Short-form Mini-Nutritional Assessment with either BMI or calf circumference is effective in rating the nutritional status of elderly Taiwanese – results of a national cohort study

The present study was aimed to validate two normalised short-form (SF) Mini-Nutritional Assessments (MNA) that contained either BMI (Taiwan version 1, T1) or calf circumference (CC; Taiwan version 2, T2) for rating the nutritional status of elderly Taiwanese. Both versions adopted Taiwanese anthropometric cut-offs, but T2 further had the BMI item replaced by CC. We compared the ability of the two SF in rating the nutritional status of 2674 elderly Taiwanese in the 1999 ‘Taiwan Longitudinal Survey on Aging’ with their respective full versions. We evaluated the agreement between the SF and full scales with weighted κ and performed Cox regression analysis for the follow-up 4-year mortality according to nutritional status rated at baseline. The results showed that the agreements between the respective SF and the full MNA were good (weighted κ: 0·679 for T1 and 0·667 for T2). Both SF performed well in predicting follow-up 4-year mortality relative to the full MNA. In conclusion, MNA-T1-SF and -T2-SF have good consistency with the full MNA and have quite comparable abilities in rating the nutritional status of elderly Taiwanese. Both SF versions appear appropriate for functioning as stand-alone units for rating the nutritional status of the elderly in community-living settings or the general population.

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Complementarity of the Mini-Nutritional Assessment and Activities of Daily Living for predicting follow-up mortality risk in elderly Taiwanese

British Journal Of Nutrition ◽

10.1017/s0007114512001730 ◽

2012 ◽

Vol 109 (4) ◽

pp. 658-666 ◽

Cited By ~ 6

Author(s):

Alan C. Tsai ◽

Li-Chin Lee ◽

Jiun-Yi Wang

Keyword(s):

Nutritional Status ◽

Activities Of Daily Living ◽

Mortality Risk ◽

Daily Living ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Cox Regression Analysis ◽

All Cause Mortality

Physical functional ability and nutritional status are two major indicators for predicting the risk of mortality in older adults. The present study examined the complementarity of the Activities of Daily Living (ADL) and the Mini-Nutritional Assessment (MNA) for predicting follow-up 4-year all-cause mortality risk in elderly Taiwanese. We analysed data of the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based longitudinal cohort study which involved 2872 men and women of ≥ 65 years old at baseline (1999). We rated their functional dependency with the ADL scale and nutritional status with the MNA (both the long form, LF and the short form, SF) at baseline, and analysed the complementarity of the two scales in predicting follow-up 4-year all-cause mortality with Cox regression analysis and the net reclassification improvement (NRI) to quantify the improvement. The results showed that both ADL and MNA offered improvement in predicting follow-up mortality risk beyond that predicted by either one alone according to the Akaike information criterion and the NRI. The MNA-SF was nearly as effective as the MNA-LF in improving the predictive ability of the ADL. The present study suggests that the MNA (especially the SF because of its simplicity and time-saving feature) together with the ADL scale might be of value for predicting the mortality risk of frail elderly living in various settings.

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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

The Journals of Gerontology Series A ◽

10.1093/gerona/glab011 ◽

2021 ◽

Cited By ~ 1

Author(s):

Juliette Tavenier ◽

Line Jee Hartmann Rasmussen ◽

Aino Leegaard Andersen ◽

Morten Baltzer Houlind ◽

Anne Langkilde ◽

...

Keyword(s):

Nutritional Status ◽

Physical Function ◽

Plasma Levels ◽

Older Patients ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Acute Illness ◽

Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

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Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

Journal of Burn Care & Research ◽

10.1093/jbcr/irab164 ◽

2021 ◽

Author(s):

Jia-Yu Wei ◽

Shu-Ting Shi ◽

Dan Sun ◽

Guo-Zhong Lyu

Keyword(s):

Wound Healing ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Reference Points ◽

Nutrition Intervention ◽

Burn Patients ◽

Cross Sectional

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

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NUTRITIONAL INDICATORS OF MALNUTRITION IN HOSPITALIZED PATIENTS

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-74 ◽

2019 ◽

Vol 56 (4) ◽

pp. 447-450 ◽

Cited By ~ 3

Author(s):

Vânia Aparecida LEANDRO-MERHI ◽

Caroline Lobo COSTA ◽

Laiz SARAGIOTTO ◽

José Luiz Braga de AQUINO

Keyword(s):

Lymphocyte Count ◽

Cox Regression ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Calf Circumference ◽

Significance Level ◽

Cox Regression Analysis ◽

Significant Difference

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher’s exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.

