Screening for malnutrition in elderly acute medical patients: the usefulness of MNA-SF.
BACKGROUND
Malnutrition is often over-seen in elderly acute medical patients. It is a need for a simple and robust screening tool.


OBJECTIVE
The aim was to evaluate, with regard to validity, the Mini Nutritional Assessment-Short Form (MNA-SF) as a screening tool for malnutrition in elderly acute medical patients.


METHODS
This is an observational study where a nurse's scoring of MNA-SF is compared to comprehensive assessment by a clinical nutritionist (gold standard). Sixty-nine patients aged 70 years and older and admitted to a general medical department in year 2000 and 2001 were included.


RESULTS
The mean MNA-SF score was 7.8 (SD +/- 2.88, range 2 to 12). Fifty-one patients (74%) scored positive for malnutrition or risk of malnutrition (MNA-SF < 11), whereas only 21 (30%) were scored to have malnutrition by the nutritionist. Sensitivity of the MNA-SF was 1.0 and specificity 0.38, giving 0.57 correctly classified subjects. Best subset logistic regression showed BMI < 23 to be the only item explaining the gold standard. When using BMI < 23, 32 (46%) subjects screened positive for malnutrition (sensitivity 0.86, specificity 0.71), giving 0.75 correctly classified subjects.


CONCLUSIONS
When screening elderly acute medical patients in general wards for malnutrition or risk of malnutrition, the MNA-SF have a high sensitivity and can be useful. The sole use of BMI < 23 may be equally effective, but will give no information leading towards an explanation. We recommend that a score of BM < 23 should be followed by MNA-SF when the aim is to identify poor nutritional status in elderly acute medical patients.
Research Group in Geriatric Medicine, University of Oslo, Norway. ahranhoff@yahoo.no
A H
AH
Ranhoff
A U
AU
Gjøen
M
M
Mowé
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D015596:Nutrition Assessment; D009752:Nutritional Status; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity