Mini Nutritional Assessment

Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Current opinion in clinical nutrition and metabolic care 01/2012; 15(1):29-41. DOI: 10.1097/MCO.0b013e32834d7647
Source: PubMed


To summarize recent evidences and advances on the implementation and the use of the Mini Nutritional Assessment (MNA).
Despite being introduced and validated for clinical use about 20 years ago, the MNA has recently received new attention in order to more widely disseminate among healthcare professionals the practice of a systematic nutritional screening and assessment of the old patient. Particularly, the structure has been implemented to face the difficulties in having the patients contributing to the assessment and to reduce further the time required to complete the evaluation. Recent data also confirm that in older populations prevalence of malnutrition by this tool is associated with the level of dependence. The rationale of nutritional assessment is to identify patients candidate to nutritional support. However, the sensitivity of the MNA is still debated because it has been associated with a high-risk 'overdiagnosis' and the advantages of a positive screening need to be assessed both in terms of outcome and money saving.
The MNA is a simple and highly sensitive tool for nutritional screening and assessment. The large mass of data collected and the diffusion among healthcare professionals clearly support its use. However, the cost-effectiveness of interventions based on its scoring deserves investigation.

Download full-text


Available from: Emanuele Cereda
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Malnutrition has been shown to affect clinical outcomes in patients with heart failure. The aim of this study was to analyze the incidence of malnutrition and to assess its prognostic significance in patients with advanced heart failure (AHF) (being evaluated for left ventricular assist device [LVAD] or cardiac transplant) based on nutrition status as assessed by the Mini Nutritional Assessment (MNA). Methods: A retrospective analysis was conducted on 154 patients. During evaluation, a complete nutrition assessment was performed, and diagnosis of malnutrition and risk of malnutrition was done with the MNA. Its possible independent association with mortality was assessed. Results: The mean (SD) age of the patients was 59.3 (14.1) years, with 76% men. Twenty-two percent were classified as malnourished, 68% at risk of malnutrition, and 10% well nourished. The mortality in the 3 groups was 26.5%, 42.0%, and 6.7%, respectively (P = .02). In the multivariate logistic regression analysis, the undernutrition state (malnourished + at risk) was an independent predictor of mortality (odds ratio, 7.9; confidence interval, 1.01-62.30; P = .04). Conclusions: The state of undernutrition is an independent predictor of mortality in patients with AHF. Early recognition of undernutrition through use of the MNA may affect the long-term prognosis of these patients by enabling early intervention.
    No preview · Article · Oct 2012 · Nutrition in Clinical Practice
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Malnutrition and functional impairment are highly prevalent in the institutionalized elderly and can lead to unfavorable outcomes.Objective To asses the relationship between nutritional status and indicators of functional capacity among recently hospitalized elderly.DesignA cross-sectional study conducted on 230 recently hospitalized elders in Cairo.MeasurementsAssessment of functional capacity was done by using activity of daily living (ADL) scale and instrumental activity of daily living (IADL) scale for both males and females. Arabic version of Mini Nutritional Assessment screening tool – short form (MNA-SF-A) and selected anthropometric and laboratory measurements.ResultsNutritional status is an independent risk factor for impaired functional capacity. Indicators of functional capacity (ADL and IADL) have been found to be significantly correlated to MNA-SF total score and laboratory markers of malnutrition in the recently hospitalized elderly.Conclusions Malnutrition is associated with reduced functional capacity in recently hospitalized elderly.
    No preview · Article · Nov 2012 · European geriatric medicine
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Dysautonomia symptoms of nutritional interest may often occur in Parkinson's disease (PD), but the role played in affecting the risk of malnutrition still needs to be clarified. A total of 208 consecutive PD outpatients hospitalised on a scheduled basis were assessed for nutritional risk by the Malnutrition Universal Screening Tool. Presence of dysautonomia symptoms (dysphagia, sialorrhoea and constipation) was investigated using clinical rating scales. In our population, prevalence of nutritional risk was 17·2 (95 % CI 12·1, 24·0) % and relied mainly on unintentional weight loss. Sialorrhoea, dysphagia, dysphagia to liquids and constipation were observed in 10·6, 11·0, 14·4 and 59·6 % of the patients, respectively. Nutritional risk was independently associated with the number of dysautonomia symptoms (OR 1·39 (95 % CI 1·00, 1·96); P = 0·048) but not with single symptoms. An independent association was also found with the severity of motor symptoms (Hoehn-Yahr stage, OR 1·48 (95 % CI 1·00, 2·55); P = 0·049) and levodopa dose (OR 1·16 (95 % CI 1·04, 1·31) mg/kg per d; P = 0·009). Nutritional risk in PD outpatients appears to depend mainly on dysautonomic syndrome, disease severity and levodopa dosage. Implications for outcome deserve further investigation. The assessment of nutritional status and of gastrointestinal dysautonomia symptoms should be part of the routine work-up of a PD patient.
    Full-text · Article · Dec 2012 · The British journal of nutrition
Show more