Vellas B, Villars H, Abellan G, Soto M E, Rolland Y, Guigoz Y, Morley J E, Chumlea W, Salva A, Rubenstein L Z, Garry P
Inserm U 558, Department of Geriatrics, Toulouse university Hospital, Toulouse, France.
J Nutr Health Aging. 2006 Nov-Dec;10(6):456-63; discussion 463-5.
The Mini Nutritional Assessment (MNA) is a simple tool, useful in clinical practice to measure nutritional status in elderly persons. From its validation in 1994, the MNA has been used in hundreds of studies and translated into more then 20 languages. It is a well-validated tool, with high sensitivity, specificity, and reliability. An MNA score > or = 24 identifies patients with a good nutritional status. Scores between 17 and 23.5 identify patients at risk for malnutrition. These patients have not yet started to lose weight and do not show low plasma albumin levels but have lower protein-calorie intakes than recommended. For them, a multidisciplinary geriatric intervention is needed, which takes into account all aspects that might interfere with proper alimentation and, when necessary, proposes therapeutic interventions for diet or supplementation. If the MNA score is less than 17, the patient has protein-calorie malnutrition. It is important at this stage to quantify the severity of the malnutrition (by measuring biochemical parameters like plasma albumin or prealbumin levels, establishing a 3- day record of food intake, and measuring anthropometric features like weight, BMI, arm circumference and skin folds). Nutritional intervention is clearly needed and should be based on achievable objectives established after a detailed comprehensive geriatric assessment. The MNA has been shown to be useful for nutritional intervention follow-up as well. The MNA can help clinicians design an intervention by noting where the patient loses points when performing the MNA. Moreover, when a nutritional intervention is successful, the MNA score increases. The MNA is recommended by many national and international clinical and scientific organizations. It can be used by a variety of professionals, including physicians, dietitians, nurses or research assistants. A short screening version (MNA-SF) has been developed, which, if positive, indicates the need to complete the full MNA. It takes less than 4 minutes to administer the MNA-SF and between 10 and 15 minutes for the full MNA.
微型营养评定法（MNA）是一种简单的工具，在临床实践中可用于评估老年人的营养状况。自1994年验证以来，MNA已被用于数百项研究，并被翻译成20多种语言。它是一种经过充分验证的工具，具有高敏感性、特异性和可靠性。MNA评分≥24表明患者营养状况良好。评分在17至23.5之间表明患者有营养不良风险。这些患者尚未开始体重减轻，血浆白蛋白水平也未降低，但蛋白质-热量摄入量低于推荐值。对于他们，需要进行多学科老年干预，该干预要考虑到所有可能干扰正常营养摄入的因素，并在必要时提出饮食或补充剂的治疗干预措施。如果MNA评分低于17，患者存在蛋白质-热量营养不良。在此阶段，量化营养不良的严重程度很重要（通过测量血浆白蛋白或前白蛋白水平等生化参数、建立3天的食物摄入量记录以及测量体重、体重指数、上臂围和皮褶厚度等人体测量特征）。显然需要进行营养干预，且应基于详细全面的老年评估后确定的可实现目标。MNA也已被证明对营养干预随访有用。MNA可帮助临床医生通过记录患者在进行MNA时失分的地方来设计干预措施。此外，当营养干预成功时，MNA评分会增加。许多国家和国际临床及科学组织都推荐使用MNA。它可供包括医生、营养师、护士或研究助理在内的各种专业人员使用。已开发出一个简短的筛查版本（MNA-SF），如果结果为阳性，则表明需要完成完整的MNA。进行MNA-SF的时间不到4分钟，而进行完整的MNA则需要10至15分钟。
