Validity of Mini Nutritional Assessment tool among an elderly population in Yeka sub-city, Addis Ababa, Ethiopia

Abstract

Background: The widely used nutritional assessment tool used for the elderly includes the Mini Nutritional Assessment (MNA) and Mini Nutritional Assessment-Short Form (MNA-SF) tool. These tools have not been evaluated for their validity and reliability among the elderly population of developing countries such as Ethiopia. This study aimed to evaluate the reliability and validity of the full and short form of the Mini Nutritional Assessment tool among the elderly in Ethiopia. Method: We evaluated the reliability and validity of the tools using a community-based cross-sectional study among 506 elderly individuals. Accuracy, sensitivity, specificity and cutoff point were evaluated to determine the validity of both the full MNA and MNA-SF tool. Reliability was assessed using Cronbach's α coefficient. The criterion-related validity of the MNA tool was evaluated by computing the correlation between the total MNA score and anthropometric measurements. The Youden index was used to determine best cutoff points of the full MNA and MNA-SF. Result: The mean MNA score was 19.9 ± 4.5. Cronbach's α value of the full MNA tool was 0.7. The overall accuracy of the full MNA was 91% (95% CI, 87.5%-94.9%). The sensitivity and specificity of the full MNA tool using an established cutoff point was 87.9% and 89.6% respectively. Youden index analysis showed that the best cutoff point to detect the malnourished and those at risk of malnutrition using the full MNA was 16 (sensitivity 90.4% and specificity 86.8%). The reliability of the MNA-SF as measured by Cronbach's α was 0.5. The overall accuracy of the MNA-SF was found to be 93% (95% CI, 0.90-0.96). By using the Youden index the best cutoff point for MNA-SF to detect malnutrition was 7.5 (sensitivity 85.7% and specificity 89%). Conclusion: The full MNA tool was a valid and reliable tool to identify elderly individuals who are malnourished, at risk of malnutrition and well-nourished with modulation of cutoff points. However, the short MNA tool was valid and but not reliable in this study.

Correlation Between Mini Nutritional Assessment and Anthropometric Measurements Among Community-Dwelling Elderly Individuals in Rural Southern Thailand

“…The previous studies in Ethiopia showed the same outcome: body weight, BMI, MUAC and CC had a significant positive correlation with MNA-SF total score. 44 This demonstrates the utility of the MNA-SF for evaluating nutritional status, as it is easy and available for use in OPD and community settings, and it correlates with many anthropometric measurements. However, the previous studies demonstrated that WC, HC, WHtR, WHR were common used in the screening risk of cardiovascular disease more than used for screen risk of malnutrition.…”

“…Previous studies in Ethiopia showed the same outcome: body weight, BMI, MUAC and CC had significant positive correlations with full MNA score. 44 , 47 A correlation between MNA score and the handgrip test was only found for the full MNA. A previous study in Indonesia showed the same outcome: the handgrip test demonstrated a significant positive correlation between handgrip strength and nutritional status as determined by the full MNA.…”

“… 52 A previous study in Ethiopia demonstrated that the MNA-SF had a sensitivity of 85.7% and specificity of 89% when using the Youden index as the best cutoff point to detect malnutrition. 44 However, venipuncture for laboratory tests, such as serum albumin levels among elderly individuals in the community setting, is not always available, and pain can occur at the venipuncture site. 56 Furthermore, the complications of venipuncture include bruising, cellulitis and hematoma at the venipuncture site.…”

Predictors of malnutrition among elderly people above 65 Years in East Ethiopia: Neglected public health concern

“…The ndings of this study employed validated tool with overall accuracy of 91% (sensitivity and speci city of 87.9% and 89.6% for the established cutoff points) [33]. It also employed valid and reliable anthropometric measurements for better outputs.…”

Nutritional Assessment in Older Adults: MNA® 25 years of a Screening Tool & a Reference Standard for Care and Research; What Next?

“…The sensitivity and specificity of the MNA ® are 80% (SD 13) and 68% (SD 22), respectively, against a wide range of criteria in 40 studies (see table 15: MNA ® Sensitivity/Specificity against Nutritional assessment parameters & other parameters) (140,222,227,228,235,241,246,248,. The same is true for the MNA ® -SF with a sensitivity of 87% (SD 10) and a specificity of 85% (SD 15) against the MNA ® , and a sensitivity of 81% (SD 18) and a specificity of 63 % (SD 20) against a wide range of criteria in 43 studies (Tables 16 & 17) (8,12,20,41,54,67,140,222,227,228,230,234,235,240,247,266,270,278,282,284,286,(288)(289)(290)(291)(292)(293)(294)(295)(296)(297)(298)(299)(300)(301)…”