Guigoz Yves, Lauque Sylvie, Vellas Bruno J
Nestlé Product and Technology Centre, Nestlé-Strasse 3, CH-3510 Konolfingen, Switzerland.
Clin Geriatr Med. 2002 Nov;18(4):737-57. doi: 10.1016/s0749-0690(02)00059-9.
In more than 10,000 elderly persons, the mean prevalence of malnutrition is 1% in community-healthy elderly persons, 4% in outpatients receiving home care, 5% in patients with Alzheimer's disease living at home, 20% in hospitalized patients, and 37% in institutionalized elderly persons. In community-dwelling elderly persons, the MNA detects risk of malnutrition and life-style characteristics associated with nutritional risk while albumin levels and the BMI are still in the normal range. In outpatients and in hospitalized patients, the MNA is predictive of outcome and cost of care. In home care patients and nursing home residents, the MNA is related to living conditions, meal patterns, and chronic medical conditions and allows targeted intervention. The MNA has been used successfully in follow-up evaluation of outcome, nutritional intervention, nutritional education programs, and physical intervention programs in elderly persons. The MNA-SF allows quick screening to determine a person's risk of malnutrition. Early detection of malnutrition is important to allow targeted nutritional intervention and should be a key component of the geriatric assessment. The MNA test is a simple, noninvasive, well-validated screening tool for malnutrition in elderly persons and is recommended for early detection of risk of malnutrition. The MNA, as a two-step procedure (screening with the MNA-SF followed by assessment, if needed, by the full MNA), is reliable and can be easily administered by general practitioners and by health professionals at hospital or nursing home admission for early detection of risks of malnutrition. The MNA has the following characteristics: * The MNA is a two step procedure: (1) the MNA-SF to screen for malnutrition and risk of mainutrition; (2) assessment of nutritional status with the full MNA. * The MNA is an 18-item questionnaire comprising anthropometric measurements (BMI, mid-arm and calf circumference, and weight loss) combined with a questionnaire regarding dietary intake (number of meals consumed, food and fluid intake, and feeding autonomy), a global assessment (lifestyle, medication, mobility, presence of acute stress, and presence of dementia or depression), and a self-assessment (self-perception of health and nutrition). The MNA-SF comprises 6 items from the 18. * The MNA is well validated. It correlates highly with clinical assessment and objective indicators of nutritional status (albumin level, BMI, energy intake, and vitamin status). * A low MNA score can predict hospital-say outcomes in older patients and can be used to follow up changes in nutritional status. * Because of its validity in screening and assessing the risk of malnutrition, the MNA should be integrated in the comprehensive geriatric assessment. * In more than 10,000 elderly persons, the prevalence of undernutrition assessed by the MNA is 1% to 5% in community-dwelling elderly persons and outpatients, 20% in hospitalized older patients, and 37% in institutionalized elderly patients.
在一万多名老年人中，社区健康老年人的营养不良平均患病率为1%，接受居家护理的门诊患者为4%，居家的阿尔茨海默病患者为5%，住院患者为20%，机构养老的老年人为37%。在社区居住的老年人中，当白蛋白水平和体重指数仍在正常范围时，微型营养评定法（MNA）能检测出营养不良风险以及与营养风险相关的生活方式特征。在门诊患者和住院患者中，MNA可预测护理结局和费用。在居家护理患者和养老院居民中，MNA与生活条件、饮食模式和慢性疾病状况相关，并可进行有针对性的干预。MNA已成功用于老年人结局的随访评估、营养干预、营养教育项目和身体干预项目。MNA - SF可快速筛查以确定一个人的营养不良风险。早期发现营养不良对于进行有针对性的营养干预很重要，应成为老年评估的关键组成部分。MNA测试是一种简单、无创、经过充分验证的老年人营养不良筛查工具，推荐用于早期发现营养不良风险。MNA作为一个两步程序（先用MNA - SF进行筛查，如有需要再用完整的MNA进行评估），可靠且全科医生以及医院或养老院入院时的健康专业人员都可轻松实施，以早期发现营养不良风险。MNA具有以下特点：* MNA是一个两步程序：（1）用MNA - SF筛查营养不良和营养不足风险；（2）用完整的MNA评估营养状况。* MNA是一份包含18个条目的问卷，包括人体测量指标（体重指数、上臂和小腿围以及体重减轻情况），并结合一份关于饮食摄入的问卷（用餐次数、食物和液体摄入量以及进食自主性）、一项综合评估（生活方式、用药情况、活动能力、是否存在急性应激以及是否患有痴呆或抑郁症）以及一项自我评估（对健康和营养的自我认知）。MNA - SF包含其中的6个条目。* MNA经过了充分验证。它与临床评估以及营养状况的客观指标（白蛋白水平、体重指数、能量摄入和维生素状况）高度相关。* MNA得分低可预测老年患者的住院结局，并可用于跟踪营养状况的变化。* 由于其在筛查和评估营养不良风险方面的有效性，MNA应纳入综合老年评估。* 在一万多名老年人中，通过MNA评估的营养不良患病率在社区居住的老年人和门诊患者中为1%至5%，在住院老年患者中为20%，在机构养老的老年患者中为37%。
