Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI).

INTRODUCTION Elderly subjects are considered a vulnerable group and they have more risk of nutritional problems. The risk of malnutrition increases in hospitalized geriatric patients. OBJECTIVES To compare the correlation between MNA and GNRI with anthropometric, biochemical and Barthel Index in hospitalized geriatric patients and to test the concordance between MNA and GNRI and between Mini Nutritional Assessment Short Form (MNA-SF) and MNA. METHODS It was a cross-sectional study on a sample of 40 hospitalized geriatric patients. For determination nutritional status we used MNA and GNRI; we evaluated the correlation between this both test with biochemical and anthropometric parameters and functional questionnaires. We used Pearson's simple correlation model, oneway ANOVA and multiple logistic regression to evaluate the relationship between MNA and GNRI. RESULTS According to MNA, 17 patients (42.5%) were malnourished and according to GNRI, 13 patients (32.5%) had high risk of nutritional complications. The concordance of MNA and GNRI was 39% and between MNA-SF and MNA was 81%. The most significant differences were detected in weight, BMI, arm and calf circumference and weight loss parameters. Barthel index was significantly different in both tests. The MNA and GRNI had significant correlations with albumin, total protein, transferring, arm and calf circumference, weight loss and BMI parameters. CONCLUSIONS In conclusion, it would be reasonable to use GRNI in cases where MNA is not applicable, or even use GRNI as a complement to MNA in hospitalized elderly patients. There is no reason why they should be deemed incompatible, and patients could benefit from more effective nutritional intervention.

[1]  A. Mudge,et al.  Helping understand nutritional gaps in the elderly (HUNGER): a prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients. , 2011, Clinical nutrition.

[2]  A. Marengoni,et al.  Self-reported socio-economic status, social, physical and leisure activities and risk for malnutrition in late life: A cross-sectional population-based study , 2011, The journal of nutrition, health & aging.

[3]  R. Jackson,et al.  Hardiness, Depression, and Emotional Well‐Being and Their Association with Appetite in Older Adults , 2011, Journal of the American Geriatrics Society.

[4]  M. Rondanelli,et al.  Body mass index and mortality in institutionalized elderly. , 2011, Journal of the American Medical Directors Association.

[5]  N. García,et al.  Study of the nutritional status of elders in Cantabria , 2011 .

[6]  M. Míguez,et al.  Suitability of the short-form Mini nutritional assessment in free-living elderly people in the northwest of Spain , 2011, The journal of nutrition, health & aging.

[7]  I. Harman-boehm,et al.  Individualized Nutritional Intervention During and After Hospitalization: The Nutrition Intervention Study Clinical Trial , 2011, Journal of the American Geriatrics Society.

[8]  A. C. Tsai,et al.  The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese , 2010, British Journal of Nutrition.

[9]  G. Sergi,et al.  Ten-year trends in vitamin intake in free-living healthy elderly people: The risk of subclinical malnutrition , 2010, The journal of nutrition, health & aging.

[10]  R. Solá,et al.  High Rates of Malnutrition in Older Adults Receiving Different Levels of Health Care in Lleida, Catalonia: An Assessment of Contributory Factors , 2010, Journal of nutrition for the elderly.

[11]  Denis A. Evans,et al.  Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time. , 2010, The American journal of clinical nutrition.

[12]  M. Reyes,et al.  [Compared nutritional assessment for older adults at family medicine settings]. , 2010, Nutricion hospitalaria.

[13]  R. Kressig,et al.  Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients , 2010, European Journal of Clinical Nutrition.

[14]  M. McCabe,et al.  Depression, nutritional risk and eating behaviour in older caregivers , 2010, The journal of nutrition, health & aging.

[15]  Dorothee Volkert,et al.  Undiagnosed malnutrition and nutrition-related problems in geriatric patients , 2010, The journal of nutrition, health & aging.

[16]  P J Garry,et al.  Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. , 2009, Nutrition reviews.

[17]  E. Cereda,et al.  The ability of the Geriatric Nutritional Risk Index to assess the nutritional status and predict the outcome of home-care resident elderly: a comparison with the Mini Nutritional Assessment , 2009, British Journal of Nutrition.

[18]  E. Cereda,et al.  The geriatric nutritional risk index , 2009, Current opinion in clinical nutrition and metabolic care.

[19]  E. Cereda,et al.  Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. , 2008, Clinical nutrition.

