Clinical Interventions in Aging (Apr 2019)
Mini Nutritional Assessment Scale-Short Form can be useful for frailty screening in older adults
Abstract
Pinar Soysal,1 Nicola Veronese,2,3 Ferhat Arik,4 Ugur Kalan,4 Lee Smith,5 Ahmet Turan Isik6 1Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey; 2National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; 3Department of Geriatric Care, Ortho Geriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genova, Italy; 4Department of Internal Medicine, Geriatric Center, Kayseri Education and Research Hospital, Kayseri, Turkey; 5The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK; 6Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Aim: Mini Nutritional Assessment-Short Form (MNA-SF) is used to assess nutritional status in older adults, but it is not known whether it can be used to define frailty. This study was aimed to investigate whether or not MNA-SF can identify frailty status as defined by Fried’s criteria. Methods: A total of 1,003 outpatients (aged 65 years or older) were included in the study. All patients underwent comprehensive geriatric assessment. Frailty status was evaluated by Fried’s criteria: unintentional weight loss, exhaustion, low levels of activity, weakness, and slowness. One point is assigned for each criterion, and frailty status is identified based on the number of points scored: 0 points, not frail; 1–2 points, pre-frail; ≥3 points, frail. A total score of MNA-SF <8, 8–11, and >11 indicates malnutrition, risk of malnutrition, and no malnutrition, respectively. Results: Of the 1,003 outpatients (mean age 74.2±8.5 years), 313 participants (31.2%) were considered frail and 382 (38.1%) pre-frail. Among frail and pre-frail patients, 49.2% and 25.1% were at risk of malnutrition and 22.0% and 1.6% were malnourished, respectively. MNA-SF with a cut-off point of 11.0 had a sensitivity of 71.2% and a specificity of 92.8% for the detection of frail participants, and with a cut-off point of 13 had a sensitivity of 45.7% and a specificity of 78.3% for the detection of pre-frailty. The area under the curve for MNA-SF was estimated to be 0.906 and 0.687 for frailty and pre-frailty, respectively. Conclusion: MNA-SF can be useful for frailty screening in older adults. Keywords: malnutrition, frailty, nutritional status, pre-frailty
