Top

The journal of nutrition, health & aging

Published in:

01-11-2016

Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA

Authors: E. Schrader, E. Grosch, T. Bertsch, C. C. Sieber, Dorothee Volkert

Published in: The journal of nutrition, health & aging | Issue 9/2016

Abstract

Objectives

The aims of this study were to determine the prevalence of malnutrition in patients of a geriatric day hospital using the Mini Nutritional Assessment short form (MNA-SF) and the full MNA, to compare both tools, and to examine the relationship between nutritional and functional status.

Design

Cross-sectional study.

Setting

Geriatric day hospital.

Participants

190 patients (72.1% female, median 80 years) aged 65 years or older.

Measurements

In consecutively admitted geriatric day hospital patients nutritional status was assessed by MNA-SF and full MNA, and agreement between both tools calculated by Cohen’s kappa. Basic activities of daily living (ADL), instrumental activities of daily living (IADL) and short physical performance battery (SPPB) were determined and related to MNA categories (Chi²-test, Mann-Whitney-U-test).

Results

36.3 % and 44.7% of the patients were at risk of malnutrition, 8.9 % and 5.8 % were malnourished according to MNA-SF and full MNA, respectively. Agreement between both MNA forms was moderate (?=0.531). No significant associations between MNA-SF and ADL, IADL and SPPB, and between full MNA and SPPB were observed. According to full MNA, the proportion of patients with limitations in ADL and IADL significantly increased with declining nutritional status (ADL: 2.1 vs. 8.2 vs. 18.2 %, p=0.044; IADL: 25.5 vs. 47.1 vs. 54.5 %, p=0.005) with a simultaneous decrease of the proportion of patients without limitations. Well-nourished patients reached significantly higher ADL scores than patients at risk of malnutrition (95 (-100) vs. 95 (85- 100), p=0.005) and significantly higher IADL scores than patients at risk or malnourished (8 (6-8) vs. 7 (5-8) vs. 6 (4-8), p=0.004).

Conclusion

The high prevalence of risk of malnutrition and the observed association between functional status and nutritional status according to full MNA call for routine nutritional screening using this tool in geriatric day hospital patients.

Glaesmer H, Künstler J, Reuter W. [Improvement of functional deficits, physical mobility and cognitive function by treatment in a geriatric day hospital.] (Article in German). Z Gerontol Geriatr 2003;36:475–483CrossRefPubMed

Forster A, Young J. Community rehabilitation for older people: day hospital or home-based services? Age Ageing 2011;40:2–4CrossRefPubMed

Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care 2012;15:29–41CrossRefPubMed

Chevalier S, Saoud F, Gray-Donald K et al. The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status. J Nutr Health Aging 2008;12:721–726PubMed

Tavassoli N, Guyonnet S, van Abellan Kan G et al. Description of 1,108 older patients referred by their physician to the «Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability» at the gerontopole. J Nutr Health Aging 2014;18:457–464CrossRefPubMed

Smoliner C, Fischedick A, Sieber CC et al. Olfactory function and malnutrition in geriatric patients. J Gerontol A Biol Sci Med Sci 2013;68:1582–1588CrossRefPubMed

Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002;18:737–757CrossRefPubMed

Rubenstein LZ, Harker JO, Salvà A et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56:M366–72CrossRefPubMed

Kaiser MJ, Bauer JM, Ramsch C et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782–788CrossRefPubMed

10.

Kaiser MJ, Bauer JM, Rämsch C et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58:1734–1738CrossRefPubMed

11.

Kaiser MJ, Bauer JM, Uter W et al. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc 2011;59:2124–2128CrossRefPubMed

12.

Lilamand M, Kelaiditi E, Cesari M et al. Validation of the Mini Nutritional Assessment-Short Form in a Population of Frail Elders without Disability. Analysis of the Toulouse Frailty Platform Population in 2013. J Nutr Health Aging 2015;19:570–574PubMed

13.

Inzitari M, Doets E, Bartali B et al. Nutrition in the age-related disablement process. J Nutr Health Aging 2011;15:599–604CrossRefPubMed

14.

Mithal A, Bonjour J, Boonen S et al. Impact of nutrition on muscle mass, strength, and performance in older adults. Osteoporos Int 2013;24:1555–1566CrossRefPubMed

15.

