FRAILTY AND NUTRITION: WHAT WE HAVE LEARNED FROM RESEARCH AND CLINICAL PRACTICE ON THE MINI NUTRITIONAL ASSESSMENT

2012 ◽  
pp. 1-4
Author(s):  
Y. GUIGOZ
Keyword(s):  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Critical Conditions ◽  
Preventive Action ◽  
Early Screening ◽  
Term Care ◽  
Targeted Interventions ◽  
Increased Risk

In this short communication, we review the relationship between frailty and malnutrition risk in the elderly. Frailty is a term used for elderly at increased risk of adverse outcomes, including disability, falls, hospitalization, need for long-term care, and mortality. The Mini Nutritional Assessment (MNA) was designed and validated in a series of studies to assess nutritional status of elderly, as integral part of the comprehensive geriatric assessment, with a 2-steps screening process; when the MNA-SF classify a person at risk, the full MNA should be completed. The MNA and MNA-SF are sensitive, specific, and accurate in identifying nutrition risk. Increased risk of malnutrition, a common condition in the elderly, is closely associated with many potential contributors of frailty. The maintenance of optimal physical and cognitive performances depends on the early screening of critical conditions to develop preventive targeted interventions; the MNA supports such preventive action.

scholarly journals Assessment of the nutritional risk of > 53-year-old men and women in Taiwan

2004 ◽  
Vol 7 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Alan C Tsai ◽  
Jack MC Chang ◽  
Harvey Lin ◽  
Yi-Li Chuang ◽  
Shu-Hui Lin ◽  
...  
Keyword(s):  
At Risk ◽  
Elderly Population ◽  
Nutritional Assessment ◽  
Dietary Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Nutritional Risk ◽  
Men And Women ◽  
Increased Risk ◽  
Old Men

AbstractObjective:The study was conducted to gain an understanding of the status of potential nutrition risks in > 53-year-old men and women in Taiwan.Methods:The study employed a validated nutrition-risk screening questionnaire, the Mini Nutritional Assessment, to assess the potential risk of undernutrition in the elderly population in Taiwan. The questionnaire was translated into the local language, Chinese, and was modified slightly based on cultural considerations. It was administered to 4440 randomly selected subjects by means of face-to-face interviews. The questionnaire included questions on subjective self-evaluations, global parameters, simple dietary assessment and some anthropometric measurements.Results:Results show that the questionnaire can be used effectively as a tool to screen for individuals who are at risk of undernutrition. It showed that the proportion of the elderly population at risk of nutritional inadequacy is relatively low, but does increase with advanced ageing. The proportion of the elderly considered at high risk of undernutrition was found to increase with age, ranging from 0.88% for 53–60-year-old subjects to 1.86% for subjects aged 60–70 years, 3.6% for 70–80-year-olds and 5.3% for >80-year-old subjects.Conclusion:The study showed that a simple questionnaire adopted from the Mini Nutritional Assessment can be employed to provide a preliminary screening and to identify individuals who are potentially at increased risk of nutritional inadequacy in the elderly population in Taiwan.

scholarly journals Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2957 ◽  
Author(s):  
Justin Chew ◽  
Audrey Yeo ◽  
Suzanne Yew ◽  
Cai Ning Tan ◽  
Jun Pei Lim ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pathway Analysis ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Mini Nutritional Assessment ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Effect Estimate ◽  
Increased Risk ◽  
The Relationship

Osteosarcopenia is associated with increased risk of adverse outcomes such as falls and fractures. Its association with frailty is less well-described, particularly in independent community-dwelling older adults. Although nutrition plays a crucial role in maintaining bone and muscle health, the complex relationship between osteosarcopenia and nutrition in the pathogenesis of frailty remains to be elucidated. In this cross-sectional analysis of 230 independent, community-dwelling individuals (mean age 67.2 ± 7.4 years), we examined the associations between osteosarcopenia with nutritional status and frailty, and the mediating role of nutrition in the association between osteosarcopenia and frailty. Osteosarcopenia was defined as fulfilling both the Asian Working Group for Sarcopenia 2019 consensus definition (low relative appendicular skeletal muscle mass adjusted for height, in the presence of either of either low handgrip strength or slow gait speed) and T-score ≤ −2.5 SD on bone mineral densitometry. We assessed frailty using the modified Fried criteria and nutrition using the Mini-Nutritional Assessment. We performed multiple linear regression, followed by pathway analysis to ascertain whether nutrition mediates the relationship between osteosarcopenia and frailty. Our study population comprised: 27 (11.7%) osteosarcopenic, 35 (15.2%) sarcopenic, 36 (15.7%) osteoporotic and 132 (57.4%) normal (neither osteosarcopenic, sarcopenic nor osteoporotic). Osteosarcopenia (β = 1.1, 95% CI 0.86–1.4) and sarcopenia (β = 1.1, 95% CI 0.90–1.4) were significantly associated with frailty, but not osteoporosis. Nutrition mediated the association between osteosarcopenia and frailty (indirect effect estimate 0.09, bootstrap 95% CI 0.01–0.22). In conclusion, osteosarcopenia is associated with frailty and poorer nutritional status, with nutrition mediating the association between osteosarcopenia and frailty. Our findings support early nutritional assessment and intervention in osteosarcopenia to mitigate the risk of frailty.

