Relationships Between Nutritional Markers and the Mini-Nutritional Assessment in 155 Older Persons

Department of Internal Medicine and Clinical Gerontology, Toulouse University Hospital, France.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 10/2000; 48(10):1300-9. DOI: 10.1111/j.1532-5415.2000.tb02605.x
Source: PubMed


To investigate the relationships between nutritional status measured by a comprehensive nutritional assessment including anthropometric measurements, nutritional biological markers, evaluation of dietary intake, and the Mini-Nutritional Assessment (MNA) nutrition screening tool.
A prospective study.
One hundred fifty-five older subjects (53 men and 102 women; mean age = 78 years; range = 56-97 years). These participants were hospitalized in a geriatric evaluation unit (n = 105) or free living in the community (n = 50).
Weight, height, knee height, midarm and calf circumferences, triceps and subscapular skinfolds, albumin, transthyretin (prealbumin), transferrin, ceruloplasmin, C-reactive protein, alpha1-acid glycoprotein, cholesterol, vitamins A, D, E, B1, B2, B6, B12, folate, copper, zinc, a 3 day food record combined with a food-frequency questionnaire; the MNA nutritional screening.
The MNA scores have been found to be significantly correlated to nutritional intake (P < .05 for energy, carbohydrates, fiber, calcium, vitamin D, iron, vitamin B6, and vitamin C), anthropometric and biological nutritional parameters (P < .001 for albumin, transthyretin, transferrin, cholesterol, retinol, alpha-tocopherol, 25-OH cholecalciferol zinc). An MNA score between 17 and 23.5 can identify those persons with mild malnutrition in which nutrition intervention may be effective.
The MNA is a practical, noninvasive, and cost-effective instrument allowing for rapid nutritional evaluation and effective intervention in frail older persons.

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    • "Several cross-sectional studies have demonstrated associations between CGA and toxicity, morbidity and mortality during cancer treatment in older patients [5] [6] [7] [8] [9] [10] [11]. The effects of chemotherapy on cognitive function have been extensively studied prospectively in women with breast cancer [12] [13]. "
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    ABSTRACT: Comprehensive geriatric assessment (CGA) gives useful information on the functional status of older cancer patients. However, its meaning for a proper selection of elderly patients before chemotherapy and, even more important, the influence of chemotherapy on the outcome of geriatric assessment is unknown. 202 cancer patients, for whom an indication for chemotherapy was made by the medical oncologist, underwent a GA before start of chemotherapy by Mini Nutritional Assessment (MNA), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Groningen Frailty Index (GFI) and Mini Mental State Examination (MMSE). After completion of a minimum of four cycles of chemotherapy or at 6 months after the start of chemotherapy the GFI and MMSE assessment was repeated. Frailty was shown in 10% of patients by means of MMSE, 32% by MNA, 37% by GFI and in 15% by IQCODE. Compared to patients who received 4 or more cycles of chemotherapy, the MNA and MMSE scores were significantly lower for patients treated with less than 4 cycles (p = 0.001 and p = 0.04 respectively). The mortality rate after start of chemotherapy was increased for patients with low MNA and high GFI scores with hazard ratios of 2.19 (95% confidence interval [CI]: 1.42-3.39; p < 0.001) and 1.80 (95% CI: 1.17-2.78; p = 0.007), respectively. After adjusting for sex, age, purpose of chemotherapy and type of malignancy these hazard ratios remained significant (p < 0.001 and p = 0.004), respectively. Finally, for the 51 patients who underwent repeated post-chemotherapy evaluation by GFI and MMSE, a statistically significant deterioration for the MMSE (p = 0.041) was found but not for the GFI. Both inferior MNA and MMSE scores increased the probability not to complete chemotherapy. Also, an inferior score for MNA and GFI showed an increased mortality risk after the start of chemotherapy. The mean MMSE score worsened significantly during chemotherapy.
    Critical reviews in oncology/hematology 08/2011; 79(2):205-12. DOI:10.1016/j.critrevonc.2010.05.009 · 4.03 Impact Factor
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    • "In contrast to our expectations and in contrast to Vellas et al. [54] who reported close correlations between the MNA and dietary intake in 105 geriatric patients and 50 community-living elderly, we found no difference in energy and protein intake between residents with malnutrition, at risk of malnutrition, or without malnutrition. Per kg BW malnourished subjects consumed even more energy and protein than those in better nutritional status (Table 4). "
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    ABSTRACT: Objective . To investigate the prevalence of malnutrition in orally and tube-fed nursing home (NH) residents in Germany and its relation to common health complaints and dietary intake. Methods . In 350 NH residents, subjects' characteristics, Mini Nutritional Assessment (MNA), and several health problems were inquired with the nursing staff using standardised interviews. In a subset of 122 residents, dietary intake was assessed by 3-day weighing records. Results . 7.7% of the participants were tube fed. 24.1% of orally nourished and 57.7% of tube-fed residents were malnourished (MNA
    Gastroenterology Research and Practice 05/2011; 2011(1687-6121):247315. DOI:10.1155/2011/247315 · 1.75 Impact Factor
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    • "reement with an earlier report ( Bauer et al . , 2005 ) , it could not be completed in a substantial part of patients because of cognitive impairment and communication problems . The absence of a correlation between MNA and serum prealbumin was in agreement with one ( Langkamp - Henken et al . , 2005 ) , but in contrast to another earlier report ( Vellas et al . , 2000 ) . However , this latter study included younger and healthier outpatients than our frail inpatients , which may explain the different findings . The calf circumference represents an anthropometric parameter of muscle mass ; it reflects disability and self - reported physical function ( Rolland et al . , 2003 ) and has been correlated w"
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    ABSTRACT: Malnutrition occurs frequently in the elderly and is associated with increased morbidity and mortality. The mini-nutritional assessment (MNA) has been used most frequently in the geriatric literature. The nutritional risk screening 2002 (NRS) has been proposed as universal screening method for hospitalized patients. The aim of our study was to compare both tools as they are correlated with protein malnutrition. MNA, NRS, and markers of protein malnutrition were measured in 104 consecutive inpatients admitted to an acute geriatric ward. The median age was 84 years (IQR: 78-89), 81 were females. The median body mass index was 23.1 kg/m(2) (IQR: 20-27.3), the median upper-arm and calf circumferences were 25 cm (IQR: 23-29) and 33 cm (IQR: 29-36). According to MNA, 23 patients were malnourished, 50 at risk of malnutrition, and 31 had a normal nutritional status. The NRS indicated that 35 were at moderate to severe risk of malnutrition and 69 at low risk. Serum prealbumin and retinol-binding protein concentrations were inversely associated with the severity of malnutrition as indicated by the NRS (P=0.06 and <0.01, respectively), whereas the MNA was not associated with these serum proteins. After adjustment for C-reactive protein and creatinine clearance, only retinol-binding protein concentrations were consistently associated with both malnutrition scores. The NRS seems to be superior compared with the MNA and serum proteins in identifying elderly patients at risk of malnutrition during acute intercurrent illness.
    European journal of clinical nutrition 08/2010; 64(8):887-93. DOI:10.1038/ejcn.2010.64 · 2.71 Impact Factor
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