Salvi F, Giorgi R, Grilli A et al. Mini Nutritional Assessment (short form) and functional decline in older patients admitted to an acute medical ward. Aging Clin Exp Res 2008;20:322–328CrossRefPubMed

16.

Schrader E, Baumgärtel C, Gueldenzoph H et al. Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients—independent of health status. J Nutr Health Aging 2014;18:257–263CrossRefPubMed

17.

Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr 2008;27:700–705CrossRefPubMed

18.

Kiesswetter E, Pohlhausen S, Uhlig K et al. Malnutrition is related to functional impairment in older adults receiving home care. J Nutr Health Aging 2013;17:345–350CrossRefPubMed

19.

Bollwein J, Volkert D, Diekmann R et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging 2013;17:351–356CrossRefPubMed

20.

Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198PubMed

21.

Sheikh JI, Yesavage JA. A knowledge assessment test for geriatric psychiatry. Hosp Community Psychiatry 1985;36:1160–1166PubMed

22.

Eveleth PB, Andres R, Chumlea WC, et al. Uses and interpretation of anthropometry in the elderly for the assessment of physical status. Report to the Nutrition Unit of the World Health Organization: the Expert Subcommittee on the Use and Interpretation of Anthropometry in the Elderly. J Nutr Health Aging 1998;2: 5–17.PubMed

23.

Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: A practical assessment tool for grading nutritional state of elderly patients. Facts Res Gerontol 1994;15–59

24.

Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61–65PubMed

25.

Volkert D, Saeglitz C, Gueldenzoph H et al. Undiagnosed malnutrition and nutritionrelated problems in geriatric patients. J Nutr Health Aging 2010;14:387–392CrossRefPubMed

26.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186CrossRefPubMed

27.

Covinsky KE, Palmer RM, Fortinsky RH et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 2003;51:451–458CrossRefPubMed

28.

Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:M85–94CrossRefPubMed

29.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174CrossRefPubMed

30.

Pereira SR M, Chiu W, Turner A et al. How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation program? BMC Geriatr 2010;10:82CrossRefPubMedPubMedCentral

31.

Malone M, Hill A, Smith G. Three-month follow up of patients discharged from a geriatric day hospital. Age Ageing 2002;31:471–475CrossRefPubMed

32.

Winter J, Flanagan D, McNaughton SA et al. Nutrition screening of older people in a community general practice, using the MNA-SF. J Nutr Health Aging 2013;17:322–325CrossRefPubMed

33.

Bahat G, Muratli S, Ilhan B et al. Body mass index and functional status in community dwelling older Turkish males. Aging Male, 2015;18;228–232CrossRefPubMed

34.

Bales CW, Ritchie CS. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu Rev Nutr 2002;22:309–323CrossRefPubMed

35.

Cederholm T, Bosaeus I, Barazzoni R et al. Diagnostic criteria for malnutrition -An ESPEN Consensus Statement. Clin Nutr 2015;34:335–340CrossRefPubMed

36.

Houston DK, Nicklas BJ, Ding J et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008;87:150–155PubMed

37.

Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr 2006;84:475–482PubMed

38.

Tsai AC, Wang J, Chang T et al. A comparison of the full Mini Nutritional Assessment, short-form Mini Nutritional Assessment, and Subjective Global Assessment to predict the risk of protein-energy malnutrition in patients on peritoneal dialysis: a cross-sectional study. Int J Nurs Stud 2013;50:83–89CrossRefPubMed

39.

Flabeau O, Laurendeau G, Laksir H et al. Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital. J Nutr Health Aging 2013;17:199–204CrossRefPubMed

40.

Feldblum I, German L, Castel H et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6:37CrossRefPubMedPubMedCentral

Title: Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA
Authors: E. Schrader
E. Grosch
T. Bertsch
C. C. Sieber
Dorothee Volkert
Publication date: 01-11-2016
Publisher: Springer Paris
Published in: The journal of nutrition, health & aging / Issue 9/2016
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-016-0691-4

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2016

Gastro-intestinal tolerance and renal safety of protein oral nutritional supplements in nursing home residents: A randomized controlled trial

Predictors of frailty in old age–results of a longitudinal study

Impact of protein nutritional status on plasma BNP in elderly patients

Fruit and vegetable intake and physical activity as predictors of disability risk factors in African-American middle-aged individuals

Food accessibility and perceptions of shopping difficulty among elderly people living alone in Japan

Association between longevity and element levels in food and drinking water of typical Chinese longevity area

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page