The ‘Mini Nutritional Assessment’ (MNA) and the ‘Determine Your Nutritional Health’ Checklist (NSI Checklist) as predictors of morbidity and mortality in an elderly Danish population

Abstract

The purpose of the present study was to evaluate the capacity of the'Determine Your Nutritional Health' Checklist (NSI Checklist) and the 'Mini Nutritional Assessment' (MNA) methods to predict nutrition-related health problems. Data were from the Danish part of the 'Survey in Europe of Nutrition in the Elderly, a Concerted Action' (SENECA) baseline survey from 1988, and the follow-up study from 1993. Based on the baseline survey thirty-nine (19 . 3 %) of the subjects were classified at high nutritional risk, 103 (51 %) were considered at moderate nutritional risk and sixty (29 . 7 %) were within the 'good' range according to the criteria in the NSI Checklist. With the MNA, 171 subjects were classified according to their nutritional risk into a well-nourished group, comprising 78 . 4 %, and a group who were at risk of undernutrition, comprising 21⋅6 % at baseline. A total of 115 subjects participated in the follow-up study. The mortality rate and the prevalence of various morbidity indicators were compared between the different risk groups. The analysis showed that subjects with a high MNA score (Ն 24) had significantly lower mortality (rate ratio estimate: 0 . 35; 95 % Cl 0 . 18, 0 . 66) compared with subjects with a low MNA score (Յ 23 . 5). In contrast, the NSI Checklist score was not a significant predictor of mortality (rate ratio estimate: 1 . 45; 95 % Cl 0 . 78, 2 . 71). The sixteen Danes judged to be at high nutritional risk by the NSI Checklist in 1988, had more acute diseases (P < 0 . 001) than the rest of the participants, between 1988 and 1993. No significant differences were found in the participation rates, hospitalization rates, physician visits, need of help or weight loss between the groups. The thirteen Danes judged to be at risk of undernutrition in 1988 by the MNA, had a lower participation rate (P < 0 . 01) and higher occurrence of acute disease (P < 0 . 05), need of help (P < 0 . 05), and weight loss (P < 0 . 001) than the well-nourished group, between 1988 and 1993. No significant differences were found in hospitalization rates and physician visits between the two groups. In conclusion, the results indicate that modified versions of the NSI Checklist and the MNA are capable of identifying a group of 70-75-year-old subjects with increased risk of certain nutrition-related health problems. Further, an MNA score Յ 23 . 5 predicts mortality in a Danish population. Screening: Elderly: Nutritional assessmentThe elderly population is particularly prone to inadequate nutritional status because of factors such as age-related physiological and social changes, occurrence of chronic diseases, use of medications, and decreased mobility (Morley, 1995). The undernutrition may not be easy to recognize or distinguish from changes resulting from the ageing process itself, and, if undetected, could result in more rapid deterioration of health and early death. Efforts are, therefore, directed to the understanding, evaluation and detection of the different factors that influence the nutritional status of elderl...

Mini nutritional assessment and 10-year mortality in free-living elderly women: a prospective cohort study with 10-year follow-up

“…In a Danish population-based study by Beck et al 21 on 202 men and women, 70-75 years old, the unadjusted HR to die was 0.35 (95% CI 0.18-0.66) for the group with a MNA score 423.5 compared with the group with a MNA score p23.5. In a Taiwanese study, Tsai et al 12 followed 2802 men and women aged 465 years for 4 years and the age-adjusted HR for the same group was 2.39 (95% CI 1.99-2.88).…”

“…A study on free-living elderly, MNA and mortality conducted by Beck et al 21 showed that participants with a MNA score 423.5 had a hazard ratio (HR) of 0.35, regarding the risk to die during the 5-year follow-up, compared with participants with a MNA score p23.5.…”

Avaliação do estado nutricional de adultos e idosos e situação nutricional da população brasileira

“…O idoso (60 ou mais anos) (5) apresenta peculiaridades relacionadas com o processo de envelhecimento, como: a) redução progressiva da altura, de um a dois cm por década; b) ganho progressivo de peso e IMC até em torno de 65 a 70 anos, diminuindo a partir de então; c) alterações da composição corporal, com redistribuição de gordura, que diminui a nível periféri-co e aumenta no interior do abdome, e redução da massa magra (5,13,62). Alguns autores consideram que a desnutrição pode ser difícil de distinguir das alterações resultantes do processo natural do envelhecimento (62,63), porém se não for detectada, pode resultar em agravamento de condições clínicas e aumento da mortalidade (62).…”

“…Alguns autores consideram que a desnutrição pode ser difícil de distinguir das alterações resultantes do processo natural do envelhecimento (62,63), porém se não for detectada, pode resultar em agravamento de condições clínicas e aumento da mortalidade (62). A população idosa é particularmente propensa a problemas nutricionais devido a fatores relacionados com as alterações fisiológicas e sociais, ocorrência de doença crônica, uso de várias medicações, problemas na alimentação (comprometendo a mastigação e deglutição), depressão e alterações da mobilidade com dependência funcional (62,64,65).…”

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

“…The k statistic for the MNA total score has been shown to be 0.51 (95% CI 0.28 -0.74; Gazzoti et al, 1997). The MNA has been found to predict length of hospital stay, costs (Pertoldi et al, 1996), and mortality (Beck et al, 1999;Comban et al, 1999). The tool has been used in elderly Swedish people receiving primary health care (Wissing & Unosson, 1999) and those in home nursing care (Saletti et al, 1999).…”