MNA-SF 的扩展版本提高了社区居住的老年人营养不良的识别敏感性。来自 PRONUTRISENIOR 项目的结果。

An extended version of the MNA-SF increases sensitivity in identifying malnutrition among community living older adults. Results from the PRONUTRISENIOR project.

机构信息

Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto (FCNAUP), Rua do Campo Alegre, N.° 823, 4150-180, Porto, Portugal.

Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto (FCNAUP), Rua do Campo Alegre, N.° 823, 4150-180, Porto, Portugal; Laboratório de Inteligência Artificial e Apoio à Decisão, Instituto de Engenharia de Sistemas e Computadores - Tecnologia e Ciência, Rua Dr. Roberto Frias, N.° 378, 4200-465, Porto, Portugal.

出版信息

Clin Nutr ESPEN. 2021 Dec;46:167-172. doi: 10.1016/j.clnesp.2021.10.018. Epub 2021 Nov 1.

DOI:10.1016/j.clnesp.2021.10.018

PMID:34857191

Abstract

BACKGROUND & AIMS: The Mini Nutritional Assessment (MNA) is the most used tool to assess malnutrition and/or its risk among older adults. Its Screening section was proposed as a short form (MNA-SF) but studies comparing the two forms present controversial results. Our main aims were to study the agreement between MNA-SF and its full form (MNA-FF) among Portuguese older adults living in the community and to develop a more sensible version of the MNA-SF.

MATERIAL AND METHODS

This cross-sectional study used a convenience sample of 456 older adults (54.2% females) aged 65-92 years (mean = 73; SD = 6). Data analyzed included: nutritional status (MNA), social support (Fillenbaum's Social Network Index), level of independency in daily activities (Lawton e Brody's scale) and eating-related quality of life. Both MNA-FF and MNA-SF classify participants as malnourished, at risk of malnutrition or with normal nutrition status. Anthropometric assessments (weight, height, arm and calf perimeters) were carried out and BMI was computed.

RESULTS

The agreement between the two classifications is 82.7%, but Cohen's k shows a weak agreement (weighted Cohen's k = 0.497; p < 0,001), and the sensitivity of the MNA-SF to detect malnutrition or its risk (as assessed by the MNA-FF) was 42.6% (despite a specificity of 98.8%). Participants classified as normal using the MNA-SF despite at risk using the MNA-FF present lower scores in two items from the Assessment section (number of full meals eaten daily and amount of fluid consumed per day). These were included in MNA-SF to obtain an extended short-version (MNA-SF8). The difference between the ROC curves for MNA-SF and MNA-SF8 justifies the preferential use of the MNA-SF8 with an estimated cut-off of 14 points, which showed high sensitivity (91.8%) and specificity (79.9%).

CONCLUSIONS

The addition of two items to the MNA-SF provides a more sensible tool to detect the risk of malnutrition among older adults. General eating-related questions seem relevant to assess malnutrition in this age group.

摘要

背景与目的

Mini Nutritional Assessment（MNA）是评估老年人营养状况和/或风险最常用的工具。它的筛查部分被提出作为一个简短的形式（MNA-SF），但比较两种形式的研究结果存在争议。我们的主要目的是研究葡萄牙社区居住的老年人中 MNA-SF 与其完整形式（MNA-FF）之间的一致性，并开发一个更敏感的 MNA-SF 版本。

材料和方法

这项横断面研究使用了一个方便样本的 456 名老年人（54.2%女性），年龄在 65-92 岁之间（平均 73 岁；标准差 6 岁）。分析的数据包括：营养状况（MNA）、社会支持（Fillenbaum 的社会网络指数）、日常生活活动的独立性水平（Lawton 和 Brody 的量表）和与饮食相关的生活质量。MNA-FF 和 MNA-SF 都将参与者分为营养不良、有营养不良风险或营养状况正常。进行了人体测量评估（体重、身高、手臂和小腿周长），并计算了 BMI。

结果

两种分类之间的一致性为 82.7%，但 Cohen's k 显示出弱一致性（加权 Cohen's k=0.497；p<0.001），MNA-SF 检测营养不良或其风险（由 MNA-FF 评估）的敏感性为 42.6%（尽管特异性为 98.8%）。尽管使用 MNA-FF 评估为有风险，但使用 MNA-SF 评估为正常的参与者在评估部分的两个项目中得分较低（每天吃完整餐的次数和每天摄入的液体量）。这些项目被纳入 MNA-SF 以获得扩展的简短版本（MNA-SF8）。MNA-SF 和 MNA-SF8 的 ROC 曲线之间的差异证明了更倾向于使用 MNA-SF8，其估计截断值为 14 分，具有较高的敏感性（91.8%）和特异性（79.9%）。