Prognostic Differences of the Mini Nutritional Assessment Short Form and Long Form in Relation to 1-Year Functional Decline and Mortality in Community-Dwelling Older Adults Receiving Home Care

2014 ◽  
Vol 62 (3) ◽  
pp. 512-517 ◽  
Author(s):  
Eva Kiesswetter ◽  
Stefanie Pohlhausen ◽  
Katrin Uhlig ◽  
Rebecca Diekmann ◽  
Stephanie Lesser ◽  
...  
2018 ◽  
Vol 39 (3) ◽  
pp. 487-492 ◽  
Author(s):  
Ana Rita Sousa-Santos ◽  
Cláudia Afonso ◽  
Nuno Borges ◽  
Alejandro Santos ◽  
Patrícia Padrão ◽  
...  

Background: Although undernutrition and sarcopenia are common among older adults and both result in worse health outcomes, data concerning the burden of these conditions in Portuguese community-dwelling older adults are scarce. Objective: The aim of this study was to firstly describe the occurrence of sarcopenia and undernutrition among a nationwide community-dwelling sample of older adults. Methods: Using a cross-sectional analysis, 1493 Portuguese older adults age ≥65 years from the Nutrition UP 65 study were evaluated. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People, and undernutrition status was evaluated by Mini-Nutritional Assessment-Short Form. Results: Sarcopenia frequency was 11.6%, and of these, 4.4% were classified with severe sarcopenia. Furthermore, 0.8% presented sarcopenic obesity. Undernutrition frequency was 1.3%, and 14.7% of the older adults were classified as being at undernutrition risk. Conclusion: Sarcopenia is present in one-tenth of the sample. This frequency taken together with undernutrition data warrants further study and preventive measures.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.


2017 ◽  
Vol 44 (12) ◽  
pp. 982-987 ◽  
Author(s):  
K. Takeuchi ◽  
M. Furuta ◽  
Y. Okabe ◽  
S. Suma ◽  
T. Takeshita ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033661 ◽  
Author(s):  
Ana Rita Sousa-Santos ◽  
Cláudia Afonso ◽  
Nuno Borges ◽  
Alejandro Santos ◽  
Patrícia Padrão ◽  
...  

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.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Laura J. Samuel ◽  
Sarah L. Szanton ◽  
Carlos O. Weiss ◽  
Roland J. Thorpe ◽  
Richard D. Semba ◽  
...  

This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70–79 in the Women’s Health and Aging Study (n=679). Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF) and defined as a score <11, financial strain was measured by (1) sufficiency of money on a monthly basis and (2) adequacy of income for food, and income was measured by ordinal categories. Mean (SD) modified MNA-SF score was 12.2 (1.80), and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk (OR=4.54; 95% CI: 2.26, 9.14) compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, (OR=4.08; 95% CI: 1.95, 8.52) remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 398-398
Author(s):  
Seoyoon Jane Lee ◽  
Miji Kim ◽  
Hayoung Shim ◽  
Heeeun Jung ◽  
Yuri Seo ◽  
...  

Abstract Social frailty does not merely affect the level of socialization, but also the means of obtaining resources for the daily lives of older adults. It is highly associated with the quality of life during advanced age. In this study, we analyzed the association between the Mini-Nutritional Assessment (MNA®) score (range 0-30) and 18 singular items and social frailty status of community-dwelling older adults. A total of 2,552 community-dwelling older adults aged 70-84 years (mean age 76.9±4.0, 51.8% female) from the Korean Frailty and Aging Cohort Study (KFACS) were assessed. The social frailty status was assessed in four categories- absence of economic resources, social resources, social activities, and social interactions. A higher MNA® score indicates better nutritional status. The prevalence of social frailty in older adults was 27.9% (mean age 78.1±4.0, 67.7% female). Approximately 40% of the participants were at risk of malnutrition or malnourished (p&lt;0.001), while socially robust group accounted for 23% (p&lt;0.001). They were at a higher risk of a lower MNA® score (odds ratio [OR] 0.90, 95% confidence interval [CI], 0.84-0.96). Socially-frail older adults have a higher possibility of not eating three full meals a day (OR 2.33, 95% CI 1.19-4.55) which increases the risk of malnutrition. In conclusion, social frailty, as a means of linking resources -including economic and social capitals- to the older adult population directly impacts the risk of malnutrition and requires an appropriate intervention.


Author(s):  
N. Shiraishi ◽  
Y. Suzuki ◽  
T. Hirose ◽  
S. Jeong ◽  
T. Shimada ◽  
...  

Objective: To date, the actual prevalence of Skeletal muscle mass (SMM) loss by rigorous definition and its related factors have not been sufficiently surveyed in the community. We therefore examined the factors related to the reductions of skeletal muscle mass (SMM) in older adults. Design: Case-control study. Subjects: One hundred twenty four community-dwelling older adults aged ≥65 years participated. Measurements: Reductions of SMM were assessed by measuring difference between SMM at baseline and SMM 1 year later, by which participants were divided into three groups. Variables of the first tertile group, who had the greatest decrease in SMM, were compared with those of the second/third tertile groups. Variables included hight, weight, body mass index (BMI), maximal knee extension strength, grip strength, lower and upper muscle quality (UMQ), 5-m walking time (WT), timed up and go (TUG), food frequency questionnaire, mini nutritional assessment short form (MNA-SF), basic health checklist. A logistic regression analysis and classification and regression trees (CART) were used for multivariate analysis in order to extract variables that predicted reductions of SMM. Results: Significant differences were observed for age, SMM, UMQ, TUG, and WT between the first tertile and the second/third tertile groups, The CART analysis indicated that vitamin D intake UMQ and 5-m WT predicted significant decrease in SMM. Conclusion: The present study suggested a possibility that future reductions of SMM could be predicted by simple indices that may contribute to early detection of individuals at risk of developing sarcopenia in old age.


Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2885 ◽  
Author(s):  
Sabrina Lau ◽  
Kalene Pek ◽  
Justin Chew ◽  
Jun Pei Lim ◽  
Noor Hafizah Ismail ◽  
...  

Malnutrition is an independent marker of adverse outcomes in older adults. While the Simplified Nutritional Appetite Questionnaire (SNAQ) for anorexia has been validated as a nutritional screening tool, its optimal cutoff and validity in healthy older adults is unclear. This study aims to determine the optimal cutoff for SNAQ in healthy community-dwelling older adults, and to examine its factor structure and validity. We studied 230 community-dwelling older adults (mean age 67.2 years) who were nonfrail (defined by Fatigue, Resistance, Ambulation, Illnesses & Loss (FRAIL) criteria). When compared against the risk of malnutrition using the Mini Nutritional Assessment (MNA), the optimal cutoff for SNAQ was ≤15 (area under receiver operating characteristic (ROC) curve: 0.706, sensitivity: 69.2%, specificity: 61.3%). Using exploratory factor analysis, we found a two-factor structure (Factor 1: Appetite Perception; Factor 2: Satiety and Intake) which accounted for 61.5% variance. SNAQ showed good convergent, discriminant and concurrent validity. In logistic regression adjusted for age, gender, education and MNA, SNAQ ≤15 was significantly associated with social frailty, unlike SNAQ ≤4 (odds ratio (OR) 1.99, p = 0.025 vs. OR 1.05, p = 0.890). Our study validates a higher cutoff of ≤15 to increase sensitivity of SNAQ for anorexia detection as a marker of malnutrition risk in healthy community-dwelling older adults, and explicates a novel two-factor structure which warrants further research.


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