title: Nutritional screening strategy in nonagenarians: the value of the MNA-SF (mini nutritional assessment short form) in NutriAction.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Questionnaire based national screening week for the risk and prevalence of malnutrition in older people (NutriAction).
  
  
  METHODS
  Older people in the community (CD) and in nursing homes (NH).
  
  
  METHODS
  General practices (n=70) and Nursing Homes (n=70).
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Antwerp, Ziekenhuisnetwerk Antwerpen, Belgium. maurits.vandewoude@ua.ac.be
authors.forename: M
authors.initials: M
authors.lastname: Vandewoude
authors.forename: A
authors.initials: A
authors.lastname: Van Gossum
mesh_terms: D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
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