title: Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care.
abstract: OBJECTIVE
  To compare the prognostic value of the revised Mini Nutritional Assessment short form (MNA-SF) classification with that of the long form (MNA-LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany.
  
  
  METHODS
  Multicenter, 1-year prospective observational study.
  
  
  METHODS
  Community.
  
  
  METHODS
  Older adults (≥ 65) receiving home care (n = 309).
  
  
  METHODS
  Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA-SF and MNA-LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living (ADLs) at baseline and after 1 year. Hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality were calculated for MNA-SF and MNA-LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA-SF and MNA-LF categories.
  
  
  RESULTS
  MNA-SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA-LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02-4.75 vs HR = 5.05, 95% CI = 1.53-16.58; malnourished: HR = 3.27, 95% CI = 1.34-8.02 vs HR = 8.75, 95% CI = 2.45-31.18). For MNA-SF categories, no differences in functional change were found. According to the MNA-LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points).
  
  
  CONCLUSIONS
  In this sample of older adults receiving home care, the MNA-LF was superior to the MNA-SF in predicting mortality and differentiating functional decline during 1 year of follow-up.
authors.affiliation: Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Kiesswetter
authors.forename: Stefanie
authors.initials: S
authors.lastname: Pohlhausen
authors.forename: Katrin
authors.initials: K
authors.lastname: Uhlig
authors.forename: Rebecca
authors.initials: R
authors.lastname: Diekmann
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lesser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: Helmut
authors.initials: H
authors.lastname: Heseker
authors.forename: Peter
authors.initials: P
authors.lastname: Stehle
authors.forename: Cornel C
authors.initials: CC
authors.lastname: Sieber
authors.forename: Dorothee
authors.initials: D
authors.lastname: Volkert
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000401:mortality*; D015596:Nutrition Assessment; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Mini Nutritional Assessment; functional decline; home care; mortality; physical function