Doroudi Taher, Alizadeh-Khoei Mahtab, Kazemi Hadi, Hormozi Sakar, Taati Fahimeh, Ebrahimi Mehdi, Koulivand Pirhossein, Fakhrzadeh Hossein, Davoudi Iran, Sharifi Farshad
Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran.
Department of Gerontology and Geriatric, Medical School, Tehran University of Medical Sciences, Tehran, Iran.
Int J Prev Med. 2019 Oct 9;10:168. doi: 10.4103/ijpvm.IJPVM_132_18. eCollection 2019.
The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly.
In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered.
The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake).
It seems the Persian version of full-MNA is more appropriate in comparison to MNA-SF for screening malnutrition in the Iranian hospitalized elderly patients.
目的是确定完整版微型营养评定法（MNA）和简版MNA（MNA-SF）的有效性、可靠性和临界值，以及哪一种更适合筛查伊朗住院老年人的营养不良情况。
在这项横断面验证研究中，从德黑兰的两家医院选取了96名年龄≥60岁的住院老年人。进行了人体测量（体重指数[BMI]、上臂中部周长[MAC]、小腿周长[CC]、腹部和腰围皮肤褶厚度）和实验室检查（白蛋白和血红蛋白水平以及红细胞计数）。使用了营养工具（完整版MNA和MNA-SF）、认知工具（简易精神状态检查）、抑郁量表（老年抑郁量表15项）和日常生活活动（ADL）指数（改良巴氏ADL）。
完整版MNA评分与MAC、BMI、腰围和CC测量值显著相关。MNS-SF评分与MAC、腰围和CC测量值显著相关。血清白蛋白与两种工具的相关性均较差。完整版MNA在临界值24时的敏感性为75%，特异性为77.8%，MNA-SF在临界值10.50时检测营养良好与营养不良受试者的敏感性为62.5%，特异性为65.3%。两种工具的内部一致性均>90%。在探索性因子分析中，完整版MNA发现了六个成分，MNA-SF发现了两个成分。完整版MNA的已知组效度体现在预期完整版MNA评分较高的老年患者与预期评分较低的患者（BMI≥24与BMI<24或有压疮或需协助进食）之间存在显著差异。
对于筛查伊朗住院老年患者的营养不良情况，与MNA-SF相比，波斯语版的完整版MNA似乎更合适。