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EVALUATION OF INPATIENTS NUTRITIONAL STATUS AND PROGNOSTIC INVOLVEMENT

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2019.3 ◽

2019 ◽

pp. 1-5

Author(s):

J. Ares Blanco ◽

L. Moreno Díaz ◽

E. Fernández-Fernández ◽

A.J. López-Alba

Keyword(s):

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Reference Group ◽

Short Form ◽

Mini Nutritional Assessment ◽

Epidemiological Data ◽

Hospitalized Patients ◽

Confounding Factors

Background: There is an association between malnutrition and mortality. However, it is unclear if this association is truly independent of confounding factors. Objectives: The objective of this study is to evaluate nutritional status, defined according to the three categories defined in the Nutritional Screening Tool “Mini Nutritional Assessment”, and to investigate its prognostic involvement. Design, Setting and Participants: Single cohort retrospective observational study in hospitalized patients between December 2013 and January 2014, who were placed under observation until September 2015 (21 months) (n=144). Nutritional status was determined by MNA short form at the beginning of the study, as well as clinical and epidemiological data. Results: Based on categories defined by MNA SF, 59 (40.97%) were well nourished, 55 (38.19%) were at risk of malnutrition, and 30 (20.83%) patients showed malnutrition. 45 patients died during follow up (31.25%). Of them, 40% (18) were malnourished, 38% (17), at risk of malnutrition, and 22% (9), well nourished. After adjusting for confounding factors, hazard ratio (95% CI) for all-cause mortality was significantly greater in the malnourished group (3.44 (1,27-9,31: p 0,015)), comparing to the reference group (well-nourished patients). Conclusions: Nutritional status defined according to the 3 categories defined in MNA short form predicts the probability of mid-term death in hospitalized patients, after adjusting for confounding factors as age and comorbidities. These data show the importance of knowing nutritional status during hospitalization for avoiding potential complications and helping the patient to overcome them.

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The research methodology for malnutrition risk identification and dietary practices among community living elderly

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v15i1.1232 ◽

2016 ◽

Vol 15 (1) ◽

Author(s):

Aliza Haslinda Hamirudin ◽

Nor Azlina A. Rahman ◽

Suriati Sidek ◽

Norain Zainudin

Keyword(s):

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Risk Identification ◽

Nutrition Intervention ◽

Dietary Practices ◽

Nutrition Screening

Introduction: Nutrition screening is an initial procedure to identify malnutrition, whilst subsequent nutrition intervention is warranted for at risk individuals. However, none of nutrition screening studies conducted among Malaysian elderly, accompanied by individualized nutrition intervention. The objective here is to describe the methodology to determine malnutrition risk and nutritional status of elderly in community at baseline and after 3 months of nutrition intervention; and to assess perception of elderly on their dietary practices. Methods: Elderly aged ≥ 60 years will be recruited as participants at several FELDA in Terengganu and Pahang with the calculated sample size of 416. Nutrition screening will be performed to identify malnutrition risk using a validated nutrition screening tool for the elderly in the community; the Mini Nutritional Assessment-Short Form. Dietary intake will be assessed using the diet history method and individualized nutrition intervention will be provided to improve nutritional status. Nutrition screening and assessment will be repeated after three months for malnourished and at risk elderly. An in-depth individual interview will be conducted to assess perception on dietary practices particularly prophetic food intake. Quantitative and qualitative data will be analyzed using IBM SPSS software and NVivo software, respectively. Results: Nutritional status of the elderly is anticipated to improve after 3 months of nutrition intervention and the elderly will perceive that their dietary practices are good. Conclusions: This research is at the forefront to provide individualized nutrition intervention following nutrition screening among Malaysian community elderly. It can potentially prevent further health complications associated with malnutrition through timely malnutrition identification and nutrition intervention.

