[Validation of MNA scale score as a nutritional risk factor in institutionalized geriatric patients with moderate and severe cognitive impairment].
BACKGROUND
comprehensive geriatric assessment includes examination of the nutritional status given the high prevalence of hyponutrition in this kind of patients, particularly in patients with associated cognitive impairment. Scales for screening the nutritional status include questions on self-perception difficult to answer by demented elder patients.


OBJECTIVE
To study the specificity, the positive predictive value, and the sensitivity of the MNA scale to detect malnutrition in patients diagnosed with Alzheimer's disease with advanced cognitive impairment.


METHODS
a population-based descriptive study with a sample of 52 patients older than 70 years, institutionalized, and with moderate-severe Alzheimer's disease was designed. The sensitivity, specificity, and positive predictive value of MNA scale were studied regarding the parameters on malnutrition of the American Institute of Nutrition (AIN).


RESULTS
the sensitivity, specificity, and positive predictive values were 60%, 94.7%, and 93.8%, respectively. There was a significant correlation (p < 0.001) between the score obtained with the MNA Scale and the Tinneti's Risk of Fall Scale (r = 0.577), the Barthel's function (r = 0.742), the MCT cognitive assessment (r = 0.651), and creatinine levels (r = 0.402). More than 50% of the sample presented at least one malnutrition parameter altered.


CONCLUSIONS
the MNA Scale presents lower sensitivity and specificity in these patients. Designing a nutritional assessment scale without subjective evaluations and only with objective parameters might improve its efficiency in institutionalized elderly patients with moderate-severe cognitive impairment.
Tarazona Santabalbina
F J
FJ
Servicio de Geriatría, Hospital de la Ribera, Alzira, Valencia, España. fjtarazona@hospital-ribera.com
Belenguer Varea
A
A
Doménech Pascual
J R
JR
Gac Espínola
H
H
Cuesta Peredo
D
D
Medina Domínguez
L
L
Salvador Pérez
M I
MI
Avellana Zaragoza
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D003072:Cognition Disorders / Q000097:blood / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology*; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012959:Socioeconomic Factors