimum use of the MNA-SF as a nutrition risk screening tool to identify malnutrition among older people. Registration details: Prospero registration number CRD42019131847

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Effects of Polypharmacy on Appetite and Malnutrition Risk Among Institutionalized Lebanese Older Adults - Preliminary Results

Current Developments in Nutrition ◽

10.1093/cdn/nzaa040_069 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 69-69

Author(s):

Berna Rahi ◽

Tracy Daou ◽

Nour Gereige ◽

Yara Issa ◽

Yara Moawad ◽

...

Keyword(s):

Older Adults ◽

Nursing Homes ◽

Nutritional Status ◽

Dietary Habits ◽

Nutritional Assessment ◽

Short Form ◽

Significant Risk ◽

Nursing Home Residents ◽

Mini Nutritional Assessment ◽

Significant Difference

Abstract Objectives We aimed to assess the polypharmacy effect on appetite and malnutrition risk among Lebanese nursing home residents. We hypothesized that polypharmacy will be associated to lower appetite and increased of malnutrition. Methods A cross-sectional pilot study was carried out in two nursing homes in the North-Lebanon region. Fifty-three older adults (OA) aged 60 and above were recruited and were interviewed face-to-face. A general questionnaire was administered to gather information about their socio-demographics, dietary habits and physical activity routine. Appetite was evaluated by the Simplified Nutritional Appetite Questionnaire (SNAQ) validated for use with nursing homes residents. The participants' nutritional status was assessed using the Short Form of the Mini-Nutritional Assessment (MNA-SF). Polypharmacy was determined if OA were taking 5 or more medications. Information about attitudes towards the use, the number and the cost of medications was also collected. Differences in SNAQ and MNA scores based on polypharmacy were tested using Independent t-tests. Logistic regression was performed to assess the association between polypharmacy and nutritional status after adjusting for several factors. Results Our sample constituted of 49.1% females with an average age of 67.6 ± 3.8 and BMI of 22.3 ± 1.7 kg/m2. The majority were widowed (79.2%) and had a low level of education (85% elementary education). Regarding the MNA scores, 33% had a normal nutritional status while 59% were at risk of malnutrition and 8% were malnourished, with an average MNA score of 10.1 ± 2.2. The average SNAQ score was 11.0 ± 3.3, with 85% scoring ≤14, indicating an significant risk of at least 5% weight loss withing 6 months. Regarding medication use, 50.9% of OA take at least 5 drugs/d with an average of 4.3 ± 2 drugs. Independent t-tests showed that MNA scores were significantly lower in those taking 5 drugs/d vs those taking less (9.4 ± 2.5 vs 10.8 ± 1.6, P = .024) while no significant difference was observed for SNAQ scores (10.3 ± 2.9 vs 11.6 ± 3.6, P = .13). Logistic regressions did not show any significant association between polypharmacy and MNA or SNAQ categories. Conclusions Lower MNA scores were observed in OA taking ≥5 drugs/d indicating a higher risk of malnutrition with polypharmacy. This is significant since malnutrition can further worsen the aging process. Funding Sources N/A.

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