Nutritional screening strategy in nonagenarians: The value of the MNA-SF (Mini Nutritional Assessment short form) in NutriAction
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To identify older subjects at risk of malnutrition using the most appropriate tool available for the specific setting and to evaluate the Mini Nutritional Assessment short form (MNA-SF) in a sample of nonagenarians.
Questionnaire based national screening week for the risk and prevalence of malnutrition in older people (NutriAction).
Older people in the community (CD) and in nursing homes (NH).
General practices (n=70) and Nursing Homes (n=70).
Questionnaire based on items from validated screening instruments: the MNA-SF, the Short Nutritional Assessment Questionnaire (SNAQ) and additional clinically relevant parameters (mobility, independence, social isolation and co-morbidities).
In total 5,334 people were screened of which 16% were aged over 90 years. In this age group, 66% of the screened individuals were at risk of malnutrition (MNA ≤ 11), and women were affected significantly more than men (p<0.001). Actual malnutrition was present in 22% (BMI <20), 20% (SNAQ) and 25% (clinical evaluation). The MNA appeared to be very sensitive but had a low specificity as well in the nonagenarians (98% and 44%) as in the younger old (97% and 52%). The SNAQ was not a sensitive tool for detecting malnutrition in this study population (25%). Although clinical impression had a low sensitivity (60–61%) it has a good specificity (86% in 90+ and 91% below 90yr).
The overall risk of and the prevalence of malnutrition is common in older people. The prevalence is higher in women, in nursing homes and in older age groups. The MNA-SF followed by a clinical subjective evaluation seems to be the preferred strategy for detecting malnutrition in nonagenarians.
Key wordsMalnutrition nonagenarians screening tool MNA
Mini-Nutritional Assessment-Short Form
Short Nutritional Assessment Questionnaire
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