scholarly journals Predictive ability of the Mini Nutritional Assessment short-form (MNA-SF) as compared to serum albumin concentration in the community dwelling elders, Meki, East Ethiopia

Author(s):  
Megersso Urgessa

Abstract Background: Different tools have been used to perform a nutritional screening and assessment, and MNA is one of the widely used and recommended tools in the geriatrics population. MNA has two forms, long and short. However, MNA short-forms have not been evaluated in Ethiopia. Therefore, this study was aimed to evaluate MNA short form against serum albumin concentration among Ethiopian elders.Methods: One hundred and seventy-six randomly selected elders entered into the community-based cross-sectional validation study. Amputated, bedridden, those with visible deformity were excluded. Original MNA questionnaires were translated to Afan Oromo and Amharic languages. All translated and pretested MNA questionnaires were administered to each participant. The anthropometrics and serum albumin concentration were measured. Reliability, validity, sensitivity, specificity, positive and negative predictive values were calculated. Receiver-operating characteristic curve (ROC-curve) analysis was plotted for MNA, to identify the area under the curve (AUC) and optimal cut-off value for prediction of malnutrition.Result: Strong association between serum albumin concentration score and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.526,p <0.05 and CC-MNA-SF 0.501, P<0.05. Similar the agreement between the long and short form of MNA was found to be a weighted kappa 0.404(0.288, 0.521) for BMI-MNA-SF and 0.426(0.333, 0.519) for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the serum albumin concentration. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400(0.322, 0.478). Also, high power to identify two categories using serum albumin concentration as golden standard with AUC for BMI –MNA-SF 0.789 (0.722-0.855) and 0.791 (0.726-0.857) for CC-MNA-SF at 95% CI. Diagnostic accuracy for BMI-MNA-SF showed that 37.1% sensitivity, 90.8% specificity, 58.5% PPV, and 80.5% NPV. Similar sensitivity 77.5%, specificity of 64.4% PPV 73.7%, and 69.0%, NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 63.64%, and 71.02% for CC-MNA-SF.Conclusion: Both versions of MNA-SF were found to be valid screening tools in the Ethiopian elders against serum albumin concentration.

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Agnieszka Guligowska ◽  
◽  
Andrea Corsonello ◽  
Małgorzata Pigłowska ◽  
Regina Roller-Wirnsberger ◽  
...  

Abstract Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.


2021 ◽  
Author(s):  
Megersso Urgessa

Abstract Background Different tools have been used to perform a nutritional screening and assessment, and MNA is one of the widely used and recommended tools in the geriatrics population. MNA has two forms, long and short. However, MNA short-forms have not been evaluated in Ethiopia. Therefore, this study was aimed to evaluate MNA short form against MNA long-form tool among Ethiopian elders.Methods One hundred and seventy-six randomly selected elders entered into the community-based cross-sectional validation study. Amputated, bedridden, those with visible deformity were excluded. Original MNA questionnaires were translated to Afan Oromo and Amharic languages. All translated and pretested MNA questionnaires were administered to each participant. The anthropometrics were measured. Reliability, validity, sensitivity, specificity, positive and negative predictive values were calculated. Receiver-operating characteristic curve (ROC-curve) analysis was plotted for MNA, to identify the area under the curve (AUC) and optimal cut-off value for prediction of malnutrition.Result Strong association between MNA-long form score and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.771,p < 0.05 and CC-MNA-SF 0.759, P < 0.05. Similar the agreement between the long and short form of MNA was found to be a weighted kappa 0.396(0.318, 0.474) for BMI-MNA-SF and 0.546(0.422, 0.669) for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the MNA-long form. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400(0.322, 0.478). Also, high power to identify two categories using MNA long-form as golden standard with AUC for BMI –MNA-SF 0.908 (0.865–0.951) and 0.880 (0.831–0.929) for CC-MNA-SF at 95% CI. Diagnostic accuracy of both versions of MNA-SF showed that 34.2% sensitivity, 100.0% specificity, 100.0% PPV, and 41.5% NPV for BMI-MNA-SF. Similar sensitivity 75.8%, specificity 83.9%, PPV 91.0%, and 61.8% NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 55.12%, and 78.41% for CC-MNA-SFConclusion Both versions of MNA-SF were found to be valid screening tools in the Ethiopian elders against Long-form MNA.