scholarly journals Population-specific Mini Nutritional Assessment effectively predicts the nutritional state and follow-up mortality of institutionalized elderly Taiwanese regardless of cognitive status

2008 ◽  
Vol 100 (1) ◽  
pp. 152-158 ◽  
Author(s):  
Alan C. Tsai ◽  
Pei-Yu Ku
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cognitive Status ◽  
Severe Malnutrition ◽  
Term Care ◽  
Institutionalized Elderly

The study was conducted to determine the effectiveness of a modified Mini Nutritional Assessment (MNA) for assessing the nutritional status and predicting follow-up mortality of institutionalized elderly Taiwanese. The study was conducted in a large long-term care centre in central Taiwan. Trained interviewers assisted by the caregivers elicited sociodemographic data, healthcare and disease history, and answers to the MNA screen from each subject. One researcher performed all subjects' anthropometric measurements. Plasma albumin and cholesterol concentrations were determined. Results showed that the MNA without BMI, modified according to population-specific mid-arm circumference and calf circumference cut-points, effectively predicted the nutritional risk status of the elderly regardless of cognitive status. Substituting caregiver's assessments for self-viewed nutrition and health status (questions O and P of MNA) improved the predicting power of the tool in cognition-normal subjects. Results showed that 21·9 % of the elderly were malnourished, 59·2 % were at risk of malnutrition and 18·9 % were normal according to self-assessment whereas 14·2 % were malnourished, 59·2 % were at risk of malnutrition, and 26·6 % were normal according to caregiver's evaluation. The tool was also effective in predicting 12- and 6-month follow-up mortality in cognition-normal and cognition-impaired elderly, respectively. Results indicate that a population-specific MNA can effectively predict the nutritional status and 6-month follow-up mortality of elderly Taiwanese regardless of cognitive condition. Easier and wider application of the tool will enable early detection of emerging nutritional problems and timely intervention to prevent the development of severe malnutrition in the elderly.

scholarly journals Nutrition and Psychosocial Factors were Associated with Possible Sarcopenia According to AWGS 2019

2020 ◽  
Author(s):  
Bokyoung Kim ◽  
Gyeong-Ye Lee ◽  
Young-Mi Seo ◽  
Ae-Rim Seo ◽  
Mi-Ji Kim ◽  
...  
Keyword(s):  
Psychosocial Factors ◽  
Social Participation ◽  
Self Efficacy ◽  
Fear Of Falling ◽  
Nutritional Assessment ◽  
Handgrip Strength ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Increased Risk ◽  
The Relationship

Abstract Background This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community.Methods The study included 1,019 subjects aged 60 and over. “Possible sarcopenia (PS)” was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutritional assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and PS.Results MNA was significantly associated with social participation (exp(B) = 1.747, p < 0.001), fear of falling (exp(B) = 2.905, p < 0.001), and self-efficacy (high/low, exp(B) = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, PS was significantly associated with MNA (exp(B) = 2.529, p < 0.001) and fear of falling (exp(B) = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (exp(B) = 0.589, p = 0.009) was significant.Conclusion The factors related to PS include risk of malnutrition, fear of falls, and self-efficacy, and social participation was associated with increased risk of malnutrition. In addition to the health program, it will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises. Finally, it is also necessary to increase regular participation in community social activities.

scholarly journals Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
A Ünsal ◽  
D Arslantaş
Keyword(s):  
Health Care Providers ◽  
Nutritional Assessment ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cluster Sampling ◽  
Care Providers ◽  
Cross Sectional

Abstract Background Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression. Methods The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes. Results The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001). Conclusions Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers. Key messages Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.

Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

2021 ◽  
Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu
Keyword(s):  
Wound Healing ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Reference Points ◽  
Nutrition Intervention ◽  
Burn Patients ◽  
Cross Sectional

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

scholarly journals Malnutrition in older adults: screening and determinants

2018 ◽  
Vol 78 (3) ◽  
pp. 372-379 ◽  
Author(s):  
Clare A. Corish ◽  
Laura A. Bardon
Keyword(s):  
Older Adults ◽  
Residential Care ◽  
Nutritional Assessment ◽  
Short Form ◽  
Meta Analysis ◽  
Protein Energy Malnutrition ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Screening Tools ◽  
Climbing Stairs

Older adults are at risk of protein-energy malnutrition (PEM). PEM detrimentally impacts on health, cognitive and physical functioning and quality of life. Given these negative health outcomes in the context of an ageing global population, the Healthy Diet for a Healthy Life Joint Programming Initiative Malnutrition in the Elderly (MaNuEL) sought to create a knowledge hub on malnutrition in older adults. This review summarises the findings related to the screening and determinants of malnutrition. Based on a scoring system that incorporated validity, parameters used and practicability, recommendations on setting-specific screening tools for use with older adults were made. These are: DETERMINE your health checklist for the community, Nutritional Form for the Elderly for rehabilitation, Short Nutritional Assessment Questionnaire-Residential Care for residential care and Malnutrition Screening Tool or Mini Nutritional Assessment-Short Form for hospitals. A meta-analysis was conducted on six longitudinal studies from MaNuEL partner countries to identify the determinants of malnutrition. Increasing age, unmarried/separated/divorced status (vs.married but not widowed), difficulties walking 100 m or climbing stairs and hospitalisation in the year prior to baseline or during follow-up predicted malnutrition. The sex-specific predictors of malnutrition were explored within The Irish Longitudinal Study of Ageing dataset. For females, cognitive impairment or receiving social support predicted malnutrition. The predictors for males were falling in the previous 2 years, hospitalisation in the past year and self-reported difficulties in climbing stairs. Incorporation of these findings into public health policy and clinical practice would support the early identification and management of malnutrition.

scholarly journals Undernutrition and associated factors in a Portuguese older adult community

2015 ◽  
Vol 28 (3) ◽  
pp. 231-240 ◽  
Author(s):  
Ana Luísa Moreira dos Santos ◽  
Teresa Maria de Serpa Pinto Freitas do Amaral ◽  
Nuno Pedro Garcia Fernandes Bento Borges
Keyword(s):  
Older Adults ◽  
Associated Factors ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Self Perception ◽  
Cross Sectional ◽  
Major Factors ◽  
Perception Of Health

OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6); being institutionalized (OR=12.6; 95%CI=1.7-90.5); or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1) were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.

scholarly journals Case–control study to estimate odds of death within 28 days of positive test for SARS-CoV-2 prior to vaccination for residents of long-term care facilities in England, 2020–2021

2021 ◽  
pp. jech-2021-218135
Author(s):  
Karthik Paranthaman ◽  
Hester Allen ◽  
Dimple Chudasama ◽  
Neville Q Verlander ◽  
James Sedgwick
Keyword(s):  
Long Term Care ◽  
Multivariable Analysis ◽  
Adverse Outcomes ◽  
Positive Test ◽  
Mortality Data ◽  
Multivariable Logistic Regression Analysis ◽  
Term Care ◽  
Increased Risk ◽  
Care Facilities

BackgroundPersons living in long-term care facilities (LTCFs) are presumed to be at higher risk of adverse outcomes from SARS-CoV-2 infection due to increasing age and frailty, but the magnitude of increased risk is not well quantified.MethodsAfter linking demographic and mortality data for cases with confirmed SARS-CoV-2 infection between March 2020 and January 2021 in England, a random sample of 6000 persons who died and 36 000 who did not die within 28 days of a positive test was obtained from the dataset of 3 020 800 patients. Based on an address-matching process, the residence type of each case was categorised into one of private home and residential or nursing LTCF. Univariable and multivariable logistic regression analysis was conducted.ResultsMultivariable analysis showed that an interaction effect between age and residence type determined the outcome. Compared with a 60-year-old person not living in LTCF, the adjusted OR (aOR) for same-aged persons living in residential and nursing LTCFs was 1.77 (95% CI 1.21 to 2.6, p=0.0017) and 3.95 (95% CI 2.77 to 5.64, p<0.0001), respectively. At 90 years of age, aORs were 0.87 (95% CI 0.72 to 1.06, p=0.21) and 0.74 (95% CI 0.61 to 0.9, p=0.001), respectively. The model had an overall accuracy of 94.2% (94.2%) when applied to the full dataset of 2 978 800 patients.ConclusionThis study found that residents of LTCFs in England had higher odds of death up to 80 years of age. Beyond 80 years, there was no difference in the odds of death for LTCF residents compared with those in the wider community.

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