Identifying the elderly at risk for malnutrition: The Mini Nutritional Assessment
Section snippets
Evaluation of nutritional status in the older population
Standard gerontologic work up of overall health status in elderly persons employs simple, quickly used, inexpensive, and internationally validated scales for rating cognitive function, functional status, walking, balance, and socioeconomic status, each of which comprise several subdomains [18]. The use of the following well-validated instruments, which encompass the major assessment domains, makes the geriatric assessment more reliable and considerably easier:
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Activities of Daily Living (ADL)
Practical considerations when using the Mini-Nutritional Assessment
When dealing with an elderly patient, the clinician must know exactly how to administer the MNA screening and assessment tools [43] and how to proceed once a patient's MNA score has been calculated. A practical guide [44] describes in detail the procedure for administering the MNA, using the two-step procedure of screening (MNA-SF) followed by the MNA assessment if indicated.
Use of the Mini-Nutritional Assessment in different settings
After thorough validation, the MNA is now used to screen for risk of malnutrition and to detect malnutrition. Studies have involved more than 10,000 elderly participants in different settings (community, general practice, home care, outpatient, hospitals, and institutions) and in different countries (Belgium, Denmark, France, Greece, Ireland, Israel, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland, the United Kingdom, and the United States).
Summary
In more than 10,000 elderly persons, the mean prevalence of malnutrition is 1% in community-healthy elderly persons, 4% in outpatients receiving home care, 5% in patients with Alzheimer's disease living at home, 20% in hospitalized patients, and 37% in institutionalized elderly persons. In community-dwelling elderly persons, the MNA detects risk of malnutrition and life-style characteristics associated with nutritional risk [56] while albumin levels and the BMI are still in the normal range [54]
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