Mini nutritional assessment.
OBJECTIVE
To summarize recent evidences and advances on the implementation and the use of the Mini Nutritional Assessment (MNA).


RESULTS
Despite being introduced and validated for clinical use about 20 years ago, the MNA has recently received new attention in order to more widely disseminate among healthcare professionals the practice of a systematic nutritional screening and assessment of the old patient. Particularly, the structure has been implemented to face the difficulties in having the patients contributing to the assessment and to reduce further the time required to complete the evaluation. Recent data also confirm that in older populations prevalence of malnutrition by this tool is associated with the level of dependence. The rationale of nutritional assessment is to identify patients candidate to nutritional support. However, the sensitivity of the MNA is still debated because it has been associated with a high-risk 'overdiagnosis' and the advantages of a positive screening need to be assessed both in terms of outcome and money saving.


CONCLUSIONS
The MNA is a simple and highly sensitive tool for nutritional screening and assessment. The large mass of data collected and the diffusion among healthcare professionals clearly support its use. However, the cost-effectiveness of interventions based on its scoring deserves investigation.
Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. e.cereda@smatteo.pv.it
Emanuele
E
Cereda
D000203:Activities of Daily Living; D000368:Aged; D003362:Cost-Benefit Analysis; D003951:Diagnostic Errors; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D015596:Nutrition Assessment; D012680:Sensitivity and Specificity