2021 ◽  
Author(s):  
Megersso Urgessa

Abstract Background Different tools have been used to perform a nutritional screening and assessment, and MNA is one of the widely used and recommended tools in the geriatrics population. MNA has two forms, long and short. However, MNA short-forms have not been evaluated in Ethiopia. Therefore, this study was aimed to evaluate MNA short form against MNA long-form tool among Ethiopian elders. Methods One hundred and seventy-six randomly selected elders entered into the community-based cross-sectional validation study. Amputated, bedridden, those with visible deformity were excluded. Original MNA questionnaires were translated to Afan Oromo and Amharic languages. All translated and pretested MNA questionnaires were administered to each participant. The anthropometrics were measured. Reliability, validity, sensitivity, specificity, positive and negative predictive values were calculated. Receiver-operating characteristic curve (ROC-curve) analysis was plotted for MNA, to identify the area under the curve (AUC) and optimal cut-off value for prediction of malnutrition. Result Strong association between MNA-long form score and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.771,p < 0.05 and CC-MNA-SF 0.759, P < 0.05. Similar the agreement between the long and short form of MNA was found to be a weighted kappa 0.396(0.318, 0.474) for BMI-MNA-SF and 0.546(0.422, 0.669) for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the MNA-long form. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400(0.322, 0.478). Also, high power to identify two categories using MNA long-form as golden standard with AUC for BMI –MNA-SF 0.908 (0.865–0.951) and 0.880 (0.831–0.929) for CC-MNA-SF at 95% CI. Diagnostic accuracy of both versions of MNA-SF showed that 34.2% sensitivity, 100.0% specificity, 100.0% PPV, and 41.5% NPV for BMI-MNA-SF. Similar sensitivity 75.8%, specificity 83.9%, PPV 91.0%, and 61.8% NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 55.12%, and 78.41% for CC-MNA-SF Conclusion Both versions of MNA-SF were found to be valid screening tools in the Ethiopian elders against Long-form MNA.


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.


2018 ◽  
Vol 78 (3) ◽  
pp. 372-379 ◽  
Author(s):  
Clare A. Corish ◽  
Laura A. Bardon

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.


2015 ◽  
Vol 61 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Derya Sarikaya ◽  
Meltem Halil ◽  
Mehmet Emin Kuyumcu ◽  
Mustafa Kemal Kilic ◽  
Yusuf Yesil ◽  
...  

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.


Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4239
Author(s):  
Mathuramat Seesen ◽  
Wachiranun Sirikul ◽  
Jetsada Ruangsuriya ◽  
Jiranan Griffiths ◽  
Penprapa Siviroj

Cognitive frailty (CF) is defined by the coexistence of physical frailty and mild cognitive impairment. Malnutrition is an underlying factor of age-related conditions including physical frailty. However, the evidence associating malnutrition and cognitive frailty is limited. This cross-sectional study aimed to determine the association between malnutrition and CF in the elderly. A total of 373 participants aged 65–84 years were enrolled after excluding those who were suspected to have dementia and depression. Then, 61 CF and 45 normal participants were randomly selected to measure serum prealbumin level. Cognitive function was assessed using the Montreal Cognitive Assessment-Basic (MoCA-B). Modified Fried’s criteria were used to define physical frailty. Nutritional status was evaluated by the Mini Nutritional Assessment–short form (MNA-SF), serum prealbumin, and anthropometric measurements. The prevalence of CF was 28.72%. Malnourished status by MNA-SF category (aOR = 2.81, 95%CI: 1.18–6.67) and MNA-SF score (aOR = 0.84, 95%CI = 0.74–0.94) were independently associated with CF. However, there was no correlation between CF and malnutrition assessed by serum prealbumin level and anthropometric measurements. Other independent risk factors of CF were advanced age (aOR = 1.06, 95%CI: 1.02–1.11) and educational level below high school (aOR = 6.77, 95%CI: 1.99–23.01). Malnutrition was associated with CF among Thai elderly. High-risk groups who are old and poorly educated should receive early screening and nutritional interventions.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4160
Author(s):  
Diogo Sousa-Catita ◽  
Maria Alexandra Bernardo ◽  
Carla Adriana Santos ◽  
Maria Leonor Silva ◽  
Paulo Mascarenhas ◽  
...  

Nutrition is an important health issue for seniors. In nursing homes, simple, inexpensive, fast, and validated tools to assess nutritional risk/status are indispensable. A multisurvey cross-sectional study with a convenient sample was created, comparing five nutritional screening/assessment tools and the time required for each, in order to identify the most useful instrument for a nursing home setting. Nutrition risk/status was evaluated using the following tools: Subjective Global Assessment (SGA), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS 2002), and calf girth (CG). The time spent completing each tool was recorded. Eighty-three subjects were included. MNA-SF and CG were the screening tools that ranked highest with regards to malnutrition identification. CG failed to identify nutritional risk/malnutrition in seniors with lower limb edema. CG was the fastest tool while SGA was the slowest. This was the first study comparing non-invasive nutritional tools with time expended as a consideration in the implementation. CG is responsive, fast, and reliable in elders without edema. MNA-SF was more efficient at detecting malnutrition cases in the elderly population. Both MNA-SF and CG are considered the most suitable for the nursing home setting.


Sign in / Sign up

Export Citation Format

Share Document