Department of Public Health and Primary Care, Academic Centre of General Practice, KU of Leuven, Kapucijnenvoer 7 box 7001, Leuven, 3000, Belgium.
BMC Prim Care. 2023 Mar 6;24(1):64. doi: 10.1186/s12875-023-02020-w.
Experience and research show that screening for malnutrition in primary care mainly takes place by monitoring the weight parameter and that validated screening instruments are hardly used. In this study we examined the effectiveness and predictive value of weight evolution in screening for (risk of) malnutrition in older people living at home, in comparison with a validated screening tool, namely the Mini Nutritional Assessment Short Form (MNA-SF).
This project was a prospective, longitudinal study with quantitative data that took place in the province of Antwerp (Belgium) from December 2020 until June 2021. The target group of this study consisted of people over 70 living at home who were visited by a home nurse on a regular basis (at least once a month). The outcome measure was the weight evolution over six months compared with the score on the MNA-SF at month six. Weight was measured and recorded once a month during 6 months. At the last weight measurement, the MNA-SF was administered. In order to assess their own nutritional state, three additional questions were asked after taking the MNA-SF.
A total of 143 patients gave consent to participate, of which 89 were women and 54 men. The mean age was 83.7 years (SD6.62) with a range of 70 to 100 years. Based on the MNA-SF score measured after six months, 53.1% (76/143) of participants had a normal nutritional status, 37.8% (54/143) scored risk of malnutrition and 4.9% (7/ 143) was malnourished. In order to detect people with (risk of) malnutrition, a PPV of 78.6%, a NPV of 60.7%, a sensitivity of 19.3% and a specificity of 96.0% were established with a weight evolution of ≥ 5% weight loss at six months. To detect malnutrition, our results showed respectively 33.3%, 98.4%, 71.4% and 92.3%.
In this study, weight evolution has a low sensitivity in screening for (risk of) malnutrition in people over 70 living at home compared to the MNA-SF. However, in order to detect people with malnutrition, this study demonstrated a sensitivity of 71.4% and a specificity of 92.3% for a weight loss of ≥ 5% at six months.
经验和研究表明，初级保健中的营养不良筛查主要通过监测体重参数进行，很少使用经过验证的筛查工具。在这项研究中，我们比较了体重变化与经过验证的 Mini Nutritional Assessment Short Form（MNA-SF）筛查工具在筛查居家老年人（有/无）营养不良风险方面的有效性和预测价值。
这是一项前瞻性、纵向研究，采用定量数据，于 2020 年 12 月至 2021 年 6 月在比利时安特卫普省进行。该研究的目标人群为定期由家庭护士上门探访（至少每月一次）的 70 岁以上居家老人。本研究的结局指标是 6 个月时的体重变化与第 6 个月时的 MNA-SF 评分进行比较。在 6 个月期间，每月测量并记录一次体重。在最后一次测量体重时，进行 MNA-SF 评估。为了评估他们的营养状况，在 MNA-SF 评估后还会询问三个附加问题。
共有 143 名患者同意参与，其中 89 名女性，54 名男性。平均年龄为 83.7 岁（标准差 6.62），年龄范围为 70-100 岁。根据 6 个月时的 MNA-SF 评分，53.1%（76/143）的参与者营养状况正常，37.8%（54/143）评分存在营养不良风险，4.9%（7/143）存在营养不良。为了检测有（无）营养不良风险的人群，6 个月时体重减轻≥5%的患者的阳性预测值为 78.6%，阴性预测值为 60.7%，灵敏度为 19.3%，特异性为 96.0%。如果检测营养不良，本研究的结果分别为 33.3%、98.4%、71.4%和 92.3%。
与 MNA-SF 相比，6 个月时体重减轻≥5%的患者在筛查 70 岁以上居家老人（有/无）营养不良方面的灵敏度较低。然而，为了检测营养不良患者，本研究表明 6 个月时体重减轻≥5%的患者灵敏度为 71.4%，特异性为 92.3%。