[20]  Jos M G A Schols,et al.  A rational approach to nutritional assessment. , 2008, Clinical nutrition.

[21]  Claude Pichard,et al.  Prognostic impact of disease-related malnutrition. , 2008, Clinical nutrition.

[22]  L. Donini,et al.  Systematic review of nutritional status evaluation and screening tools in the elderly. , 2007, The journal of nutrition, health & aging.

[23]  E. Steinhagen-Thiessen,et al.  Nutrition status and pressure ulcer: what we need for nutrition screening. , 2007, JPEN. Journal of parenteral and enteral nutrition.

[24]  E. Cereda,et al.  The new Geriatric Nutritional Risk Index is a good predictor of muscle dysfunction in institutionalized older patients. , 2007, Clinical nutrition.

[25]  M. Kuzuya,et al.  Is serum albumin a good marker for malnutrition in the physically impaired elderly? , 2007, Clinical nutrition.

[26]  G. Sergi,et al.  Role of visceral proteins in detecting malnutrition in the elderly , 2006, European Journal of Clinical Nutrition.

[27]  David R. Thomas,et al.  Prevention and treatment of pressure ulcers. , 2006, Journal of the American Medical Directors Association.

[28]  L. Donini,et al.  Nutritional status and evolution of pressure sores in geriatric patients. , 2005, The journal of nutrition, health & aging.

[29]  N. Koren-Morag,et al.  Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. , 2005, The American journal of clinical nutrition.

[30]  Ioannis Nicolis,et al.  Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. , 2005, The American journal of clinical nutrition.

[31]  J. Stechmiller,et al.  Mini nutritional assessment and screening scores are associated with nutritional indicators in elderly people with pressure ulcers. , 2005, Journal of the American Dietetic Association.

[32]  D. Román,et al.  Mini Nutritional Assessment (MNA) como método de evaluación nutricional en pacientes hospitalizados , 2005 .

[33]  O. Ljungqvist,et al.  Nutritional status, well-being and functional ability in frail elderly service flat residents , 2005, European Journal of Clinical Nutrition.

[34]  Y. Rolland,et al.  Sarcopenia, Calf Circumference, and Physical Function of Elderly Women: A Cross‐Sectional Study , 2003, Journal of the American Geriatrics Society.

[35]  M. Elia,et al.  ESPEN guidelines for nutrition screening 2002. , 2003, Clinical nutrition.

[36]  J. Nordenström,et al.  Nutritional Status Using Mini Nutritional Assessment and Subjective Global Assessment Predict Mortality in Geriatric Patients , 2002, Journal of the American Geriatrics Society.

[37]  K. Covinsky,et al.  Serum Albumin Concentration and Clinical Assessments of Nutritional Status in Hospitalized Older People: Different Sides of Different Coins? , 2002, Journal of the American Geriatrics Society.

[38]  J. L. Nogueira,et al.  Impact of an intervention nutrition program during prenatal on the weight of newborns from teenage mothers. , 2001 .

[39]  J. Morley.  Anorexia, body composition, and ageing , 2001, Current opinion in clinical nutrition and metabolic care.

[40]  P. Garry,et al.  Relationships Between Nutritional Markers and the Mini‐Nutritional Assessment in 155 Older Persons , 2000, Journal of the American Geriatrics Society.

[41]  T. Cederholm,et al.  Body mass index as a predictor of 1 year mortality in geriatric patients. , 2000, Clinical nutrition.

[42]  J. Morley,et al.  Assessment of protein energy malnutrition in older persons, Part II: Laboratory evaluation. , 2000, Nutrition.

[43]  B. Frey,et al.  The prognostic significance of protein-energy malnutrition in geriatric patients. , 1995, Age and ageing.

[44]  J. Eisenberg,et al.  Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. , 1988, The American journal of clinical nutrition.

[45]  A. Roche,et al.  Estimating Stature from Knee Height for Persons 60 to 90 Years of Age , 1985, Journal of the American Geriatrics Society.

[46]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .

[47]  J. Martínez,et al.  [Assessment of calf circumference as an indicator of the risk for hyponutrition in the elderly]. , 2009, Nutricion hospitalaria.

[48]  M. Berger,et al.  Nutritional status and food intake in nine patients with chronic low-limb ulcers and pressure ulcers: importance of oral supplements. , 2006, Nutrition.

[49]  M. Pathy,et al.  Markers of the nutritional status in acutely ill elderly patients. , 1988, Gerontology.