ABSTRACT
Protein calorie malnutrition (PCM) is common and often undiagnosed in older adults. Left untreated, PCM carries both clinical and financial risks, including decreased quality of life, declining functionality, the inability to live independently, and increased health care costs. The prevalence of PCM in older adults calls for a systematic and standardized approach to nutrition screening that includes the use of a validated screening tool. Recommended by international organizations, the Mini Nutritional Assessment® (MNA) is highly specific and reliable and the most well-validated nutrition screening tool for adults 65 and older. Simple, noninvasive, inexpensive, and easy for nurses and other clinicians to use, the newest MNA-short form (MNA-SF) can quickly and easily identify older adults who are at risk for malnutrition or malnourished. Nurses are key players in successful malnutrition screening in hospitals, long-term care, home care, and community settings. It is strongly recommended that nurses incorporate the newest MNA-SF into all practice settings where older adults receive care.
Subject(s)
Evidence-Based Nursing , Geriatric Assessment , Malnutrition , Nutrition Assessment , Aged , Education, Nursing, Continuing , HumansABSTRACT
OBJECTIVES: To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA). DESIGN: Retrospective pooled analysis of previously published datasets. SETTING: Hospital, rehabilitation, nursing home, community. PARTICIPANTS: Four thousand five hundred seven people (75.2% female) with a mean age of 82.3. MEASUREMENTS: The prevalence of malnutrition in the combined database and in the four settings was examined. RESULTS: Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, 50.5%; hospital, 38.7%; nursing home, 13.8%; community, 5.8%). In the combined database, the "at risk" group had a prevalence of 46.2%. Consequently, approximately two-thirds of study participants were at nutritional risk or malnourished. CONCLUSION: The MNA has gained worldwide acceptance and shows a high prevalence of malnutrition in different settings, except for the community. Because of its specific geriatric focus, the MNA should be recommended as the basis for nutritional evaluation in older people.
Subject(s)
Geriatric Assessment/methods , Malnutrition/epidemiology , Nutrition Assessment , Population Surveillance/methods , Aged , Aged, 80 and over , Female , Humans , Male , Nursing Homes , Prevalence , Retrospective Studies , Risk Factors , United States/epidemiologyABSTRACT
There is agreement among international nutrition organizations and healthcare accrediting organizations that nutrition screening is essential to identify patients needing further nutrition assessment to determine appropriate nutrition intervention. Numerous nutrition screening tools are used in hospitals, but many, if not most, have never been validated for the care setting, patient population, or outcome they strive to identify. Thus, it is unclear if they appropriately identify patients who truly need further nutrition assessment and, potentially, intervention. Several nutrition screening tools reported in the literature have been validated in a variety of care settings and patient populations and have been shown to achieve the desired outcome. These tools include the Malnutrition Universal Screening Tool, Nutritional Risk Screening 2002, Mini Nutritional Assessment, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and the Subjective Global Assessment. It is important for clinicians to understand how the tools were validated and for which population and care setting they were developed, and to determine if the tool might be appropriate for use in their institution.
