Nutritional and functional status in geriatric day hospital patients–MNA short form versus full MNA

• Published in: The Journal of nutrition, health & aging Vol. 20; no. 9; pp. 918 - 926
• Main Authors: Schrader, E., Grosch, E., Bertsch, T., Sieber, C. C., Volkert, Dorothee
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.11.2016; Springer Nature B.V
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Aging; Agreements; Cross-Sectional Studies; Female; Frailty; Geriatric Assessment; Geriatrics; Geriatrics/Gerontology; Hospitalization; Hospitals; Humans; Male; Malnutrition; Malnutrition - epidemiology; Medicine; Medicine & Public Health; Neurosciences; Nursing care; Nursing homes; Nutrition; Nutrition Assessment; Nutritional Status; Older people; Patients; Prevalence; Primary Care Medicine; Quality of Life Research; Rehabilitation; Risk; Germany; geriatric day hospital patients; functional status; mini nutritional assessment; Nutritional status
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-016-0691-4

Objectives The aims of this study were to determine the prevalence of malnutrition in patients of a geriatric day hospital using the Mini Nutritional Assessment short form (MNA-SF) and the full MNA, to compare both tools, and to examine the relationship between nutritional and functional status. Design Cross-sectional study. Setting Geriatric day hospital. Participants 190 patients (72.1% female, median 80 years) aged 65 years or older. Measurements In consecutively admitted geriatric day hospital patients nutritional status was assessed by MNA-SF and full MNA, and agreement between both tools calculated by Cohen’s kappa. Basic activities of daily living (ADL), instrumental activities of daily living (IADL) and short physical performance battery (SPPB) were determined and related to MNA categories (Chi 2 -test, Mann-Whitney-U-test). Results 36.3 % and 44.7% of the patients were at risk of malnutrition, 8.9 % and 5.8 % were malnourished according to MNA-SF and full MNA, respectively. Agreement between both MNA forms was moderate (?=0.531). No significant associations between MNA-SF and ADL, IADL and SPPB, and between full MNA and SPPB were observed. According to full MNA, the proportion of patients with limitations in ADL and IADL significantly increased with declining nutritional status (ADL: 2.1 vs. 8.2 vs. 18.2 %, p=0.044; IADL: 25.5 vs. 47.1 vs. 54.5 %, p=0.005) with a simultaneous decrease of the proportion of patients without limitations. Well-nourished patients reached significantly higher ADL scores than patients at risk of malnutrition (95 (-100) vs. 95 (85- 100), p=0.005) and significantly higher IADL scores than patients at risk or malnourished (8 ( 6 - 8 ) vs. 7 ( 5 - 8 ) vs. 6 ( 4 - 8 ), p=0.004). Conclusion The high prevalence of risk of malnutrition and the observed association between functional status and nutritional status according to full MNA call for routine nutritional screening using this tool in geriatric day hospital patients.