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Population-specific Mini Nutritional Assessment effectively predicts the nutritional state and follow-up mortality of institutionalized elderly Taiwanese regardless of cognitive status

British Journal Of Nutrition ◽

10.1017/s0007114507873600 ◽

2008 ◽

Vol 100 (1) ◽

pp. 152-158 ◽

Cited By ~ 31

Author(s):

Alan C. Tsai ◽

Pei-Yu Ku

Keyword(s):

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Cognitive Status ◽

Severe Malnutrition ◽

Term Care ◽

Institutionalized Elderly

The study was conducted to determine the effectiveness of a modified Mini Nutritional Assessment (MNA) for assessing the nutritional status and predicting follow-up mortality of institutionalized elderly Taiwanese. The study was conducted in a large long-term care centre in central Taiwan. Trained interviewers assisted by the caregivers elicited sociodemographic data, healthcare and disease history, and answers to the MNA screen from each subject. One researcher performed all subjects' anthropometric measurements. Plasma albumin and cholesterol concentrations were determined. Results showed that the MNA without BMI, modified according to population-specific mid-arm circumference and calf circumference cut-points, effectively predicted the nutritional risk status of the elderly regardless of cognitive status. Substituting caregiver's assessments for self-viewed nutrition and health status (questions O and P of MNA) improved the predicting power of the tool in cognition-normal subjects. Results showed that 21·9 % of the elderly were malnourished, 59·2 % were at risk of malnutrition and 18·9 % were normal according to self-assessment whereas 14·2 % were malnourished, 59·2 % were at risk of malnutrition, and 26·6 % were normal according to caregiver's evaluation. The tool was also effective in predicting 12- and 6-month follow-up mortality in cognition-normal and cognition-impaired elderly, respectively. Results indicate that a population-specific MNA can effectively predict the nutritional status and 6-month follow-up mortality of elderly Taiwanese regardless of cognitive condition. Easier and wider application of the tool will enable early detection of emerging nutritional problems and timely intervention to prevent the development of severe malnutrition in the elderly.

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Denture Wearing and Malnutrition Risk Among Community-Dwelling Older Adults

Nutrients ◽

10.3390/nu12010151 ◽

2020 ◽

Vol 12 (1) ◽

pp. 151 ◽

Cited By ~ 2

Author(s):

Ya Su ◽

Michiko Yuki ◽

Kengo Hirayama ◽

Miho Sato ◽

Tianfang Han

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

The Elderly ◽

Community Dwelling ◽

Partial Denture

Most studies have associated denture wearing with a higher risk of malnutrition and lower nutritional intake in the elderly. As the effect of wearing dentures remains debatable, the aim of this study was to determine if older adults wearing dentures have a higher risk of malnutrition. We recruited 294 Japanese community-dwelling adults aged ≥65 years from two elderly welfare centers in Sapporo. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess their nutritional status. Their demographic characteristics, eating habits, and health status were assessed using a questionnaire. Moreover, salt-impregnated taste paper and bioelectrical impedance analysis were used to obtain salt taste sensitivity and body composition (body mass index and protein mass). The mean age of older adults was 75.8 ± 5.8 years and 71.1% were women. We found that 74.1% of the older adults wore dentures. The proportion of the whole population with a risk of malnutrition was 23.5%. Multivariate analysis revealed that partial denture wearing could be protective against the risk of malnutrition. In this study, we found more partial denture wearers with normal nutritional conditions and cooking by themselves than non-denture-wearing older adults. Furthermore, complete denture wearers were eating significantly less meats or fish every day. This study suggests that using partial dentures to replace the lost teeth to meet the dietary needs of the elderly is critical to maintaining a healthy nutritional status. Moreover, it also indicates the importance of providing education to older adults who wear complete dentures.

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Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey

European Journal of Public Health ◽

10.1093/eurpub/ckz187.033 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

S Aydoğan ◽

A Ünsal ◽

D Arslantaş

Keyword(s):

Health Care Providers ◽

Nutritional Assessment ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Mini Nutritional Assessment ◽

The Elderly ◽

Cluster Sampling ◽

Care Providers ◽

Cross Sectional

Abstract Background Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression. Methods The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes. Results The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001). Conclusions Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers. Key messages Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.

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